Cancer of the oesophagus characteristically presents with difficulty in swallowing, with food tending to stick in the patient’s throat. It may also be associated with weight loss, chest pain or a cough. GPs should refer patients to a specialist thoracic or gastrointestinal surgeon who should perform an examination and organise investigations to include full blood count, biochemical profile and chest x-ray. This should be followed by a barium swallow and fibreoptic oesophagoscopy where biopsies are taken. Staging investigations will also include CT scanning.
Treatment depends on the stage and site of the tumour. If confined to the oesophagus, surgery (an oesophagectomy) may be performed. Radical and palliative radiotherapy may also be offered as treatment.
The prognosis of oesophageal cancer is often poor and therefore medical negligence claims are often difficult to prove. 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.
However, mistakes in diagnosing oesphageal cancer can be very serious. Medical negligence claims may be brought for:
- Failure to carry out adequate examination or take an accurate history
- Failure to refer a patient to a specialist thoracic or gastrointestinal surgeon for further investigation
- Mistakes in interpreting the investigations
- Mistaken diagnosis of cancer of the osephagus
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