The Roanoke Times just published an article from “To Your Good Health.” An informative and educational column on infectious diseases and public health issue written by Dr. Keith Roach, a highly respected physician at Weill Cornell Medical College. Today’s column was based upon a wife’s report of how her husband’s doctors failed to provide him with basic competent medical care.
The wife reported that her 62 year old husband had stage 4 prostate cancer. He has “metastatic disease” which means the cancer has moved outside the prostate to multiple sites in his spine, pelvis, and shoulder. His cancer is very aggressive and his prognosis is poor.
Now we get to the really bad/inexcusable part of the story….the all too common part. The husband had a routine checkup in October of 2013 which revealed (via blood test) his PSA level (prostate-specific antigen) was 11.2. An elevated PSA is a strong indicator for the presence of prostate cancer. A PSA level 0 – 4 is usually considered to be normal but, as we age, the range goes up. By age 60 a PSA of 4.5 or 5 could be normal. One thing is clear: a PSA of 11.2 for a 62 year old man is not normal. Good medicine requires the patient be informed of his PSA level, what it means, and a discussion should follow on what happens next.
What was the rest of the story for the husband? He was told nothing….nada! He was first made aware of this October 2013 elevated PSA when he is diagnosed with prostate cancer in January of 2015 (15 months later) when his PSA had risen to 85.3. He now has few, if any, meaningful treatment options.
My Take: I have seen variations of this scenario multiple times during my legal career. I have seen family doctors fail to advise their patient of a significantly elevated PSA. I have seen family doctors order PSA testing from a laboratory and then place the lab results in the patient’s chart, never looking at them for a year or more. In all of these cases, the patient died from metastatic prostate cancer.