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A disturbing study reported in the journal Cancer reported that misdiagnosis of cancer is much more common than realized. Worse, the authors concluded that many of the misdiagnoses caused serious harm to the patient. Time is the key element for people with treatable cancers. Treatment for many types of cancers has improved so that complete recovery and long-term survivability is no longer a surprise.

That picture changes drastically for the worse if a tumor metastacizes to parts of the body distant from the original tumor. The starkest example is probably skin melanomas, most of which can be readily removed with complete success in their early stages, but which are generally untreatable once they have spread. The journal article highlighted problems with tissue samples as a serious cause of misdiagnosis. Another significant cause is the failure of the patient’s doctors to follow up adequately on suspicious symptoms or laboratory findings, to perform the basic task of ruling out potential harmful causes until the origin of the symptoms or findings are known.

Many a “successful” cancer misdiagnosis case in the legal system arises when a person dies or has a significant likelihood of a cancer recurrence because their primary care doctor misunderstood the significance of a suspicious symptom or simply failed to learn its cause. Such lack of follow-up can have more serious consequences than outright patient abandonment. At least if the patient knows his doctor is discontinuing his care, he can take steps to find another physician. If the doctor has dropped the diagnostic ball, the patient may not realize it until it is too late.The best primary care doctors are medical detectives who treat their patients’ unexplained troublesome symptoms as clues which must be followed until the medical culprit is apprehended.

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