In its March 2019 report on waiting times for cancer treatment, the National Audit Office highlights that 1.94 million NHS patients with suspected cancer were referred urgently for diagnosis in 2017/2018.
The standard set by NHS England is that patients referred on an urgent basis by their GP with suspected cancer should be seen by a specialist with two weeks. The government has pledged that there should be a maximum of a 62 day wait between any urgent referral and subsequent treatment. Unfortunately, due to increasing pressures on the NHS, the NHS was unable to meet these targets. Only 78.6% of patients were treated within 62 days.
What difference does delay in cancer treatment make?
Any diagnosis of cancer brings with it all sorts of worries and concerns for the individual and their family. Delays in diagnosis and treatment increase the severity of the condition, the risks associated with treatment, and the chances of recovery. In some cases, the shock, fear and uncertainty during the uncertainty of the diagnosis, treatment and recovery process are so great that they can lead to psychological injury, particularly where medical errors, delays and miscommunication expose the patient to further, more radical, invasive or extensive treatment, to the growth or spread of the cancer, to higher risks of recurrence or to lower chances of survival.
At Boyes Turner, our experienced medical negligence lawyers have helped clients and their families recover compensation following delays in treatment of many types of cancer. Some of the most common cancer delay areas where we can help are described below.
In cases of cervical cancer, delays may be caused by communication failures, misinterpreted or incorrectly reported smear test or other investigations. A delay can result in the advancement or spread of the disease, and the woman needing more extensive treatment than they would have needed without the delay. It may also affect survival chances and risk of recurrence.
The dangers of delayed treatment of cervical cancer highlight the importance of early detection via regular cervical screening. The importance of screening cannot be underestimated. Screening can highlight abnormal cells which can be treated at an early stage before they develop into cancer. If caught at an early stage, treatment for cervical cancer may avoid the need for as invasive treatment, such as chemoradiotherapy and brachytherapy. As the cancer reaches later stages, radiotherapy becomes necessary and this can have life-changing consequences, such as permanent damage to other parts of the body, as well as leading to infertility. As well as the physical consequences, there is increased emotional distress too.
There has been a decline in the number of women taking up cervical screening and as a result there has been a drive to encourage women to attend screenings and research into alternative ways to screen for cervical cancer. Free HPV vaccination is now taking place amongst teenage girls and will shortly be extended to boys to reduce cervical cancer from HPV infection. We hope that as a result of such initiatives the suffering that is caused by cervical cancer will be greatly reduced in future.
According to Cancer Research UK, breast cancer is the most common cancer in the UK. In England, women between age 50 and 71 are offered breast screening every three years. Genetic testing can also be carried out in women with a strong family history of breast cancer. Breast cancer screening and early treatment saves lives.
As with cervical cancer, in cases of delayed treatment of breast cancer, patients may require more extensive treatment, such as mastectomy, and may also require additional treatment such as radiotherapy and chemotherapy which they may not have needed at an earlier stage.
A number of high-profile campaigns have been run over the past years which have raised awareness of the symptoms of breast cancer and the need to see a doctor as soon as symptoms arise. Symptoms of breast cancer can include finding a lump, developing pain in the breast, skin changes such as puckering, dimpling or a rash, and changes affecting the nipple, such as a nipple becoming inverted or leaking.
Delays in diagnosing breast cancer can be due to an incorrectly interpreted mammogram, misunderstandings and miscommunication, inadequate examination of the patient or failing to attach significant importance to the patient’s reported symptoms.
One of the main consequences of a delay in breast cancer diagnosis and treatment is that a patient who may not have needed adjuvant therapy, i.e. radiotherapy and chemotherapy, may require such treatment. Such treatment carries risks to the breast skin and tissue which can make future reconstruction difficult. Radiotherapy and chemotherapy can also cause damage to other internal organs.
Brain tumours can cause a range of different symptoms depending on where they are located in the brain. According to the NHS website, such symptoms can include headaches, seizures, nausea and vomiting, visual and speech problems. A person can also undergo mental or behavioural changes such as memory problems or changes in personality.
In delay cases involving treatment of malignant brain tumours, a tumour can increase in size during a period of delay and, depending on the location of the tumour, this can have neurological as well as ophthalmic (visual) consequences. Treatment for a brain tumour will depend on various factors which include the size of the tumour and how far it has spread. Often treatment will include surgery. In cases of cancerous tumours, delay can lead to the tumour growing in size and affecting a wider area of the brain. This can make surgery for difficult and also recovery more complicated as, depending on what part of the brain is affected, the patient can suffer permanent neurological, speech and language, or visual impairment. As with any cancer, delay also increases the risk of the cancer spreading which may result in more extensive treatment and a worsened long-term outcome or prognosis.
We have experience dealing with cases involving delays in diagnosing Ewing’s sarcoma, a rare cancer which forms in bones and soft tissue. This type of cancer primarily affects young people and delays from misdiagnosis can often arise when the doctor mistakes the child’s symptoms for ‘growing pains’.
Similarly to the types of cancer already mentioned, periods of delay give cancer the opportunity to spread, making treatment more difficult and the prognosis, or long-term outcome, worse.
What is being done to reduce cancer delays?
NHS England has committed to increase the proportion of patients diagnosed with cancer at early stages from 50% to 75% by 2028. Its plans include:
- setting a new cancer diagnosis standard from April 2020 to ensure patients find out whether they have cancer within 28 days of their first appointment with a specialist;
- rolling out Rapid Diagnostic Centres across the country from 2019;
- committing up to £200 million to help improve cancer diagnostic services;
- working with Health Education England to train additional staff, including endoscopists, histopathologists and radiographers.
What compensation can I claim for cancer treatment delays?
Boyes Turner’s experienced clinical negligence specialists have recovered compensation for clients who have suffered severe physical and psychological injury caused by negligent delay in diagnosis and treatment of cancer. Each claim is valued according to the individual client’s own injuries and circumstances, but successful claims commonly include compensation for:
- the pain, suffering and disability caused by the delay;
- loss of earnings and pension;
- home adaptations to meet the injured client’s needs;
- specialist equipment to regain independence;
- costs of care and household assistance;
- costs of rehabilitation and therapies, including counselling if there has been psychological injury;
- costs of private treatment, if required, such as IVF fertility treatment;
- compensation for the bereaved, dependant family (in fatal cases);
- other expenses arising from the negligence, such as the cost of travel for hospital appointments.
If you or a family member have been injured or bereaved owing to cancer treatment delays, and you would like to find out about making a claim, contact us by email email@example.com.