Cancer Misdiagnosis Common
Sources: Best Doctors and the National Coalition on Health Care Joint Study; American Journal of Medicine; BMJ Quality and Saftey
Cancer is diagnosed more commonly than most physicians, themselves are aware. A series of recently published studies indicate a misdiagnosis rate from 15% to 28% of the time. There are a number of reasons cited by medical professionals for this seemingly high rate of misdiagnosis for cancer: Among these are: fragmented medical records; time-strapped doctors simply not having enough time with patients; errors in pathology interpretation; patients not knowing or sharing important pieces of their family medical history; and an inflexible adherence to protocols. In addition to the number of lost and damaged lives, there are considerable financial costs associated with a high misdiagnosis rate. $700 Billion dollars are estimated to be wasted by the US Medical System each year– countless billions of which are from diagnostic error.
Over 1.6 million new cancer cases in the U.S. are projected to occur in 2013, according to the American Cancer Society. Some 400 pathologists, medical oncologists and surgical oncologists were polled to determine their awareness of the relative rate of cancer misdiagnosis. When participating doctors were asked how often they would estimate misdiagnoses rates in oncology, the majority (60.5%) estimated 0 to 10% of the time. Only 4.8% believed misdiagnoses occur 20-30% of the time. These numbers counter published studies which show misdiagnosis rates in general reaching up to 28%, and up to 44% for some types of cancer, according to the Journal of Clinical Oncology. This lack of physician awareness is also concerning.
When asked what types of cancer conditions physicians believe are most often misdiagnosed or mischaracterized, 21 conditions were named. Leading the top five misdiagnosed cancer conditions by a considerable margin was Lymphoma, followed by Breast Cancer, Sarcomas and Melanoma.
Does this mean that all cancer misdiagnosis is the result of medical malpractice by a physician? No. However the number is too large to attribute the rate of misdiagnosis to exemplary medical care in all circumstances. So what does this mean for you, the patient? Be your own health care advocate. Insist on follow up testing if you feel that something is being treated lightly or may be overlooked. If physicians who specialize in the recognition and treatment of cancer are unaware of how frequently it is misdiagnosed, they might not be so quick to find it.
The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Skin Cancer, Aspirin Cuts Risk?
Source: Cancer (online Journal, March 11, 2013); American Cancer Society
ASPIRIN is one of the most widely used medications in the world, with an estimated 40,000 tons of it being consumed each year. In countries where Aspirin is a registered trademark owned by Bayer, the generic term is acetylsalicylic acid (ASA).
Plant extracts, including willow bark and spiraea, of which salicylic acid was the active ingredient, had been known to help alleviate headaches, pains, and fevers since the father of modern medicine, Hippocrates (460 BC and 377 BC) described the use of powder made from the bark and leaves of the willow tree. A French chemist, Charles Frederic Gerhardt, was the first to prepare acetylsalicylic acid in 1853. Synthetic Aspirin was first isolated by Felix Hoffmann, a chemist with the German company Bayer in 1897, and was thereafter copyrighted.
The aspirin study included 59,806 postmenopausal Caucasian women aged 50 to 79 years. During a median follow-up of 12 years, 548 incident melanomas were confirmed by medical review. Women who used ASA had a 21% lower risk of melanoma relative to nonusers. Increased duration of ASA use (<1 year, 1-4 years, and ≥5 years) was associated with an 11% lower risk of melanoma for each categorical increase and women with ≥5 years of use had a 30% lower melanoma risk. In contrast, use of non-ASA NSAIDs and acetaminophen were not associated with melanoma risk.
The obvious conclusions are that postmenopausal women who used ASA had a significantly lower risk of melanoma, and that longer durations of ASA use are associated with greater protection. Although this study was limited by the observational design and self-report of NSAID use, the findings suggest that ASA may have a chemopreventive effect against the development of melanoma and warrant further clinical investigation.
