Lung Cancer May Have Been Misdiagnosed as COVID-19 During Pandemic
The Covid-19 pandemic has adversely affected lung cancer survival rates, a report has found. The similarity in symptoms has caused confusion amongst medical practitioners, meaning some patients may have been wrongly diagnosed with the coronavirus.
More lung cancer patients are dying
A report by the UK Lung Cancer Coalition says that in some geographical regions, lung cancer referrals dropped by 75% during the UK’s first lockdown last spring. The result, according to Professor David Baldwin, a respiratory medicine consultant at the University of Nottingham, is that: “at least a third of patients with lung cancer have already died since the beginning of the pandemic”. He added that “some deaths will not have been recognised as lung cancer and may have even been labelled as Covid-19″.
Lung cancer is Ireland’s deadliest type of cancer, accounting for 19% of cancer deaths in women and 23% in men. Patient survival relies on an early diagnosis and prompt treatment. In fact, the report says that there is a “16% increase in mortality if the time from diagnosis to surgery is more than 40 days.” The report goes on to say that “a delay of three months or more can mean the progression from a potentially curative tumour towards one that is only suitable for palliative care”.
Why is lung cancer being misdiagnosed?
Medical practitioners know that an early diagnosis of lung cancer is vital to the patient’s survival. So why are GPs failing to refer patients to lung cancer specialists, and why are lung cancer survival rates decreasing? As Professor Sir Mike Richards, former director of the National Cancer Institute explains: “there is a specific problem for lung cancer, which is the overlap of symptoms with Covid-19. Some patients may develop cough symptoms and be told to stay at home until their symptoms get worse. This has resulted in an increase in late-stage presentations”.
In other words, doctors are confusing the early stages of lung cancer for the coronavirus. Both illnesses begin with a persistent cough. In the case of lung cancer, this should initiate an immediate referral to a lung cancer specialist. But in the case of the coronavirus, the medical advice is to stay at home and wait to see what happens. Doctors want to limit the spread of Covid-19, meaning those with mild symptoms are asked to self-isolate, rather than attend their GP surgery or hospital. This has resulted in some lung cancer patients being diagnosed in the later stages of the disease.
The problem with late-stage cancer presentation
As with all types of cancer, a patient’s chance of survival is greatly improved if their lung cancer is diagnosed in the early stages. This ensures treatment can be carried out straightaway, while the cancer remains relatively contained. The problem with a delay in diagnosis is that the cancer is given an opportunity to spread. This makes it much harder to treat. The report by the UK Lung Cancer Coalition estimates that “the impact of the Covid-19 pandemic could lead to an additional 1,372 deaths due to lung cancer, reversing the progress achieved in lung cancer over recent years”.
This news will be hard to bear for lung cancer patients and their families. As the report highlights, there is a short window of opportunity in which to successfully treat lung cancer. A delay of just three months can be the difference between a curable disease and a terminal illness. Sometimes, this delay occurs because a patient dismisses their symptoms and fails to seek early medical advice. But as this report shows, there are times when medical mistakes are to blame. The Covid-19 pandemic has made such mistakes all the more likely, particularly when it comes to the detection of lung cancer.
Other misdiagnoses from Covid-19
However, it’s not just lung cancer diagnoses that have been hit by the pandemic. Some countries have reported that other cancer rates have been impacted too. NHS England, for example, has said that detection and referral rates for breast cancer have been affected. To add to the problem, there is a backlog of cancer tests and treatments amongst those who are already ‘in the system’. This includes those who are known to have primary or secondary cancer. Some routine screenings were also suspended last year, making it harder to catch asymptomatic cancers in the early stages, particularly bowel, breast and cervical cancer.
In July 2020, a report published in the medical journal The Lancet concluded that: “substantial increases in the number of avoidable cancer deaths in England are to be expected as a result of diagnostic delays due to the Covid-19 pandemic in the UK. Urgent policy interventions are necessary, particularly the need to manage the backlog within routine diagnostic services to mitigate the expected impact of the Covid-19 pandemic on patients with cancer.” Similar issues are expected to arise in Ireland, where it was announced in May 2020 that routine cancer screening was to be among the last of normal non-Covid-19 healthcare services to resume.
Can GPs and hospital be held liable?
