Misdiagnosis: Malpractise?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

julios
Regular Member


Date Joined Jun 2010
Total Posts : 38
   Posted 9/23/2010 6:58 PM (GMT -6)   
Last Spring I had a DRE and my uro got a scared look on his face and said it was VERY abnormal. He did a biopsy a couple days later and confirmed PCa with Gleason score 9.

Backup in time 4 years earlier:
During a routine physical at age 49 my primary care doc did a DRE and believed something on the left side of the gland to be abnormal. He sent me to a urologist with a report of what he'd observed. The uro did a DRE and felt the same abnormality, but wrote it off as the seminal vesicles causing that feeling. My PSA was 1.67.

For the next three years I had two trips to my primary doc, but no DREs were done. Finally, after close to 4 years after that first DRE the doc did another DRE and said there is still something really wrong on the left side. So a trip back to the same uro finally led to the diagnosis. Upon consultation with the uro after receipt of the biopsy report, he said I had likely had PCa for at least 4 years.

I have read a lot of research on the benefits of catching PCa early, especially aggressive ones like mine. If left untreated too long, the cancer extends beyond the gland and into other surrounding tissues, including the lymph nodes, making curative surgery more difficult.

I had RRP early this summer. The pathology report grades it at pT3b. My first post op PSA was detectable, so now I have to have radiation before getting a chance to recover from ED. My surgeon (Fagin) tells me my ED and urinary status will be forever frozen about at the level it is at the time radiation begins.

I'm feeling if I had caught it 4 years ago, I could have improved my chance for curing this, and certainly would have avoided the radiation and HT, and could have recovered from ED.

Ive never contemplated suing anyone; not really my style. but now I'm feeling there may be some malpractice here. I would really appreciate hearing others thoughts. ALao, any tips on where to get answers on this?
Age 52

At Diagnosis of PCa, had Gleason 9 and normal PSA

Radical Prostatectomy on July 7th, 2010 by Dr. Fagin using daVinci

25% to 50% nerves spared on left, 100% spared on right.

Continent from day one.

Pathology showed postive margins and extension beyond gland, including seminal vesicals and lymph nodes. Stage upgraded to T3b.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6898
   Posted 9/23/2010 7:21 PM (GMT -6)   
My first thought was - did you insist that the GP do a DRE each year, and he refused? The GP reacts to reported problems, unless you ask for and pay for a full-blown physical.
 
The uro? maybe he did not catch it, but did you insist, and go back for a recheck?
 
My GP does not call and insist that I come in unless I miss an appointment I scheduled.
 
In my mind - the GP did what he was asked to do. The uro? Would have been nice if he had forced you to schedule a follow-up DRE in a year, but would you have done it?
 
I don't see malpractice. I see all of us, who don't want to go see doctors unless a vital part is falling off.
 
 (let me add, lest someone think badly of me - )
 
I am not saying you are responsible, just that perhaps no one is. I did not even think of a PSA until age 56, and it was a nurse who suggested it. First one was the only one, and the worst.
I did not ask, and no one is obligated to force tests on me.
I came back a G 4+5 after surgery. Was it 6 months old? 10 years old? No one knows, nor will they.
I return to my original premise - men do no generally go looking for problems. I, for one, go to the doc when I have issues I recognize. Period. No symptoms, no appointment.

Post Edited (142) : 9/23/2010 8:43:34 PM (GMT-6)


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 9/23/2010 7:32 PM (GMT -6)   
Julios, This is an awful story. It is bad enough to have PCa, but to have your doctors miss it so blantantly is a crime. I honestly don't know if you have legal reecourse. You probably need to talk to a lawyer, but you have a serious medical condition. Don't let this legal issue side track you from dealing with your PCa, It's your top priority. Best of luck. BB
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3634
   Posted 9/23/2010 7:47 PM (GMT -6)   
Julios, four years ago, at age 48, PSA 1.67, did anyone even MENTION ordering a biopsy?? Having your PSA tested at least every year? I've had 10 DRE's , by 8 different doctors, and only 2 ever thought I was "abnormal" right up until the time of my surgery..So I would put little faith in DRE exams.

