Doctors typically employ two tests to test males for prostate cancer. The idea is to diagnose the cancer early – before it has a chance to spread while treatment can be used to eliminate the cancer rather than wait until the cancer advances and spreads at which point there is currently no known cure. The initial test is the digital examination. During this examination the physician uses a gloved finger to physically examine the prostate gland for any signs of enlargement, hardening, or the existence of nodules, any of which could be a sign of cancer. The other test is the PSA blood test which measures the amount of prostate specific antigen in the patient’s system. A PSA over 4. ng/ml is generally regarded as high. As prostate cancer raises the PSA level when prostate cancer advances doctors generally advice a biopsy when the PSA test registers abnormally high.
When a factor other than prostate cancer triggers the PSA level to rise the elevated PSA is referred to “false positive.” A biopsy has known potential complications, such as the risk of infection and the danger of significant bleeding. Because of these 2 issues some doctors advocate that male patients use a strategy of “watchful waiting.” With this strategy the physician tracks the man’s raised PSA over a period of months or even years. They might likewise suggest starting treatments like medication for infection to see if the treatment brings down the PSA back to normal levels.
One of the problems with this strategy is that a physician may wait too long before advocating a biopsy. As the PSA increases the probability increases that the rising levels are due to prostate cancer, as does the likelihood that the cancer has metastasized. Men with prostate cancer who have a PSA concentration less than 10 ng/mL have a seventy to eighty percent chance of having organ-confined disease, as opposed to fifty percent for men with PSA levels 10 to 50 ng/mL, and just 25% with higher PSA levels
Treatment options for advanced prostate cancer may include hormone therapy, radiation therapy, orchiectomy (the surgical removal of the testicles), and maybe even chemotherapy. Treatment will normally lead to a major decrease in the PSA levels for awhile. Over time, though, treatment ceases to be effective as the cancer continues to progress. This is typically associated with a new rise in the PSA level. After the treatment no longer works, the cancer is fatal. This year, an estimated ninety thousand men will lose their lives in the U.S. from advanced prostate cancer.
What percentage of these 90,000 deaths will be because of a physician counseling the manhis patient to follow the “watchful waiting” method and then waiting too long to finally diagnose the cancer? We might never know how many of these deaths could have been prevented had the physician instead advised the patient to undergo a biopsy.
However, if you or a member of your family were among those whose physician heldup the detection of prostate cancer until it spread, you should consult with a competent medical malpractice attorney immediately. This may constitute a departure from the accepted standard of medical care and might lead to a medical malpractice claim.