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.
PSA Testing for Prostate Cancer
By: Gayle R. Lewis, Esquire
Sources: British Medical Journal 2013;346:f2023; BBC Health News
A STUDY initiated by Sweedish researchers was recently published in the British Medical Joural. The goal of the study was to determine the association (if any) between concentration of prostate specific antigen (PSA) at age 40-55 and subsequent risk of prostate cancer metastasis (spread) and mortality (death) in an unscreened population to evaluate when to start screening for prostate cancer and whether rescreening could be risk stratified.
The resarchers conclude that PSA concentrations can indicate not only the current risk of cancer—and hence the need for prostate biopsy—but are also predictive of the future risk of prostate cancer metastasis and cancer specific death. They recommed screening on men at highest risk, with three lifetime PSA tests between the ages of 45 and 60 sufficient for at least half of the male population. This is likely to reduce the risk of overdiagnosis while still enabling early cancer detection among those most likely to gain from early diagnosis. As such, a risk stratified approach to PSA screening will improve the ratio of its benefits and harms.
The Malmö Preventive Project in Sweden looked at a large study of 21 277 Swedish men aged 27-52 (74% of the eligible population) who provided blood at baseline in 1974-84, and 4922 men invited to provide a second sample six years later. Rates of PSA testing remained extremely low during median follow-up of 27 years.
Main outcome measures Metastasis or death from prostate cancer ascertained by review of case notes.
The risk of death from prostate cancer was associated with baseline PSA: 44% of deaths occurred in men with a PSA concentration in the highest 10th of the distribution of concentrations at age 45-49 (≥1.6 µg/L). Although a 25-30 year risk of prostate cancer metastasis could not be ruled out by concentrations below the median at age 45-49 (0.68 µg/L) or 51-55 (0.85 µg/L), the 15 year risk remained low at 0.09% at age 45-49 and 0.28% at age 51-55, suggesting that longer intervals between screening would be appropriate in this group.
The Lewis Law Firm handles cases of misdiagnosis and late diagnosis of prostate cancer in Philadelphia and New Jersey. Call for FREE consultation today. Serving NJ and PA. Have you or a loved one been diagnosed and treated for prostate cancer? Contact the Lewis Law Firm for a free consultation.
Breast Cancer, Ovarian Cancer and Prostate Cancer Same Gene
Sources: BBC Health News; Jorunal Oncology
THE BRCA2 gene has been linked to hereditary breast cancer and ovarian cancer. Now scientists say that as well as being more likely to get prostate cancer, men with BRCA2 are also more likely to develop aggressive tumours and have the poorest survival rates. Men with the gene should be treated quickly to save lives. More than 40,000 men are diagnosed with prostate cancer every year. 1 in every 100 men with prostate cancer have the BRCA2 mutation.
Prostate cancer can grow either extremely slowly or very quickly. Some men may live symptom-free for a lifetime, despite having this cancer. Those with BRCA2 and prostate cancer should be treated early and aggressively because their tumour is more likely to spread.
Quick Facts about Prostate Cancer: 1.) The prostate is a small gland in the pelvis found only in men. It’s job is to make the fluid part of semen; 2.) Prostate cancer does not normally cause symptoms until the cancer has grown; 3.) Prostate cancer can be diagnosed by taking a biopsy (a small tissue sample of the prostate gland); 4.) Some men may be advised to delay having treatment if the tumour is very slow growing; 5.) Others may want to have surgery to remove the entire prostate; 6.) For some, treatment may offer the best chance of cure but it can cause serious side effects including impotence and incontinence
Patients with BRCA2-mutations were significantly less likely to survive their cancer, living an average of 6.5 years after diagnosis compared with 12.9 years for non-carriers. They were also more likely to have advanced disease at the time of diagnosis. Men with a significant family history of breast and/or ovarian cancer in addition to prostate cancer should be offered BRCA1/2 testing at diagnosis, but it is not routinely offered to all patients diagnosed with prostate cancer.
The Lewis Law Firm has a history of representing patients with Breast, Ovarian and Prostate Cancers. Have you or a loved one been diagnosed and treated for prostate cancer? Contact the Lewis Law Firm 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.
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
New Biomarker for Metastatic Prostate Cancer?
Sources: Medical News Today; Thomas Jefferson University
An inter-institutional team effort, initiated by Thomas Jefferson Unversity’s Michael A. Augello of the Department of Cancer Biology at Thomas Jefferson University, has found a potential biomarker for determining who will get the metastatic (and lethal) form of prostate cancer, which is usually contained or containable if caught in early stages.
Cyclin D1b regulates a large gene network, the researchers found, which was shown to cooperate with androgen receptor (AR) signaling to fuel metastatic progression in multiple models of prostate cancer. Studies have shown that Cyclin D1b expression is elevated in early stages of prostate cancer (in up to 30% of primary disease), and researchers have now demonstrated that this occurs more frequently in late stage castration-resistant prostate cancer: up to 80%.