Malpractice?? for what?? PC in a 48 year old is quite rare. Gleason 9 is equally rare. If doctors ordered biopsies on every man who had an "abnormal" DRE and a PSA under 2.0 there would be open rebellion at the vast numbers of negative biopsy findings. It's bad enough now, with 75% of prostate biopsies coming back negative.

Look at my history. I'm not happy, but I'm not suing anyone..
Age 68.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 9/23/2010 8:03 PM (GMT -6)   
Julios,

I also had a bulge felt by my primary physician. Sent to URO, did biopsy, no PC, just HPINS.

Year and few months later went to another Uro for kidney stones. He did a DRE also, felt bulge, and did a biopsy. Gleason 9.

Surgery at Cleveland Clinic, clean margins, 15 month PSA <.01.

I say all this to say

Gleason 9 is a nasty, aggresive form of prostate cancer. It grows very quickly

You have no way of knowing when the HPINS became cancerous. I would say as a non-doctor, that 1.67 indicates you didn't have very much if any PC at the time

You can beat yourself up, you can sue the doctor and spend a lot of money on lawyers, and maybe you can get something, the odds are as a non-lawyer, you can't.

You can just accept that it is what it is, and concentrate your efforts on fighting the disease, not the doctor. You need all the mental strenght, all the physical stamina, and well being .

This disease is a son of a b. You will find guys with a Gleason 6 on here who had 5 % volume , and had to have SRT. You will find guys who have Gleason 8's or 9's who are still doing ok without the radiation. There is not a lot of rhyme or reason sometimes.

I certainly am not telling you what to do. I have had to go through a lot of thinking on this whole thing, and I have found that just accepting the hand I am dealt, and playing it, has given me a lot more peace than wishing for an ace.

I do wish you the best of luck. Hopefully the PSA will go down on the next test,and some of your worry will be for nothing. On the other hand, many men here have gone to the next step and done very well.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 9/23/2010 8:03 PM (GMT -6)   
Julios,

I feel your pain and anger, I had a GP fail to tell me about a 3 point jump in my PSA over a period of just over a year, (full story in signature) by the time I got treatment it was almost 2 years later. I have very similar stats to what you posted, so far so good but I'm waiting for the PSA to rise.

On the advice of some here I didn't pursue legal action (yet) I was and am concentrating on dealing with recovery and the added stress of what would certainly be a bitter legal fight just wasn't worth it (yet). Notice the (yet)s I checked out the statute of limitations on malpractice and am holding my options open in case the surgery couldn't get it all. The way I figure it, no harm no foul, if my PSA stays undetectable the results are the same as if I'd had the surgery when the PSA first jumped. In my state the statute of limitations is 2 years from when you first discovered the malpractice.

Your path is yours to choose, I would agree with those urging keeping your focus on recovery, for now.
Best of luck
Dave in Durango CO
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 9/23/2010 8:24 PM (GMT -6)   
Julios,
I think you would have a difficult time proving malpractice. PC is sometimes difficult to detect (see my history). With a psa of less than two and given your age most doctors wouldn't recommend a biopsy. Also many doctors wouldn't recommend surgery for a G9 with a confirmed nodule.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2840
   Posted 9/23/2010 8:28 PM (GMT -6)   
Julios
- wishing you all the best for your battle against PCa....
- we go through different levels of grief before and after diagnosis and surgery/treatment of PCa....
5 steps of grief
1- denial
2- anger
3 - bargaining
4 - depression
5 - acceptance
- your "sue" thoughts may be tied into this...

- we all have to be responsible for our own health and well being , but that is not always possible.

-wishing you all the best for your upcoming treatment and recovery.
hugs
BRONSON

Post Edited (tatt2man) : 9/23/2010 8:47:40 PM (GMT-6)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6898
   Posted 9/23/2010 8:56 PM (GMT -6)   
Julios,
I added a note on my first response - there is no one who should hold a 40-something man obligated to go off and search for a cancer that he should not have - unless there were family histories that were "writing on the wall".
But, I did not ask either. Is my doctor responsible? Only if there were tests I was obligated to take that would reveal PCa. There were not, he did not, and I did not ask.
 