The Lewis Law Firm has a long history of representing patients with cancer, and their families in Phildelphia and New Jersey. If you or a loved one have been diagnosed with cancer, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Childhood Cancers Increasing!
Sources: National Cancer Institute; US Centers for Disease Control & Prevention (CDC)
ON AVERAGE 1 to 2 out of every 10,000 children in the United States are diagnosed with some form of cancer. Cancer is the leading cause of death by disease among U.S. children 1 to 14 years of age. Over the past 20 years, there has been some increase in the incidence of children diagnosed with all forms of invasive cancer, from 11.5 cases per 100,000 children in 1975 to 14.8 per 100,000 children by 2004. In 2007, approximately 10,400 children under age 15 were diagnosed with cancer and about 1,545 children were expected to die from the disease. Although this makes , cancer is still relatively rare in this age group. On the positive side, the 5-year survival rates for all childhood cancers combined increased from 58.1 percent in 1975–77 to 79.6 percent in 1996–2003.
Long-term trends in incidence for leukemias and brain tumors, the most common childhood cancers, show patterns that are somewhat different from the others. Incidence of childhood leukemias appeared to rise in the early 1980s, with rates increasing from 3.3 cases per 100,000 in 1975 to 4.6 cases per 100,000 in 1985. Rates in the succeeding years have shown no consistent upward or downward trend and have ranged from 3.7 to 4.9 cases per 100,000. For childhood brain tumors, the overall incidence rose from 1975 through 2004, from 2.3 to 3.2 cases per 100,000.
Despite advances in detection, the causes of childhood cancers remain largely unknown. Some genetic conditions, such as Down syndrome and ionizing radiation exposure, explain a small percentage of cases. A number of studies are examining suspected or possible risk factors for childhood cancers, including early-life exposures to infectious agents; parental, fetal, or childhood exposures to environmental toxins such as pesticides, solvents, or other household chemicals; parental occupational exposures to radiation or chemicals; parental medical conditions during pregnancy or before conception; maternal diet during pregnancy; early postnatal feeding patterns and diet; and maternal reproductive history. Researchers are also studying the risks associated with maternal exposures to oral contraceptives, fertility drugs, and other medications; familial and genetic susceptibility; and risk associated with exposure to the human immunodeficiency virus (HIV).
Current treatments for pediatric cancers continue to lag. Most children’s cancers are treated primarily with chemotherapy over the course of one to several years. Some cancers also require radiation therapy, surgery, and/or bone-marrow transplants. Chemotherapy is a group of highly toxic chemical drugs that were developed to kill fast-replicating cells. These drugs are non-specific -they don’t distinguish between diseased and healthy tissuess and result in severe reactions such as hair loss, nausea, significant weight loss and weakness associated with thier toxicity. As if that weren’t enough, most pediatric cancer protocols suggest combination chemotherapy which involves the infusion of several different toxic drugs over the course of time to kill cells at differing levels of development. Radiation therapy, while it can be targeted, is also an indiscriminate killer of healthy tissue and organs. Even if a cure or remission is obtained, children can develop long-term medical problems, including the development of secondary cancers from the chemotherapy or radition itself.
The Lewis Law Firm has a long history of representing children with cancers, and their families in Phildelphia, PA and New Jersey. If you or a loved one have been diagnosed with liver cancer, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Pancreatic Cancer Continues to Rise
Sources: National Cancer Institute; National Institutes for Health
PANCREATIC cancer will kill 38,460 of the 45,220 people who are diagnosed with it in 2013 in the US. Pancreatic cancer is a disease in which malignant (cancer) cells are found in the tissues of the pancreas. Also called exocrine cancer. The pancreas makes pancreatic juices. These juices contain enzymes that help break down food. The pancreatic juices flow through the main duct to the duodenum, the first part of the small intestine.
The pancreas is also a gland that makes insulin and other hormones. These hormones enter the bloodstream and travel throughout the body. They help the body use or store the energy that comes from food. For example, insulin helps control the amount of sugar in the blood.
