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Missing the DX

Posted By Molly McGuane, Wednesday, April 17, 2019
Updated: Tuesday, May 7, 2019

It’s estimated that every year 12 million people in the United States are affected by a misdiagnosed disease or condition. Incidences of cancer misdiagnosis can be particularly concerning, unfortunately altering the course of a person’s life. In the beginning stages of many cancers, symptoms can be vague and difficult to differentiate from more common illnesses. A misdiagnosis early on can be very detrimental and potentially lethal if the cancer continues to grow and spread. While the fault of a misdiagnosis of a disease doesn’t necessarily fall on a specific doctor or healthcare team, there are steps that doctors and patients can take to reduce the instance of a misdiagnosis.

Commonly Misdiagnosed Cancers

Melanoma

Woman with a tan applying sun blockAs an unfortunately common skin cancer, melanoma takes the lives of nearly 9,000 patients every year. Melanoma is caused by exposure to UV radiation that is generated from tanning beds and from exposure to the sun. Melanomas emerge on the skin as an irregular-looking mole or dark spot on your skin, but can be easily missed or misdiagnosed.

Health care providers and patients can be more vigilant about their skin by remembering the anagram ABCDE when looking at their moles and beauty spots. “A” stands for asymmetrical, “B” for irregular borders, “C” for abnormal color, “D” is for diameter, and “E” is for evolving in shape or size. These signs shouldn’t be ignored and moles or marks with these characteristics should be tested by a pathologist.

Primary care doctors and physician assistants should also recommend that patients see a dermatologist annually or biannually based on their risk. They should also encourage patients to perform “self check-ups” regularly to be alert of any new or changing skin lesions. Extra diligence could lead to a more accurate and early diagnosis, which is crucial in skin cancer and melanoma cases.

Colorectal Cancer

In many cases, cancer of the colon or the rectum often begins as a growths known as polyps, that grow in the walls of these areas over time. The best way to find colorectal cancer early is through screenings, but the problem of misdiagnosis comes when symptoms are misunderstood and screenings are done too late.

Symptoms of colorectal cancer can be uncertain, like unexplained weight loss, fatigue, and a change in bowel movements and symptoms like these can be misunderstood even by medical professionals, especially in younger patients. Most frequently, colon cancer can be misdiagnosed as irritable bowel syndrome (IBS), diverticulitis, and ulcerative colitis due to similar symptoms including rectal bleeding and abdominal pain.

If pain continues or new symptoms arise, a colonoscopy or CT scan might be necessary to check for any serious issues. It’s also important to keep in mind that colorectal can be genetically connected and 1 in 3 people who are diagnosed with colorectal cancer have a familial connection. Understanding a patient's family history is an important step in diagnosing disease and can provide additional insight into their symptoms. While it’s on the patient to know their family history, healthcare professionals can assist by impressing the importance of knowing that history upon their patients and making sure to ask when issues arise.

Lung Cancer

Man smokingThe most widespread cancer globally is lung cancer, and it can be caused by a number of environmental factors. The most obvious reason for developing lung cancer has historically been smoking and secondhand smoke, but cancers of the lung can also arise from elements in the air and invisible and odorless carcinogens we may not even realize that we are exposed to.

Symptoms of lung cancer, and related cancers of the lung like mesothelioma, often first appear as a persistent cough, pain in the chest, or shortness of breath. These symptoms could be easily misdiagnosed as asthma, COPD, or even a common cold. Lung cancer and mesothelioma are common occupational cancers, so knowing a patient’s occupational history can also lead to a better understanding of their condition. Those who have worked as firefighters, miners, and in the construction industry are more vulnerable to carcinogens like asbestos and silicates.

Breast Cancer

Understanding a patient's family medical history can also help in being vigilant about the beginning stages of breast cancer. Breast cancer affects 1 in 8 women in the United States and the risk of a patient developing breast cancer can nearly double if a mother, sister, or daughter has also been diagnosed.

The beginning stages of breast cancer develop as a lump in the breast tissue but can be missed entirely if screening isn’t done frequently enough. Breast cancer screens are done routinely at primary care and OB-GYN appointments, and self checkups can also be performed to check for any abnormal bumps.

If there are any abnormalities in a mammogram, a follow-up imaging screening, mammogram, or biopsy should be scheduled in a timely manner so that the potential cancer does not worsen. Those who are at a higher risk for developing breast cancer need to communicate that risk with their primary physicians and specialists as well as their family history for the most accurate and timely testing.

How are we Closing the Gap?

Missing a cancer or other disease diagnosis can have regrettable consequences for patients and their families. Both healthcare professionals and those they treat can play a role in a misdiagnosis and they are an unfortunate reality of human error. However, the medical community is taking the time to learn from mistakes and invest in technology that analyzes stored data and can close the gap on inaccuracy. Being able to log patient data from around the world can help better understand symptom patterns and allow for more accurate testing, including mammograms and lung cancer screenings.

The use of artificial intelligence and telehealth in the medical field is helping connect the dots on cancer symptoms, but there is still a lot of ground to cover in perfecting these technologies in the real world. Today, AI should just be used to augment the human work of healthcare and there is still an active role doctors and other professionals can take to avoid a misdiagnosis.

Physician's assistant going over a patient's medical history.

Discussing personal, family, and occupational history and impressing the importance of gathering and communicating that information on your patients is vital to their well being. The more information you know about their health and history, the more accurately you can understand their symptoms. Recommending patients to keep up with an annual schedule of appointments and cancer screenings is another way primary care physicians can help their patients be preventative and avoid a missed or late diagnosis. Communicating closely with every healthcare provider working with the patient including nurses, radiologists and lab technicians is important for everyone’s understanding. Attention to detail and thorough communications will ensure that no important information is missed.


Molly McGuaneMolly McGuane is a communications specialist and health advocate for the Mesothelioma and Asbestos Awareness Center. She is passionate about informing others on cancer prevention and rare disease. Molly's areas of content expertise are cancer prevention, rare disease, occupational health, and asbestos exposure.

Tags:  clinical practice  emotional wellness  medical care  misdiagnoses  Physical Wellness 

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