Bowel cancer symptoms and signed can sometimes be missed – read our guide to the facts and the avenues to claiming compensation.
Bowel cancer diagnosis
Many people are diagnosed with bowel cancer as a result of their GPs spotting symptoms that may be caused by cancer and referring them for further investigations and tests.
This is a crucial service, as it gives people more chance of being diagnosed while the cancer is still at an early and more treatable stage. It poses a huge challenge for GPs, however, as they need to ensure that the people whose symptoms are most likely to be cancer are spotted out of a large number of patients who may have very similar symptoms.
Bowel cancer symptoms
When a person has potential cancer symptoms, he or she should be referred through the 'two week wait' urgent referral route and should then see a specialist within two weeks. NICE has produced guidelines for different types of cancer to help GPs to work out who needs to be referred and what kind of symptoms they need to be looking out for. In respect of bowel cancer, the guidance is that a suspected cancer pathway referral should be instigated if;
- They are aged 40 or over with unexplained weight loss and abdominal pain or
- They are aged 50 or over with unexplained rectal bleeding or
- They are aged 60 and over with:
- Iron-deficiency anaemia or changes in their bowel habit, or
- Tests show occult blood in their faeces.
In addition, the guidelines state that a referral for possible bowel cancer should be considered in people with a rectal or abdominal mass.
Additional bowel cancer symptoms
A referral should also be considered in adults aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings;
- Abdominal pain
- Change in bowel habit
- Weight loss
- Iron-deficiency anaemia.
Only about 10 people out of every 100 patients referred under the two week wait go on to be diagnosed with cancer, and there often turns out to be a much less worrying cause for the symptoms.
However, while this system can work very well to spot potential symptoms of cancer, there are occasions when symptoms are not identified and the two week referral is not made by the GP. This can lead to a delay in diagnosis of cancer. This is particularly relevant in the case of bowel cancer as many of the symptoms can be symptoms of other conditions.
Bowel cancer misdiagnosis – facts and statistics
A recent survey from Bowel Cancer UK, of patients under the age of 50, found that:
- One in five people had to see their GPs five times or more before being referred to a specialist.
- One in four people surveyed felt ignored by their GP.
People are sometimes misdiagnosed with irritable bowel syndrome, diverticulitis and colitis rather than bowel cancer being considered, especially younger people.
IBS may exhibit symptoms similar to bowel cancer such as abdominal pain, fatigue, loss of appetite and a swollen stomach and symptoms of diverticulitis include severe abdominal pain, changes in bowel habits and rectal bleeding. Symptoms can also sometimes be put down to haemorrhoids (piles). There have been instances of people being told by GPs that they are too young to be suffering from bowel cancer and their symptoms wrongly put down to a more innocent cause. It is only when the symptoms do not resolve and they return to the surgery that an urgent referral is made and the cancer detected through an MRI scan or colonoscopy. It seems that, despite the referral guidelines in relation to under-50s, that some GPs still fail to take seriously symptoms in younger patients.
Bowel cancer misdiagnosis claims
Sadly, a misdiagnosis leading to a delay in diagnosing bowel cancer can mean that, by the time the correct diagnosis is made, the cancer may have progressed and may be more difficult to treat. In some cases, the delay has meant that the cancer has spread to other organs and is no longer treatable.
What do I have to show?
In order to bring a claim for misdiagnosis or delay in diagnosis of cancer, it needs to be shown that the GP acted unreasonably in not making an urgent referral to a specialist and that the care provided was sub-standard. In addition, it needs to be shown that diagnosing the cancer earlier would have made a difference to the overall outcome.
Some cancers are so aggressive that an earlier diagnosis would not have made any difference to the patient's prognosis. The delay also usually needs to be long enough to have made a difference, usually at least several months. This is something that an Oncologist would need to consider and comment upon and when investigating a potential claim we would obtain all of the patient's medical records and ask a specialist to comment on the treatment provided.
Even where a patient has been successfully treated, more radical treatment may be required than would have been the case had the cancer been detected earlier.
A claim can also sometimes be brought by the family of a patient who has died as a result of bowel cancer if it can be shown that a misdiagnosis led to their death or led to their death occurring sooner than it would otherwise have done.
If you are concerned that your GP is not taking your symptoms seriously, ensure that you keep returning to the surgery if the symptoms are not improving. Raise any concerns you have and make sure the GP is fully aware of all your symptoms, sometimes people are reluctant to discuss what they consider to be embarrassing symptoms however the GP needs to have all of the information in order to consider whether an urgent referral is appropriate.