Studies have found the following risk factors for cancer of the pancreas:
- Smoking: Smoking tobacco is the most important risk factor for pancreatic cancer. People who smoke tobacco are more likely than nonsmokers to develop this disease. Heavy smokers are most at risk.
- Diabetes: People with diabetes are more likely than other people to develop pancreatic cancer.
- Family history: Having a mother, father, sister, or brother with pancreatic cancer increases the risk of developing the disease.
- Inflammation of the pancreas: Pancreatitis is a painful inflammation of the pancreas. Having pancreatitis for a long time may increase the risk of pancreatic cancer.
- Obesity: People who are overweight or obese are slightly more likely than other people to develop pancreatic cancer.
Early cancer of the pancreas often doesn’t cause symptoms. When the cancer grows larger, you may notice one or more of these common symptoms: Dark urine, pale stools, and yellow skin and eyes from jaundice; Pain in the upper part of your belly; Pain in the middle part of your back that doesn’t go away when you shift your position; Nausea and vomiting; and stools that float in the toilet.
Advanced cancer may cause these general symptoms: Weakness or feeling very tired; Loss of appetite or feelings of fullness; Weight loss for no known reason
At this time, cancer of the pancreas can be cured only when it’s found at an early stage (before it has matastasized or spread) and even then, only if surgery can completely remove the tumor. For people who are not surgical candidates or who are diagnosed late, the only treatment is palliative.
The Lewis Law Firm has a long history of representing people with pancreatic and other cancers, and their families in Philadelphia and New Jersey. If you or a loved one have been diagnosed with pancreatic cancer which was misdiagnosed or diagnosed late, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Breast Cancer Still a Leading Cause of Cancer Death for Women
Source: US Centers for Disease Control and Prevention (CDC)
MAJOR findings contained in the most current comprehensive report of cancer statistics, compiled in the United states reveals that Breast Cancer is still a leading killer of women. The three most common cancers with which women continue to be diagnosed are:
1. Breast cancer (123.1 per 100,000 women) or 1.5 million new cases of breast cancer per year
2. Lung cancer (54.1 per 100,000 women).
3. Colorectal cancer (37.1 per 100,000 women).
Lung Cancer remains the leading cause of death for women, ending the lives of 38.6 per 100,000 women. Despite advances in detection and treatment, Breast Cancer continues to be the second leading cause of death from cancer among women, ending the lives of 22.2 per 100,000 women. Colorectal cancer is a close third, ending the lives of 13.1 per 100,000 women.
The data come from a collaborative effort of: the CDC’s National Program of Cancer Registries (NPCR); the National Cancer Institute’s (NCI) Surveillance, Epidemiology and end Results (SEER) Program; and, the North American Association of Central Cancer Registries (NAACCR). The section on childhood cancer includes incidence data for more than 13,000 cancer cases and 2,000 cancer deaths among children and adolescents aged 19 years or younger. These data are presented by race, sex, age, and primary site as well as by specific cancer types.
The three most common cancers among men include:
1. Prostate cancer (137.7 per 100,000 men)
2. Lung cancer (78.2 per 100,o00 men).
3. Colorectal cancer (49.2 per 100,000 men).
The leading causes of cancer death among men are: Lung cancer (62.0 per 100,000 men), Prostate Cancer (22.0 per 100,000 men) with Liver and Colorectal Cancer not far behind. These alarming statistics suggest that we have a long way to go before we reduce, to any significant degree, deaths from cancers in the US.
The Lewis Law Firm has a long history of representing women with Ovarian, Cervical, Endometrial and breast cancer in Philadelphia and New Jersey. If you or a loved one have been diagnosed with breast cancer which was misdiagnosed or diagnosed late, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Quiting Smoking Relieves Anxiety.
Sources: The British Journal of Psychiatry; BBC Health News
Notwithstanding the belief that smoking can relieve stress, a study published in the British Journal of Psychiatry has found that smokers who successfully quit feel less anxious than their smoking peers.
