Colorectal Cancer Missed in Colitis Patient
There is a known link between ulcerative colitis and colorectal cancer. That is why someone who suffers from colitis must undergo regular checks to see whether a tumour as formed in the rectum or bowel.
If there is a failure to carry out this surveillance and a patient's colorectal cancer is missed, the care could be deemed substandard. The patient, or their family, would be entitled to pursue a claim against those at fault.
To find out more about making a claim for medical negligence, please contact us at Glynns Solicitors.
Ulcerative colitis
Ulcerative colitis is a condition in which the bowel and the rectum become inflamed. It is a chronic condition, which means it cannot be cured; treatment is instead focused upon managing the illness, rather than eradicating it.
It is not really known what causes ulcerative colitis. It is classed as an 'autoimmune' condition, which is when the body mistakenly attacks its own immune system. It is thought the body wrongly identifies good bacteria in the gut as bad bacteria and tries to fight them off, causing the bowel to become inflamed.
This inflammation is what leads to the patient's symptoms. The symptoms of ulcerative colitis include diarrhoea (which may contain blood or mucous), tummy pain and cramps, and frequently passing stools. The more severe the inflammation is, the worse these symptoms will be.
As mentioned above, ulcerative colitis cannot be cured. Treatment is aimed at bringing a patient's symptoms under control. This can be achieved with a variety of medication including tablets to suppress the immune system and steroids to reduce the inflammation.
Complications of ulcerative colitis
Ulcerative colitis can put the bowel and rectum under tremendous strain. Having repeat flare-ups of inflammation can stretch the bowel, and can also damage the lining of the bowel wall leading to ulcers. Further complications can also arise, either as a result of the medication or the condition itself.
The NHS Choices website lists the following as potential complications of ulcerative colitis:
- Osteoporosis, where the bones are weakened by the persistent use of steroids
- Poor growth and development in children with ulcerative colitis
- Primary sclerosing cholangitis, where the bile ducts become inflamed
- Toxic megacolon, where gas gets trapped in the colon, causing it to swell
- Bowel cancer
Most of these complications are quite rare, aside from cancer where the risk is widely known. The longer the patient has ulcerative colitis, the greater the risk will be. This cancer is most likely to develop in the colon or the rectum. This is known as colorectal cancer.
Monitoring the development of colorectal cancer
Because there is a known link between ulcerative colitis and colorectal cancer, the patient should undergo regular reviews. This involves the patient having frequent sigmoidoscopies or colonoscopies, where a thin flexible tube is inserted into the bowel via the rectum. The tube has a camera attached to the end and allows medical practitioners to see whether there are any unusual growths inside the colon.
The frequency with which these check-ups should be performed depends upon the patient's condition. Someone with severe symptoms will need a colonoscopy every year, while others who have long periods of remission (where there are no symptoms) may only need one every five years.
These reviews are very important because it will ensure any cancerous tumours are detected early on. It is much easier to treat colorectal cancers in the early stages because the tumour will be small. Over time the cancer will grow and will eventually spread, perhaps to the liver, lymph nodes or the lungs.
Once the cancer has spread the treatment will be more extensive, requiring chemotherapy and possibly radiotherapy. Whereas had the cancer been detected earlier, the patient would probably only have needed a colectomy, where part of the bowel is removed. A delay in diagnosis and treatment also makes it much less likely that a recovery will be made, thereby reducing the patient's life expectancy.
Failure to monitor a patient
If medical practitioners did not carry out this surveillance, there is a risk that the patient will develop colorectal cancer without anybody knowing about it.
The symptoms of colorectal cancer can be very similar to ulcerative colitis, so the patient may not seek medical help until there is significant weight loss and/or fatigue. That is another reason why regular monitoring is important, because the tumour may not cause any problems that the patient considers abnormal until the later stages.
It is the duty of the patient's GP to recognise that follow-up is needed and to refer the patient to hospital for a check-up. It is also the duty of the hospital to ensure that the patient receives regular appointments and that their care is not overlooked due to administrative or communication errors.
If mistakes such as these are made and clinicians do not realise that a patient's follow-up is overdue, the level of care could be deemed substandard. If the patient develops a colorectal tumour but this remains undiagnosed due to the lack of surveillance, there could be a case of medical negligence.
This is because had the patient received an acceptable standard of care, he/she would have undergone regular monitoring, the tumour would have been detected early on, the treatment would have been less extensive and more successful, and on the balance of probabilities the patient would have made a full recovery.
But due to the delay, the patient experienced a prolonged period of pain and suffering while they lived with an undiagnosed tumour. The treatment would have been more invasive and less effective. Ultimately the patient may not survive or may have a shortened life expectancy.
Talk to a solicitor
If you or your loved one has suffered due to missed colorectal cancer, there could be a case of medical negligence. If so, you will be legally entitled to pursue a claim against those at fault. This might be a GP for failing to realise that a follow-up was needed or failing to make a referral to hospital. There may also be grounds for a claim against a hospital for allowing follow-up to be lost. To find out more, please do not hesitate to get in touch.
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