Lung cancer was once thought to be a death sentence, but now with early detection at an early stage when the tumor is small, treatment can produce a high cure rate. Good history taking, physical examination, and chest x-rays can detect many cancers. If your physician finds something suspicious, especially if you are a smoker or at a high risk for developing lung cancer, he has access to many other diagnostic studies to investigate further. CT Scans and other radiologic studies, sputum cytology (microscopic examination of mucous coughed up from deep in the lungs), bronchoscopy (the viewing of the lungs through a scope passed through the nose and throat into the lungs) and biopsies (microscopic analysis of a small piece of lung tissue) are all tools available to your physician. The key is early diagnosis followed by prompt and appropriate treatment.
Too often physicians overlook obvious warning signs because they did not take the time or the thought required to ask the right questions. Many people experience signs of problems when the lung tumors are small and treatable. Development of a persistent cough, bloody sputum, an increase in sputum produced or a pneumonia may be the early warning signs, and if heeded should lead to a diagnostic study like a chest x-ray or CT scan that can lead to the diagnosis.
If shortcuts are taken in history taking, your doctor may miss early warning signs. If he is moving too quickly to appreciate that you are at risk for lung cancer AND you are having signs that may indicate a problem, he may miss an opportunity to make a timely diagnosis of your cancer at a time where treatment might give you a cure.
Your doctor needs to take the time to talk to you, and you need to clearly express your concerns as well. He has a duty to inquire about your risk factors for developing lung cancer. Factors that could place you at a higher risk for developing these cancers include:
Listening for abnormal breath sounds is a vital part of the physical examination and percussion of the chest (thumping on the chest wall and listening for sounds transmitted through underlying tissues, e.g., sound transmission through a solid mass would result in a dull thud) may yield important information, as well.
Your weight should be taken and recorded with each visit. Weight loss may also be a sign of cancer so serial weights showing an unintended decline in weight may be a sign of cancer. There is no single finding that will confirm the diagnosis of lung cancer, however good history taking, consideration of risk factors, plus a good physical examination could raise concerns so that additional radiologic and other testing are pursued appropriately.
Health care providers sometimes become overly reliant on technologies, so that physicians may assume that negative chest x-ray means there in no cancer, even when the patient has signs and symptoms that suggest that a lung cancer diagnosis should be explored. A negative finding could mean that there is no lung mass, but it also may meant that the radiologist misinterpreted the study, or the study may be technically inadequate (overexposed, underexposed, blurry, missed the target area, or a mass could be hiding behind a rib or other structure that makes it hard to see, etc.
Lost test results, abnormal test results that get filed without notifying the patient, failure to follow-up on inadequate or inconclusive examinations due to miscommunications, correct test reports that get misfiled or are not read, mislabeled specimens . . . Mistakes happen, but they happen more with short staffing and substandard procedures in place.
Getting a consultation with a pulmonologist, who is a specialist trained to evaluate problems of the lungs, is often the appropriate means to explore suspicions of lung cancers. While many health insurance plans discourage the use of specialists for problems that the generalist could treat, bringing in a pulmonologist in to direct the work-up of a possible lung cancer is arguably cost effective to stream-line the selection of diagnostic studies, as well as making the diagnosis quickly and getting the patient to the correct treaters, radiologists and/or oncologists and/or chest surgeons in the most efficient manner.
Failing to bring in a pulmonologist to manage a potential lung cancer may result in untimely and inappropriate diagnostic studies and may complicate the referral process for getting cancer treatment.
In some health plans, physicians are given financial incentives to not refer their patients to specialists or order diagnostic testing or interventions.
If you are in a health maintenance organization or a health plan with "capitation" you are at risk from a doctor operating under the influence of financial incentives.
The most common allegations of negligence in lung cancer cases are:
Diagnostic delays can lead to treatments that take away the quality of life, and may result in unnecessary and premature death.
In early stages, treatment may consist only of removal of the segment of involved lung; in later stages radiation therapy, chemotherapy and debilitating operations may be needed.
Lung cancer screening and treatment modalities are improving cancer prognoses and survival. Many types of lung cancer can be cured, but they all require early detection and treatment.
If you fear that substandard medical care or outright errors resulted in a delay in detecting your cancer, or caused complications in your cancer care that hurt your chance of recovering, I will look at your case free of charge, and tell you if you may have been the victim of medical malpractice. If your case is outside our jurisdiction, we can help you to find skilled and ethical counsel in your area.
Mark R. Bower, Esq
Law Offices of Mark R. Bower, PC