Researchers found a “significant” decrease in anxiety levels among the 68 smokers who had quit after six months. The effect was greater among those who had mood and anxiety disorders than those that smoked for pleasure.
The researchers – drawn from several universities including Cambridge, Oxford and Kings’s College in London – said the findings should be used to reassure smokers attempting to quit that concerns about increased anxiety levels were unfounded. However, the study did suggest that a failed attempt to seemed to increase anxiety levels by a modest degree among those who had mood disorders.
For those who smoked for pleasure a relapse did not alter anxiety levels. The researchers said it seemed that smokers, in particularl those that smoked to cope with stress, were more likely to have a cigarette soon after waking up to stave off withdrawal symptoms, which include anxiety. By quitting, they removed these repeated episodes of anxiety and actually felt less anxious as a result.
Add one to your new year resolutions.
If you or a loved one have been diagnosed with breast, ovarian, cervical, prostae, liver or lung cancer which was misdiagnosed or diagnosed late, contact the Lewis Law Firm for a FREE consultation and review of your case, today. The Lewis Law Firm has a long history of representing patients with cancer and their families in Pennsylvania and New Jersey.
Posted by: David M. Schwadron, Esquire
Liver Cancer May Not Be Your Primary Cancer
Sources: National Cancer Institute; American Cancer Society; PUBMED
THE LIVER is one of the largest organs in the body. It has four lobes and fills the upper right side of the abdomen inside the rib cage. Among it’s important functions are: Filtering harmful substances from the blood; Making bile to help digest fats from food; and, Storing glycogen (sugar), which the body uses for energy.
Adult pimary liver cancer (hepatocellular carcinoma) is a disease in which malignant (cancer) cells form in the tissues of the liver. It is estimated that there will be 28, 720 new cases of liver cancer and 20,550 and deaths from liver and intrahepatic bile duct cancer in the United States in 2012. And the numbers are rising. The incidence of liver cancer in the US has increased from 1.4 per 100,000 population to 2.4 per 100,000. Among black men, the incidence is 6x higher than white men in the US. Given that as a population, Asians have a higher carrier rate of Hepatitis B, Vietnamese-American men are 13x more at risk, Korean-American men are 8x more risk and Chinese-American men are at 6x more risk for liver cancer. There has been a 41 percent increase in the mortality rate from primary liver cancer. The age-specific incidence of this cancer has progressively shifted toward younger people. Why is the rate of liver cancer increasing? Risk factors attributed to the increase in liver cancer include:
- -Cirrhosis (5% of patients eventually develop liver cancer)
- -Hepatitis B infection (a factor in 80% of all liver cancer cases)
- -Hepatitis C infection (the most significant causes of liver cancer worldwide)
- -Chemicals (Aflatoxin has also been implicated as a factor in parts of the world where this mycotoxin occurs in high levels in ingested food)
- -Obesity (in the US in particular)
Primary Liver cancer still relatively uncommon in the United States. Here, metastatic cancer in the liver is far more common than primary liver cancer. Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. A tumor formed by metastatic cancer cells is called a metastatic tumor or a metastasis. Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lungs and forms a metastatic tumor is metastatic breast cancer, not lung cancer. Although some types of metastatic cancer can be cured with current treatments, most cannot. So if you are diagnosed with liver cancer, there is a good probability that you have a primary cancer somwhere else in your body. The primary symptoms of liver cancer are:
- -A hard lump on the right side just below the rib cage
- -Discomfort in the upper abdomen on the right side
- -Pain around the right shoulder blade
- -Unexplained weight loss
- -Jaundice (yellowing of the skin and whites of the eyes)
- -Unusual tiredness
- -Nausea
- -Loss of appetite
A mass or tumor in the liver (found on MRI or CT scan) is often the only clue. Liver cancer is potentially curable by surgical resection, but surgery is the treatment of choice for only the small fraction of patients with localized disease. If the cancer is metastatic, then cure is unlikely. The prognosis (chance of survival) depends on the degree of local tumor replacement and the extent of liver function impairment. Therapy other than surgical resection includes: chemotherapy; hepatic artery ligation or embolization; percutaneous ethanol injection; radiofrequency ablation; cryotherapy;and radiation.