The group found that Cyclin D1b, a variant of the cell cycle regulator Cyclin D1a, functions independently of the cell cycle to promote metastasis in both early and late stage prostate cancer. “Numerous clinical and pre-clinical studies have effectively demonstrated that AR signaling is critical for progression to metastatic disease, but our knowledge of AR targets which can induce metastatic phenotypes is limited,” said Dr. Knudsen, who assisted in the research. ”Our data describe how cross talk between the cell cycle and AR can rewire the AR signaling axis to enhance the expression of genes which elicit metastasis in both early and castration resistant prostate cancer models.”
Metastatic resistant prostate cancer represents the most lethal form of the disease, which arises when AR is reactivated despite continued hormone therapy. Soft tissue metastasis (spread) to the liver and lung represents a particularly aggressive form of prostate cancer, whose presence predicts for decreased survival time in prostate cancer patients. There is little knowledge as to how these metastatic events occur, and identification of pathways and biomarkers of this lethal event could greatly benefit prostate cancer patients.
Have you or a loved one been diagnosed and treated for prostate cancer? Contact the Lewis Law Firm for a free consultation.
Tort Reform -The Big Lie
Source: Public Citizen Report -Congress Watch Division (Public Citizen is a national non-profit consumer organization with more than 300,000 members and supporters).
Medical malpractice payments were at their lowest level on record in 2011
In contrast to the hundreds of thousands of annual avoidable adverse events (and tens or hundreds of thousands of deaths) that major studies attribute to medical mistakes, only 9,758 medical malpractice payments were made on behalf of doctors in 2011. However, policymakers and leaders of physician groups have spent the past two decades championing efforts to restrict patients’ legal rights, calling for Tort Reform and arguing of a crisis. There is no evidence that patients have received any benefits in exchange for ceding their legal remedies. Instead, the evidence suggests that litigation restrictions have suppressed meritorious claims, forcing malpractice victims and ordinary patients to absorb the costs of treating injuries caused by uncompensated medical errors.
Despite suggestions by those seeking to reduce patients’ legal rights that medical malpractice lawsuits are largely “frivolous,” the vast majority of payments compensate for extremely serious harms. 80% of the money paid for medical negligence in 2011 compensated victims or their surviving family members for harms defined by the NPDB as significant permanent injuries; major permanent injuries; quadriplegia, brain damage, or injuries requiring lifelong care; or death. The latter two categories (quadriplegia, brain damage, or injuries requiring lifelong care; and death) accounted for 44 percent of the dollars spent to compensate victims of medical malpractice.
Declines in Litigation Do Not Translate into Lower Costs for Consumer
Between 2000 and 2011, the value of medical malpractice payments fell 11.9 percent while healthcare spending nearly doubled, increasing 96.7 percent (both calculations in unadjusted dollars). These figures debunk claims that medical malpractice litigation is responsible for rising healthcare costs, as well as promises that patients should expect savings from litigation restrictions.
There Is No Evidence that the Decline in Medical Malpractice Payments Is Due to Safer Medical Care
For years, observers of healthcare safety issues referred to the 1998 Institute of Medicine (IOM) report, “To Err Is Human,” for guidance on the prevalence of medical errors. That study concluded that 44,000 and 98,000 patients were dying every year because of avoidable medical errors. In 2010 and 2011, three major studies reached conclusions on medical errors at least as shocking as those in the IOM report. The administrator of the Centers for Medicare and Medicaid Services (CMS), found that the number of adverse events could be 10 times greater than originally thought.
Comparing the well-recognized prevalence of medical errors with the relatively small numbers of malpractice payments leads to the inescapable conclusion that the overwhelming majority of medical errors do not lead to litigation. Harvard School of Health’s Michelle M. Mello and her co-authors in 2007 wrote in analysis of existing literature that only “2 to 3 percent of patients injured by negligence file malpractice claims … The findings of our analysis indicate that the overwhelming proportion of the costs of hospital medical injures are shifted to parties other than the hospital.”15
Uncompensated Medical Errors Are Costing Both Victims and Taxpayers Significantly
To put this figure in perspective, the total number of payments made in 2011 equaled only a little more than 1 percent of the number of Medicare patients that the Department of Health and Human Services estimates to suffer serious, avoidable injuries in a given year—and that’s just Medicare patients. This demonstrates that the vast majority of medical malpractice errors are not resulting in malpractice compensation payments for patients.
Conclusion
The juxtaposition of declining medical malpractice payments, skyrocketing medical costs, and consistent findings of rampant medical errors discredit the underlying promises of those who have campaigned to reduce patients’ access to legal remedies. The only sensible response is for policymakers and physicians to dedicate themselves to pursuing patient safety measures with the same vigor they have applied to limiting patients’ legal rights. That is a solution we could all live with.
The Lewis Law Firm has a long history of standing up for injured patients and their families. If you or a loved one have been the victim of physician or hospital malpractice, please contact the Lewis Law Firm for a FREE consultation and case review, today.
~Posted by: Gayle R. Lewis, Esquire
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