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.
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.
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.
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.
Sources: American Cancer Society; MD Anderson Cancer Center of the University of Texas
LIVER cancer is one of the most rapidly increasing cancers in the US, with 22,600 cases of primary liver diagnosed in the United States in 2009. It is a killer cancer with an overall 5-year survival rate of around 15%. The Liver is an Essential organ and the largest organ in the body, the liver is pyramid-shaped and located under your right ribs. It has two sections called lobes. The liver essential because you can’t live without it. Some of its important functions are to: Break down and store nutrients from the intestine; Manufacture some of the clotting factors your body needs to stop bleeding; Make bile that helps the intestine absorb nutrients; and, Help get rid of waste.
Liver cancer can begin in the liver as primary liver cancer or can start as cancer somewhere else and metastasize or (spread) to the liver. The liver’s size and high blood flow make it a prime target for cancer cells moving through the bloodstream. Colorectal, breast and lung cancers are the most common primary sources of metastatic liver cancer.
The most common form of primary liver cancer is Hepatocellular carcinoma (HCC). As the name suggests, these cancers start at the cellular level and care common in people with liver damage, such as cirrhosis. Fibrolamellar HCC is a rare subtype that often has a higher chance for successful treatment than other types of liver cancer. Other types of liver cancer include Bile duct cancers (cholangiocarcinomas) and Angiosarcomas and hemangiosarcomas, which are usually not diagnosed until they are in advanced stages.
Studies have shown that patients with small, resectable tumors (tumors that can be removed), who do not have cirrhosis or other serious health problems, are likely to do relatively well if their cancers are removed. The overall 5-year survival is over 50%. For people with early-stage liver cancers who are able to have a liver transplant, the 5-year survival rate is in the range of 60% to 70%. However, only a small number of liver cancers are found in the early stages and can be removed with surgery. For all stages combined, the relative 5-year survival rate from liver cancer is about 15%. One reason for the low survival rate is that most patients with liver cancer also have other liver problems (co-morbitities) such as cirrhosis and metastasis (spread) of cancer.
The Lewis Law Firm has a long history of representing people with liver and other cancer in Philadelphia 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.
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.
Sources: Centers for Disease Control and Prevention (CDC); Jemal A, et al., Cancer statistics, 2009. CA: A Cancer Journal for Clinicians 2009;59(4):225–249; U.S. Cancer Statistics Working Group Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2009.
CANCER is the second most common cause of death among children between the ages of 1 and 14 years in the US, surpassed only by accidents. More than 16 out of every 100,000 children and teens in the U.S. were diagnosed with cancer, and nearly 3 of every 100,000 died from the disease. The most common cancers in children were leukemia (cancer of the bone marrow and blood) and brain and central nervous system cancers.
In 2005,* 4.1 of every 100,000 young people under 20 years of age in the U.S. were diagnosed with leukemia, and 0.8 per 100,000 died from it. The number of new cases was highest among the 1–4 age group, but the number of deaths was highest among the 10–14 age group.
Brain and Central Nervous System Cancer
In 2005,* 2.9 of every 100,000 people 0–19 years of age were found to have cancer of the brain or central nervous system, and 0.7 per 100,000 died from it. These cancers were found most often in children between 1 and 4 years of age, but the most deaths occurred among those aged 5–9.
Deaths from Childhood Cancer Declining
During the past 25 years, there have been significant improvements in the five-year relative survival rate for all of the major childhood cancers. The five-year relative survival rate among children for all cancer sites combined improved from 58% for patients diagnosed in 1975–1977 to 80% for those diagnosed in 1996–2004. A CDC study found that from 1990 to 2004, childhood leukemia death rates fell by 3.0% per year, childhood brain and other nervous system cancers by 1.0% per year, and all other childhood cancers combined by 1.3% per year, likely reflecting better treatment of childhood cancers. (2005 is the most recent year for which statistics are available)
The Lewis Law Firm has a long history of representing Women and Children in Philadelphia and New Jersey. If you or a child have been diagnosed and treated for cancer, contact the Lewis Law Firm for a free consultation.
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
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
- -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.
Sources: Choosing Wisely.org (An Initiative of the American Board of Internal Medicine Foundation) Press Release; NY Times Health Blog
Under the “educational initiative” of Choosing Wisely, led by the American Board of Internal Medicine Foundation and involving 8 other specialty boards are recommending less routine testing for their patients. The thought process is that unnecessary testing is costly to the health care system and may actually harm patients. The move comes, not surprisingly, as insurance companies and third party payors (The US Government) are looking to shift costs back to hospitals and physicians. If there is any doubt as to the financial focus, the initiative is openly partnering with Consumer Reports on the initiative. The lists are presented as a series of questions (which will likely follow as practice recommendations) that patients and their physicians should question with suggested answers, including:
Q. Do patients need brain imaging scans (CT or MRI) after fainting, also known as simple syncope? A. Probably not. Research has shown that, with no evidence of seizure or other neurologic symptoms during an exam, patient outcomes are not improved with brain imaging studies. (American College of Physicians)
Q. Do patients need stress imaging tests for annual checkups? A. Not if you are an otherwise healthy adult without cardiac symptoms. These tests rarely result in any meaningful change in patient management. (American College of Cardiology)
Q. Should patients going into outpatient surgery receive a chest x-ray beforehand? A. If the patient has an unremarkable history and physical exam, then no. Most of the time these images will not result in a change in management and has not been shown to improve patient outcomes. (American College of Radiology)
Q. Do patients need a CT scan or antibiotics for chronic sinusitis? A. Most acute rhinosinusitis resolves without treatment in two weeks and when uncomplicated is generally diagnosed clinically and does not require a sinus CT scan or other imaging. (American Academy of Allegry, Asthma & Immunology)
Q. Should dialysis patients who have limited life expectancies and no signs or symptoms of cancer get routine cancer screening tests? A. These tests do not improve survival in dialysis patients with limited life expectancies, and can cause false positives which might lead to harm, over treatment and unnecessary stress. (American Society of Nephrology)
The Organizations, representing some 375,000 physicians, who released lists of questions with Choosing Wisely are: The American Academy of Allergy, Asthma & Immunology; The American Academy of Family Physicians; The American College of Cardiology; The American College of Physicians; The American College of Radiology; The American Gastroenterological Association; The American Society of Clinical Oncology; The American Society of Nephrology; and The American Society of Nuclear Cardiology.
From the press Release: “Today these societies have shown tremendous leadership in starting a long overdue and important conversation between physicians and patients about what care is really needed,” said Christine K. Cassel, M.D., president and CEO of the ABIM Foundation. “Physicians, working together with patients, can help ensure the right care is delivered at the right time for the right patient. We hope the lists released today kick off important conversations between patients and their physicians to help them choose wisely about their health care.” Consumer Reports (CR) – the world’s largest independent product-testing organization – is working with the ABIM Foundation and the specialty societies to lead the effort.”
Even specialists such as oncologists (cancer doctors) are being urged to cut back on scans for patients with early stage breast and prostate cancers that are not likely to spread rapidly. Patient advocacy groups and other specialists have expressed caution, warning that the directives could be misinterpreted and applied too broadly at the expense of patients.
If you or a loved one have been harmed by poor medical care, contact the Lewis Law Firm for a free consultation and opinion. The Lewis Law Firm is dedicated to improving the quality of health care delivery in Pennsylvania and New Jersey.
Posted by: Gayle R. Lewis, Esquire