Failure to Diagnose & Delay in Treatment of Colon & Rectal Cancer

Evaluate breaches in the standard of care for Failure to Diagnose & Delay in Treatment of Colon & Rectal Cancer

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Change in bowel movement patterns
    Symptoms not elicited
    Answer unknown
    Dark colored stools/blood in stools/rectal bleeding
    Weight loss
    Weakness/fatigue
    Presence of abdominal mass
    Why is this important?
    The most common symptoms of colon/rectal cancer includes abdominal cramps, bloating, gas, change in bowel movement patterns, rectal bleeding, presence of an abdominal mass, weakness, fatigue and weight loss.
    (2007) 35 EMEDIC 6 48-51

  • Which of the following risk factors did the patient exhibit? (Choose all that apply) Why is this important?
    Answer this question
    Risk factors are useful for identifying subjects at increased risk for a disease or for a particular outcome that results from a disease process.
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  • Was a physical examination performed and documented? Why is this important?
    Answer this question
    A physical examination is necessary for any patient presenting with a positive medical history and clinical symptoms suggestive of colon cancer. Patients presenting with clinical symptoms suggestive of colon rectal cancer must undergo a thorough physical examination. The exam must include botha detailed and careful abdominal and rectal examination.
    (2007) 35 EMEDIC 6 48-51

  • Was a routine screening for colorectal cancer recommended for the asymptomatic patient? Why is this important?
    Answer this question
    Colorectal cancer causes symptoms in only 10% to 15% of patients. Therefore, screening is necessary for asymptomatic at risk individuals.
    (2002) 82 ESRCNA 5 943-957

  • Which of the following diagnostic screening tests was recommended? (Choose all that apply) Why is this important?
    Answer this question
    Four organizations have proposed guidelines for colorectal cancer screening. The most comprehensive guidelines were jointly developed by the American Gastroenterological Association (AGA) and the Federal Agency on Health Care Policy and Research (AHCPR).
    (2002) 82 ESRCNA 5 943-957

  • What was the outcome of the screening test? Why is this important?
    Answer this question
    If the results of the physical exam or blood tests suggest that colorectal cancer might be present, further diagnostic studies will be necessary.
    (2001) 28 EPCCOP 3 661-674

  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    Regular follow up physical examinations, laboratory studies and diagnostic imaging evaluations are needed for effective follow-up care.
    (2002) 16 EHOCNA 4 907-926

  • Which of the following laboratory investigations were recommended?(Choose all that apply) Why is this important?
    Answer this question
    Diagnostic laboratory studies are vital for diagnosis.
    (2007) 35 EMEDIC 6 48-51

  • Which of the following imaging studies were recommended? (Choose all that apply) Why is this important?
    Answer this question
    Imaging studies are vital to the diagnosis and prognosis of colon rectal cancer. A CAT scan of the abdomen and pelvis is a critical diagnostic tool, is non-invasive, readily available and often used for elderly individuals.
    (2001) 28 EPCCOP 3 661-674

  • Was the patient referred to a specialist? Why is this important?
    Answer this question
    Once priorities and goals have been agreed on, referral to the appropriate professionals should be made in a timely manner. To deliver care requires a coordinated approach that allows sharing of skills and expertise. The skills of members from all professional disciplines should be utilized to enable all patients to achieve their maximum potential.
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  • To what type of specialist was the patient referred? Why is this important?
    Answer this question
    Early consultation with a specialist may be critical in the prognosis. The expertise of both a gastroenterologist and an oncologist early in the disease process may afford the patient a more positive.
    (2002) 16 EHOCNA 4 907-926

  • Which of the following diagnostic procedures were performed to confirm the diagnosis of colon-rectal cancer?(Choose all that apply) Why is this important?
    Answer this question
    When clinical symptoms, the physical exam, or results of blood tests remotely suggest colorectal cancer, further diagnostic studies must be performed. Colonoscopy has been increasingly advocated as a screening strategy of choicein colorectal cancer.
    (2001) 28 EPCCOP 3 661-674

  • Was a biopsy of the suspected lesion performed? Why is this important?
    Answer this question
    Colonoscopy is very sensitive for detection of both small and large neoplastic lesions, completely examines the entire colon and rectum, and provides the opportunity for the detection and endoscopic removal of adenomas and biopsies of suspicious mass lesions.
    (1997) 11 EHOCNA 4 579-810

  • What was the result of the biopsy? Why is this important?
    Answer this question
    Biopsy is used as a definitive diagnostic tool for all rectal cancers before undergoing elective treatment.
    (2007) 35 EMEDIC 6 48-51

  • Was a biopsy recommended? Why is this important?
    Answer this question
    Biopsy is used as a definitive diagnostic tool for all rectal cancers before undergoing elective treatment.
    (2007) 35 EMEDIC 6 48-51

  • Which of the following methods were used to stage the cancer? (choose all that apply) Why is this important?
    Answer this question
    Histological staging of colorectal cancers is performed postoperatively.
    (2007) 35 EMEDIC 6 48-51

  • Was the staging work-up performed in accordance with the “American Joint Committee on Cancer”guidelines? Why is this important?
    Answer this question
    The American Joint Committee on Cancer (AJCC) adopted the tumor-node-metastasis (TNM) cancer staging system, and this has proven to be the most significant staging system.
    (2013) 47 EADSUR 1 199-211

  • Which of the following treatment options were recommended?(Choose all that apply) Why is this important?
    Answer this question
    Surgical resection of the tumor is the first choice of treatment in colon rectal carcinoma.
    (2000) 80 ESRCNA 2 535-569

  • Were pre-operative evaluations performed? Why is this important?
    Answer this question
    The purposes of pre-operative testing are to assess a pre-existing health problem, further characterize a suspected problem, influence perioperative management, and predict perioperative complications. In patients in whom some risk factor is suspected, testing is appropriate and may include a complete blood count, coagulation studies, serum chemistry (including liver function tests), echocardiography, electrocardiography, cardiac stress testing, chest radiography, pulmonary function tests, and pulse oximetry. Pregnancy testing should be done in women of childbearing capacity.
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