Some patients may go into remission and a few patients (without metastatic disease) may be candidates for liver transplantation. There are a limited number of livers availabile in the US for transplantation. One of our clients, who unfortunately died from his late diagnosed liver cancer, had tried to obtain a liver donor from Korea prior to a recurrence of cancer.
The Lewis Law Firm represents patients who have been diagnosed late with liver cancer and metastatic cancer. If you or a loved one have been diagnosed with liver cancer contact the Lewis Law Firm for a FREE consultation and case review, today.
Future Gene Therapy for Prostate Cancer?
Source: ScienceDaily; R. L. Vinall, J. Q. Chen, N. E. Hubbard, S. S. Sulaimon, M. M. Shen, R. W. DeVere White, A. D. Borowsky. Initiation of prostate cancer in mice by Tp53R270H, 2012
Researchers from University of California Davis, have found that a genetic mutation may play an important role in the development of prostate cancer. The p53 (or Tp53) gene was previously thought to be a factor in late progression of prostate cancer, but until now has never been shown to act as an initiating factor. The findings may open new avenues for diagnosing and treating the disease. Prostate cancer is the leading cancer diagnosis in men in the United States (Affecting 1 in 6 men). Although it is curable in about 80% of men with localized disease, the rate is much lower if the cancer is highly virulent and/0r has been diagnosed late after it has spread beyond the prostate gland.
So what did they find? “Our team found a molecular pathway to prostate cancer that differs from the current conventional wisdom of how the disease develops,” said Alexander Borowsky, associate professor of pathology and laboratory medicine and principal investigator of the study. “With this new understanding, research can go in new directions to possibly develop new diagnostics and refine therapy.” Investigators developed a mouse model genetically engineered to have a mutation in the “tumor suppressor” gene, p53 - in the cells of the prostate gland, itself. These mice were significantly more likely to develop prostate cancer than control mice without the mutation, and provided the first indication that the p53 mutation could be involved in the initiation of prostate cancer. Prior studies have associated p53 mutation with disease progression in prostate cancer, but this is the first to find that it can have a role in the early initiation of prostate cancer, as well. Until now, understanding of the role of p53 was that mutation occurred exclusively as a late event in the course of prostate cancer. Based on the findings in the new mouse model that the researchers developed, p53 mutation not only can initiate prostate cancer but might also be associated with early progression toward more aggressive forms of the disease.
How does it work? The p53 gene encodes for a protein that normally acts as a tumor suppressor, preventing the replication of cells that have suffered DNA damage. Mutation of the gene, which can occur through chemicals, radiation or viruses, causes cells to undergo uncontrolled cell division. Exactly how the p53 mutation promotes the initiation and progression of prostate cancer remains to be clarified and is a focus of current research by the UC Davis team. Genetic mutations can initiate cancers in a variety of ways. Those include promotion of uncontrolled cell growth and loss of the gene’s normal cell growth-suppressor functions. “Knowing that prostate cancer can develop via p53 mutation opens new opportunities for researchers in the field,” said Borowsky. ”
Broader Reach? The p53 mutation is also of intrest for other cancers, including breast, lung and esophageal cancers. Another application of the discovery could be the development of a new diagnostic test for prostate cancer based on the presence of the p53 mutation as a biomarker. According to Dr. Borowsky, “This is a game-changer in the understanding of prostate cancer.”
The Lewis Law Firm has a history of representing patients who have been misdiagnosed or diagnosed late with prostate cancer, breast cancer, cerivcal and ovarian cancer and pancreatic cancer. If you or a loved one were misdiagnosed or diagnosed late with cancer, contact the Lewis Law Firm for a FREE consultation and case review today.