As one who went from great health to supposedly near death's door in a month, I can only wish you the best, and encourage you to move ahead with deliberate attention.
 

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 9/23/2010 9:28 PM (GMT -6)   
Regal "your own fault"... were you born without a heart?
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Listed on patholgy as PT3, but with extraprostatic extension,
microscopic invasion of the bladder neck, PT3A is perhaps the case.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain! Update 7/14/2010: When I tried changing this sig a few days after creating it, system was broken. My new rad oncologist are discussing IMRT.. though he says he can see why waiting a bit and watching the PSA on super sensitive basis might make sense. I am leaning towards IMRT.. thinking is my body is pretty strong now, i'm 51, and if I can rid my body of this while trying to minimize the side effects.. I dunno. No really Good answers. When I said I didnt want radiation to the point of being a veg.. I really meant there is a limit as to where I wish to go in order to realize only a small increase in life expectancy.. and not that I am an unreasonable person. I do, after all, have an obligation to my wife and kids.

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/24/2010 6:24 AM (GMT -6)   
Julios, was sorry to read of your story. I can definitely understand your anger over the situation but in all honesty do not see you winning a lawsuit which would be very expensive and lengthy.

My husband's PSA jumped up about 4 years before his diagnosis (he was 53 at the time). DREs performed by both his "regular" MD and the urologist revealed nothing, as did the biopsy. Four years later, when another big jump in PSA occurred during a routine annual physical, he was sent back to the urologist for another biopsy...this time, it came back positive in 2 out of 10 cores with a Gleason 3+3 and 3+4. He had surgery in March 2008, and his stage was upgraded from a T1c to a T3a (clean margins, etc. but EPE was noted in one small area). Is it likely that the cancer was there four years earlier...I would have to say "yes" but with a negative DRE and biopsy, there was nothing any doctor could do.

Yes, it's possible that if your cancer had been caught 4 years earlier it might have been "curable" but it's also very possible that your cancer was at a more advanced stage and would have required additional therapies. There's just no way to know and no way to prove it.

I do hope that you find some peace of mind and lots of hope from those here who are in the same situation, but I am sorry that you are facing it.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0, September 2010 0.0.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 9/24/2010 6:30 AM (GMT -6)   
Have heard of other cases even worse than your example, which agreed is still less than perfect medical practice. There are some lawyers whom specialize in this area...and would need to be very knowledgable in order to prove their cases and also use expert(s) testimony type witnesses to testify. I have heard of a case or two whereby a patient won, based upon similar idea of being diagnosed to late, based upon various errors or similar type scenario. I doubt it is easy to win such in court. It is also very difficult to pin point a PCa patients risks...but alot of mistakes are basically made and way to often which is pointed out by some of the leading oncologists. This is why patients helping other patients whom know some of these overlooked or questionable things, might help steer another to get further opinions, certain testings, or re-evaluations. Everyone is under the false security that because you have a doctor, he is automatically an expert and specialist in PCa if you need examples many on this forum could write them down, part of it is the disease itself is very strange to diagnose and comprehend...full of exceptions etc. Hope you can deal with this and make no endorsement as to what you do.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2216
   Posted 9/24/2010 6:40 AM (GMT -6)   
Hope that you focus on recovery and then later look at legal action, but adding a lawsuit to your plate now would not improve your health. Hope all goes well and keep us posted.
Michael

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 9/24/2010 6:55 AM (GMT -6)   
Sorry, very sorry, to hear about your situation

Is not the pertinent question "Why was no biopsy done at the beginning?"
If it was believed to be a seminal vesicle problem then should that not have been treated or followed up to see if it had gone away. Did nobody say "Come back in 3/6 months and we will have another look/feel."? if not why not? I can however understand that a low PSA would make them think PCa was not so likely.

