Of all of the forms of cancer, lung cancer causes the most deaths worldwide in both men and women, and the American Lung Association estimates 158,000 Americans will die from lung cancer in 2015.
As with all other cancers, timing of diagnosis is a critical issue in terms of surviving lung cancer. As cancer develops, it can spread throughout the body, making it significantly more difficult to treat successfully. Lung cancer is a particularly deadly disease because patients experience few or no symptoms during the early stages. As a result, the disease is often too far advanced to effectively treat upon diagnosis.
In this article we'll look at the proper diagnosis procedure for lung cancer, some common misdiagnoses of the condition, and what you'll need to show in order to bring a viable medical malpractice claim based on misdiagnosis of lung cancer.
Symptoms of lung cancer include coughing, coughing up blood or phlegm, fatigue, unexplained weight loss, recurrent respiratory infections, hoarseness, wheezing, and shortness of breath.
A doctor who suspects lung cancer will order a chest radiograph. Although results sometimes reveal an obvious mass, negative results do not necessarily rule out lung cancer. When the suspicion of lung cancer is high, a doctor should order a bronchoscopy and/or a CT scan. Once an irregularity is found on one of the above tests, the results are usually confirmed via biopsy.
It is possible for a doctor - or radiologist - to read the results of a chest radiograph or other imaging test and miss an irregularity suggestive of lung cancer. This is most common when a patient sees a doctor for symptoms unrelated to lung cancer. But even when the patient does see a doctor for symptoms associated with lung cancer, the doctor may misdiagnose the disease because other illnesses have similar symptoms, including the following:
Tuberculosis is a common, but sometimes lethal, infectious disease caused by microbacteria. Symptoms include cough, blood-tinged sputum, fever, night sweats, and weight loss. Because several of the most common symptoms associated with both tuberculosis and lung cancer coincide, doctors are prone to diagnosing one as the other. This problem is compounded by the fact that an image of a lung cancer patient on a radiograph can appear similar to that of a tuberculosis patient.
If a doctor performs a biopsy where suspected tuberculosis could be mistaken for lung cancer, examination of the results should differentiate the two conditions.
Pneumonia is also a fairly common condition caused by an infection that results in inflammation of the lungs. Some of the most common symptoms associated with pneumonia include cough, fever, and chills.
A radiograph image of a patient with lung cancer can also appear similar to a patient with pneumonia. However, the symptoms of the two conditions tend to vary sufficiently, which often prevents doctors from confusing the two. Nonetheless, if any ambiguity is present, a doctor should perform a biopsy to ensure a proper diagnosis.
Sarcoidosis is a systematic inflammatory disease that can affect any organ, but most commonly affects the lungs. Symptoms are often vague and can include a hacking cough, shortness of breath, fatigue, lack of energy, and numerous other symptoms.
Again, a radiograph image of a lung cancer patient can appear similar to that of a sarcoidosis patient. The variations in symptoms are often sufficient to distinguish the two diseases. But when ambiguities do exist, a doctor should perform a biopsy to confirm the diagnosis.
In assessing most patients who present with a potential health problem, a doctor performs what’s called a differential diagnosis. This means making a list of possible medical conditions that could be behind the symptoms, conducting a series of tests, then ruling out different conditions that don’t match up to test results, until a definitive diagnosis can be determined. So, let’s take the case of a patient who presents with potential symptoms of lung cancer, but the doctor fails to properly diagnose the condition, and sends the patient home, saying it’s just mild pneumonia.
In order to hold the doctor legally liable for medical malpractice, the patient (usually through his or her attorney and a retained medical expert witness) will show how the doctor deviated from the accepted medical standard of care in conducting the differential diagnosis -- first walking the jury through what a reasonably skilled physician would have done under similar circumstances, and then showing how the doctor’s chosen course of treatment in the instant case failed to meet that standard.
For an overview of the legal issues in a cancer misdiagnosis case, see this introductory article.