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Paul McNeil, Head of Personal Injury and Medical Negligence
Patients with pancreatic cancer generally present with symptoms which include abdominal and back pain, weight loss, anorexia and fatigue. Many patients are asymptomatic until they present with obstructive jaundice. Because of the position of the tumour, late presentation is very common. GPs who suspect their patient has pancreatic cancer should refer them to a general surgeon or gastroenterologist where investigations should include full blood count, renal and liver function tests, measurement of serum levels of tumour marker C19.9, a chest x-ray and abdominal CT scan.
Following these initial tests patients should proceed to endoscopic retrograde cholangiopancreatography (ERCP) during which cytology samples will be obtained by biopsy or suction of the pancreatic duct.
Delays in Diagnosis
Up to 90% of patients present with advance disease which is surgically inoperable. For the few patients who are operable, they should be referred to a surgeon with expertise in pancreatic surgery. Those with inoperable disease tend to have a very poor prognosis. They are can be treated with palliative chemotherapy or a coeliac axis block which block the pain nerves.
Mistakes in diagnosing pancreatic cancer can therefore be very serious, particularly if the opportunity to undergo surgery is lost. To succeed 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. Medical negligence 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 for further investigation
- Mistakes in interpreting the investigations
- Mistaken diagnosis of pancreatic cancer resulting in unnecessary surgery
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