Hard for me to compare to my own situation. With me nothing was detectable with a DRE. I'd simply had a routine health check at a time when I had never even heard of PSA testing and it came back with a PSA of 8.6. It was the high PSA that made them want to do a biopsy when I was only 48.

I can understand that you feel bad about this, but I think however that what matters is your health and you should concentrate your physical and mental energy on dealing with the medical problem, which as we all know can call for a great deal of effort.

All the best
Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
Tired
BMs weird
14 Sep 10 PSA <0.1
Erections OK

NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 9/24/2010 7:39 AM (GMT -6)   
"Small, smooth, and firm". My husband would report with smugness the results of his annual DRE during his total physical. I know if anything other than that had been detected, his PCP would have had him go for further tests IF IT HAD BEEN A CHANGE. I have no idea what medical protocol is for obvious abnormality at original DRE. However, with prostate cancer at the top of the list for men's cancers, it seems as though it would have generated more alarm bells. An experienced lawyer would know.

At this point, however, stress is a major inhibitor to the healing and repair work your body needs. If malapractice suits are "not your style" then fighting against your nature is exactly that - a fight at a point in your life when you already have a huge one on your plate. I hope that you are able to focus all your energies on healing. I wish you all the best with your care.
Husband 60yrs., no symptms: PSA 10/04 2.73, 12/06 3.64, 5/09 3.9, 10/09 4.6, 1/10 5.0w/ free PSA 24
6 core biop 4/1/10 path rept: rt mid: adnocarc. G=3+3, 5% of core; R apx v. susp. minute ca, R base bnign w/ mod. atrophy, L side atrphy only; 2nd opnion JH confrmd
MRI - 15mm nodule
BiLatRP surg 7/6/10, path: T2c, nodes, sem.ves, extra caps. neg., adenoc both sides G=3+3 cntinent, Viagr-8/27 ED

Jim is sick
Regular Member


Date Joined Mar 2010
Total Posts : 118
   Posted 9/24/2010 10:30 AM (GMT -6)   
Fairwind said...
PC in a 48 year old is quite rare.
48 is pretty close to 50, and I've always been told at 50 the chance of having PCa is roughly the same as your age from that point forward. 48 to 50-ish% is not rare.
48, 5' 8", 210lbs, 170lbs, good health.
8-7-09, 3.22
11-13-09, 4.25.
2-12-10, 32 cores. 3 reveal PCa, 10%, Gleason 3+3=6, T1C.

Current Treatment: AS, next appt. Oct. 2010. No meat, no dairy, lots of fruits, nuts, veges.

Preferred Treatment: I just want someone to harvest my immune cells, genetically engineer them to fight my prostate cancer, and then infuse them back into my body.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3634
   Posted 9/24/2010 10:41 AM (GMT -6)   
"As men increase in age, their risk of developing prostate cancer increases exponentially. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 39 for ages 40 to 59, and 1 in 14 for ages 60 to 69. More than 65% of all prostate cancers are diagnosed in men over the age of 65."

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/24/2010 10:45 AM (GMT -6)   
I had posted somewhere in the past a table that outlined the number of prostate cancer diagnosis by age group. I fell into a category that had only 1500 or so for my age group (40-45) for a 5 year period. And it was just a few hundred for under my age group. it is indeed very rare for a 44 year old man to be diagnosed with advanced disease but we have quite a few members here.

I just attribute it to bad luck...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 9/24/2010 2:13 PM (GMT -6)   
Hey Julios,

Look at my stats. I was in a very similar situation. I had my 50 year physical at age 52 but my GP did not order a PSA ( it would have been my first) because he read a study that said men with no symptoms, no cancer in the family and normal DRE lead to over treatment and only saved one manin 1000.

