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Prostate cancer is a terrible disease. Although not perfect there are diagnostic tests that aid doctors to determine when the cancer is present in a patient. However given the likelihood of false negatives (a negative test result although the patient actually has cancer) doctors have to follow up and redo tests as appropriate if patient symptoms and screening tests keep showing the possibility of cancer. The failure to do so may reslt in a malpractice claim.
In one reported lawsuit a man told his family doctor that he was having urinary frequency and burning. The doctor began the man on antibiotics and refered the man to a urologist. The urologist did a cystoscopy which revealed that the individual had an enlarged prostate. The urologist additionally did a PSA blood test which came back a 16.3 (anything above a 4.0 is normally accepted as high). Therefore the urologist performed a biopsy two months later. The biopsy was interpreted by a pathologist as showing no sign of cancer.
The next year the individual returned to the urologist. Now the PSA came back a 2.9 (normally regarded as in normal range). The urologist concluded that the patient had BPH (a benign enlargement of the prostate). After 3 months the individual saw the primary care physician with complaints of fever and nocturia (needing to urinate during the night). The physician began him on another round of antibiotics. A follow up urine culture came back negative. The primary care physician therefore referred the individual to the urologist. The urologist did a PSA test which came back a 6.4 (again, high).
A biopsy analyzes portions of the prostate. Hence, it is possible for a biopsy to miss the cancer. Yet, the urologist chose to depend on the preceding year's biopsy and to not do another one as a follow up. Rather, the urologist failed to follow up on the male's complaints and elevated PSA.
The next year the man returned to his family doctor. His symptoms continued to include nocturia. On physical examination the doctor noted that the individual had a highly enlarged prostate. Yet, the physician failed to order a PSA or re-refer the man to a urologist. Standard blood testing 4 months later revealed that the male patient's PSA was at 7.4 Neither doctor did anything to follow up.
The subsequent year the family doctor recorded that the PSA level was 9.8 Once more, no follow up or referral to a urologist. Yet another year and the patient is still complaining of nocturia. This time the PSA was 9.7 No follow up and no referral. Five years after the person's initial complaints of urinary problems the family doctor again recorded a significantly enlarged prostate gland and a PSA that had reached a 31. The physician finally refered the individual back to the urologist.
The urologist verified that the patient's prostate was enlarged and started the man on antibiotics for (two weeksto be followed by an additional PSA test. After the PSA test was done 2 weeks soon after it registered a 33. A biopsy followed which revealed cancer every sample taken.
Testing afterwards found that the man had cancer metastasis to the lymph nodes, the liver and bone. Even after a course of both hormone therapy and radiation therapy the individual passed away nearly eighteen months following his diagnosis. The law firm that represented his family recorded that a settlement for $1,000,000 was reached in the case.