If you or your loved one has been affected by a cancer misdiagnosis, then you will no doubt be feeling angry and upset. This is perfectly understandable. You are probably seeking answers to questions such as: ‘why was my cancer diagnosis delayed?’ And, ‘is my GP or the treating hospital to blame?’ And, ‘could the outcome have been any different?’ It can be difficult to get these kinds of answers out of your doctor, particularly in the middle of a pandemic. Medical practitioners are not quick to accept blame, and the added pressures of Covid-19 are making communication all the more difficult.
Ordinarily, if your cancer was missed due to medical errors, then the GP or hospital would be held liable. Medical practitioners have a legal duty to provide their patients with a reasonable standard of care. When we consider what is ‘reasonable’, it is necessary to assess whether another competent GP, oncologist or other healthcare practitioner would have taken the same course of action. So, if you reported symptoms such as a persistent cough, fatigue and difficulty breathing, then would another GP have mistaken your lung cancer for the coronavirus? If not, then the GP has failed to provide a reasonable standard of care.
Cancer misdiagnosis and medical negligence claims
If a medical practitioner provides a substandard level of care, then the next question that must be answered is: did this cause a patient to suffer an avoidable injury? If the answer is yes, then that patient will have grounds for a medical negligence claim. Where a patient has died, their family is entitled to make a claim instead. Medical negligence claims often relate to cancer cases, particularly where a delay in diagnosis has occurred. This is because had the cancer been diagnosed earlier, then on the balance of probability, the patient’s prospects would have been improved.
This is best illustrated with an example. Imagine that Gary sees his GP complaining of abdominal pain, unexplained weight loss and blood in his stool. These are the tell-tale symptoms of bowel cancer. A reasonable GP would send Gary for further testing to either confirm or rule out a diagnosis of bowel cancer. Instead, Gary’s GP makes a provisional diagnosis of IBS and sends him home. Gary repeatedly contacts his GP complaining of similar symptoms, but time and time again he is wrongly diagnosed, without ever be referred to a bowel cancer specialist.
Finally, Gary becomes seriously unwell and his cancer is detected. But by now, the cancer has spread. He has endured months of suffering without the correct treatment. Because the cancer has advanced, he requires surgery and aggressive radiotherapy. Furthermore, he is told that his treatment might not be effective. All of these outcomes could have been avoided, had Gary been diagnosed when he initially presented to his GP. His cancer would have been easier to manage and he would have required less invasive treatment – which, on balance, probably would have been successful.
What happens if you are misdiagnosed?
Using the example described above, it is very likely that Gary would have grounds for a medical negligence claim. This is because another reasonably competent GP would have suspected bowel cancer and sent him for diagnostic tests. The GP has therefore failed to provide an acceptable level of care. In turn, this has caused Gary to suffer an avoidable injury. Namely, he has experienced a prolonged period of pain and suffering and the need for invasive treatment. He also faces a poor prognosis.
If you have a similar story – or your loved one does – then you could be in a position to make a medical negligence claim.
Medical negligence claims in the Covid-19 era
However, the lines are slightly more blurred in the Covid-19 era. While the healthcare system may be struggling, that does not give doctors and nurses an excuse to deliver a poor standard of care. Nevertheless, certain medical services have been limited following Government orders. It remains to be seen what impact this will have on medical negligence claims. Medical practitioners may be given immunity against a legal claim if, for example, your cancer was not detected because your routine screening/diagnostic test was delayed. Similarly, medical practitioners may not be accountable if your cancer treatment plans were altered.
This puts the patient in an entirely unknown position. If your cancer care was adversely affected because of Covid-19, then are you entitled to pursue a medical negligence claim? The best way to find out is to contact us at Gibson & Associates. We specialise in medical negligence claims in Ireland and can clarify your legal position. We stay updated on the latest legal developments, making us best-placed to advise you further. After discussing the circumstances of your cancer diagnosis and treatment, we will explain whether you have grounds to make a medical negligence claim.
Speak to our medical negligence solicitors
While the Covid-19 pandemic has impacted all our lives, it has had a particularly traumatic effect on cancer patients. If your cancer diagnosis or treatment has been adversely affected by the coronavirus, please get in touch. Our medical negligence solicitors offer clear, straightforward legal advice. We will advise whether you are in a position to take legal action. If so, we can manage the process on your behalf, working to get the redress you deserve.
To speak to a medical negligence solicitor, complete our online enquiry form, or phone us on+353 (0)1 872 3143 today.
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