Now look at my stats. My first PSA was 17.8 Biopsy up to 70% 7/12
I am incontinent and have ED. Would I be sitting here wearing pee pads if my GP had ordered the test during my "complete" physical? - I'll never know.
Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%. 8/9/10 Now at 0.24 still 90%
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. "There must be another issue."
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 "Short sphincter"
7/15/2010 one year: 2 pads per day. 140 ml/day, dry in bed.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04
1/14 6 months - 0.05 (Siemens Centaur)
4/14 9 months - 0.04 (Siemens Centaur) and <0.01 (Roche ECLIA).
7/12 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/24/2010 3:06 PM (GMT -6)   
Julios,  Just google "prostate cancer malpractice".  You can get a good idea about recent cases.  The operative words that show up frequently: failure to detect, failure to screen, delayed screening, uro knew or should have known. In one case the uro followed the screening guidelines but it didn't make any difference in the case - the uro lost. 
 
Carlos

julios
Regular Member


Date Joined Jun 2010
Total Posts : 38
   Posted 9/24/2010 4:28 PM (GMT -6)   
Thank you all, for taking time to give me your impressions. It really helps. Jeff (worried guy), I really feel for you; thanks for sharing that. Our conditions are similar, except I have seminal vesicles and LN involvement in addition.

Actually, I have no anger at anyone. And I really do try to live my life living up to my responsibilities, and as a dad and as a staff supervisor, sometimes that includes ensuring others live up to theirs. From what I've read, performing a biopsy when such an abnormality is found is the current recommended practise. Back then, I knew nothing about PCa, PSA and biopsies, and had experienced my first DRE. I was too uninformed to even think about a biopsy or a second opinion. And I was never told to have it checked again. Im smart enough to eat right and excersize, and to go to the doc when something hurts. But back then I wasn't smart enough to ask for a biopsy. I was just glad the doc said I was ok. I'm expert in my job and do my job pretty well, and rely on others with the right expertise to do theirs. I may not have a good case, but if there is someone out there who isn't doing their job right, they may hurt someone else if no one says anything.

Carlos, thanks for the google search. I have done that as well, but need to do more.

I have my surgery behind me and my followup treatment determined, and will of course always keep that priority #1.

BTW, my surgeon, Dr Fagin, was not the one who misdiagnosed me. I highly recommend
Dr Fagin.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3634
   Posted 9/24/2010 5:12 PM (GMT -6)   
Julio, the only thing i could offer,...That first Urologist you went to, the guy who thought it was the vesicles causing the lump, that doctor should have taken notes during that examination as to what he found and recommended..Those notes may still exist. Your chances of ever seeing those notes are slim to none, but it might be worth a try..Be warned, if you just walk in and ask to see the notes in question, the doctor will know there might be a problem and if the notes turn out to be incriminating, they will certainly disappear.

Sometimes, during one of these DRE exams or similar moments the doctor may be saying things that you will have no recollection of the next day..I know this has happened to me...

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 201
   Posted 9/24/2010 8:52 PM (GMT -6)   
Julious-I think prevailing in a malpractice action would be difficult.
However, it does seem like the uro should have done a biopsy when he felt an abnormality during the DRE.
 
But biopsies don't always find the cancer.
Several members have had high PSA's and multiple biopsies before the cancer was found.
Also, you'd have to prove an earlier detection would have resulted in better results following treatment.
And prove you would have pursued treatment with a positive biopsy if you were a candidate for AS.
 
Too many uncertainties.
 

jxmuldoon
Regular Member


Date Joined Nov 2009
Total Posts : 43
   Posted 9/24/2010 8:59 PM (GMT -6)   
Julious,

See a medical practice lawyer. Doing so is free. They work on a contingency basis. Only an experienced malpractice guy can assess your case. Everything depends on the facts.

I think your early doctors screwed up, and may continue to screw up. Perhaps a lawsuit will cause them to be more careful in the future. You will do other men a favor by checking this out.
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, April 25, 2018 2:27 PM (GMT -6)
There are a total of 2,955,594 posts in 324,232 threads.
View Active Threads


Who's Online
This forum has 162233 registered members. Please welcome our newest member, Miner76913.
365 Guest(s), 11 Registered Member(s) are currently online.  Details
spouse21, island time, Sr Sailor, Goose2018, Girlie, BillyBob@388, blksteeda, InTheShop, Busted1, IntestinalWasps, Tall Allen