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Patients with carcinoma of the bowel tend to present to their GP with a history of rectal bleeding and altered bowel habit. This may be accompanied by abdominal pain and weight loss. Following examination, GPs should refer patients to a specialist bowel surgeon. The bowel surgeon should then repeat the examination and perform a proctoscopy and sigmoidoscopy. Investigations should be arranged to include a full blood count, liver and renal function tests, chest x-ray and barium enema. Lower gastrointestinal endoscopy using fibreoptic endoscope may then be organised and biopsies taken of the suspicious area. Staging investigations will also include CT scanning.
Delays in Diagnosis
Treatment depends on the stage and site of the tumour. If it is confined to the bowel, surgery (colectomy, resection, proctectomy) will be performed. Depending on the type of cancer (Dukes A, B or C) patients may be offered adjuvant chemotherapy (with Dukes C colon cancer) or radiotherapy (with rectal cancer).
If bowel cancer is diagnosed early the chance of being cured is normally good. To succed in a medical negligence claim you need to prove that the delay affected the outcome. Usually this means you need to prove that during the delay the cancer progressed to a more advanced stage. Therefore, delays of a few months are unlikely to be enough. However if cancer is left, it is likely to grow and can spread to other parts of the body. Mistakes in diagnosing bowel cancer can therefore be very serious. Claims may be brought for:
- Failure to carry out an adequate examination or take an accurate history
- Failure to refer a patient to a specialist bowel surgeon for further investigation
- Mistakes in interpreting the investigations
- Mistaken diagnosis of bowel cancer
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