How Medical Malpractice Lawsuits Might Arise If Stage 4 Prostate Cancer Is Because Of Delay From Watchful Waiting Recommendation

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Physicians typically employ two tests to test men for prostate cancer

. The thought is to diagnose the cancer in the beginning stages while treatment can be used to eliminate the cancer rather than wait until the cancer advances and spreads at which point there is at this time no known cure. The first test is the digital examination. During this examination the doctor uses a gloved finger to physically examine the prostate gland for any signs of enlargement, hardening, or the presence of growths, any of which could be a sign of cancer. The second test is the PSA blood test which measures the level of prostate specific antigen in the man's system. A PSA greater than 4. ng/ml is usually regarded as abnormal. Since prostate cancer raises the PSA level when prostate cancer advances physicians normally recommend a biopsy when the PSA test registers high.

Raised PSA test results may, however, be attributable to variables other than cancer, like inflammation of the prostate or infection. Such elevated PSA readings are classified as "false positives." A biopsy has known potential complications, like the danger of infection and the danger of significant bleeding. Stating the possibility of false positive PSA results and the dangers related to biopsies, some doctors take a "watchful waiting" stance, whereby a male patient's elevated PSA is monitored over the course of several months or years. They might additionally recommend going on medication for infection to see if the treatment reduces the PSA.

The threat with this method is that the doctor might wait too long without doing any additional tests to evaluate whether the high PSA level is because of prostate cancer. If waiting leads to the metastasis of the cancer to areas outside the prostate capsule then the man will no longer have treatment options that can eliminate and cure the cancer. Men with prostate cancer who have a PSA level below 10 ng/mL have a seventy to eighty percent chance of having organ-confined disease, compared to fifty percent for men with PSA levels 10 to 50 ng/mL, and only twenty five percent with higher PSA levels

Treatment options for advanced prostate cancer may include hormone therapy, radiation therapy, orchiectomy , and maybe even chemotherapy. Treatment will normally lead to a major decrease in the PSA levels for awhile. In time, treatment may cease to be effective and the cancer will again continue to progress. When treatment ceases to be effective, prostate cancer is fatal. This year, approximately 90,000 men will die in the U.S. due to metastatic prostate cancer.
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This is why physicians generally recommend that a biopsy ought to be performed if a male patient's blood test indicates a PSA level above 4. ng/ml. Because the biopsy only takes samples, it is possible that the biopsy might yield a false negative, thereby no finding the cancer. This is why doctors in addition ordinarily propose that biopsies be redone if the PSA levels stay elevated, even after treatment for other possible causes.

By taking a "watchful waiting" strategy and only monitoring a male patient's high PSA, a physician places the patient at risk of not doing anything about the cancer until it gets to an advanced, possibly untreatable, stage. This may constitute a departure from the accepted standard of medical care and may lead to a malpractice claim.

How Medical Malpractice Lawsuits Might Arise If Stage 4 Prostate Cancer Is Because Of Delay From Watchful Waiting Recommendation

By: J. Hernandez

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