Posted by: Gayle R. Lewis, Esquire
Re-thinking Chemotherapy.
Source: Medical News Today; Science journal
Chemotherapy used to be a very blunt instrument. The chemicals used in chemotherapy were originally developed for destruction of human life of the battlefields of World Wars (ie. Mustard gas). This is once of the reasons why chemotherapy causes injuries to other organs, damaging symptoms such as hair loss, and even secondary cancers. More recently, oncologists (doctors who specialize in cancer treatment) have benefited from advances in genetics to sharpen chemotherapy. One of the newest advances is predicting the “life-cycle” of cancer cells so that doctors can target cancers which might be easier to kill. More accurately they can identify those cancer cells that are close to the end and can push them (chemically speaking) off the ledge.
For those of you who want the technical explanation, here it goes: (The rest of you can skip to the next paragraph) It all comes down to proteins -in this case BH3 peptides within the BCL-2 family. BCL-2 proteins cause apoptosis (the process of cellular death) and scientists believe that they can influence this process by adding BH3 peptides to tip cell balance in favor of apoptosis vs. replication. In a very literal sense, the scientists are able to trick the cancer cells into committing cellular suicide. In the admittedly small study of tumors from 85 patients, including myelomas, leukemias and ovarian cancers, the chemotherapy was most successful against tumors which had the greatest mitochondrial tiping in the laboratory.
It may not sound like much to most people, but this is a radical new way of looking at exactly how chemotherapy works. It has been thought for years that chemotherapy attacks rapidly proliferating (fast growing) cells which eventually group to form tumors. This doesn’t really explain why chemotherapy doesn’t work effectively against skin cancers, for example. The idea that chemorherapy is effective mainly against cancer cells which are close to dying may aid in the development of new chemotherapy agents which have less collateral damage.
Posted by: Gayle R. Lewis, Esquire
Radiation Still Common Treatment for Cancer
Source: MD Becker Partners, Life Science Digest; American Cancer Society
An estimated 1.1 million patients were treated with radiation in 2009, representing an increase of 15% from 2007 according to a market research study published by IMV Medical Information Division.
The clinical application of radiation therapy in oncology (using high-energy radiation to shrink tumors and kill cancer cells) dates back to the early 1900s when radium was used to successfully treat a pharyngeal carcinoma in Vienna. By the 1930s, fractionated X-rays were used to cure a group of patients with inoperable cancer of the larynx. Today, radiation therapy remains a cornerstone of cancer treatment and is often used in combination with surgery and chemotherapy.
Radiation can be delivered to a cancer patient using several techniques. These include using a machine outside of the body (external-beam radiation therapy), placing radioactive material in the vicinity of cancer cells (internal radiation therapy, or brachytherapy), and systemic radiation therapy using injected substances (radiopharmaceuticals) that travel in the blood to seek and destroy cancer cells.
Despite numerous medical and scientific advances following its clinical introduction more than a century ago, radiation therapy is an important and growing treatment option for breast, prostate, lung and other cancers. A recent article in the Journal Cancer suggests that 52% of all cancer patients should receive radiation. The American Cancer Society expecting approximately 1,596,670 new cancer cases to be diagnosed in 2011.
However, most types of radiation do not specifically attack cancer cells and cause injury to normal tissues surrounding the tumor. The goal of radiation therapy is to maximize the dose delivered to tumor cells while minimizing exposure to normal, healthy cells. For Prostate Cancer patients, complications of radiation include: bleeding; irritation and pain; urinary frequency; urgency; and, incontinence. Radiation therapy directed to the chest is commonly employed to treat lung, esophageal, breast and lymphoma cancers. However, lung inflammation caused by radiation therapy, called radiation pneumonitis, is the most common complication.
Given the prominent role of radiation therapy in cancer treatment, the development of novel agents that protect normal tissue against the effects of ionizing radiation represents a large market opportunity and unmet medical need.
Post: Gayle R. Lewis, Esquire