Another cancer report

THE PUBLICATION of another report into cancer misdiagnosis is a further indictment of our health system.

THE PUBLICATION of another report into cancer misdiagnosis is a further indictment of our health system.

This time the problem centres around the work of a locum consultant radiologist who worked at the Louth/Meath group of hospitals from August 2006 to August 2007.

Nine patients had their diagnosis of lung cancer delayed by up to 14 months as a result of errors made by the specialist. The Health Service Executive (HSE) report into the affair concluded the delayed diagnosis had shortened the lives of six of the nine patients.

Eight people suffered delayed palliative care. And in the case of one woman, a 60 percent chance of cure by surgery was lost as a result of a missed diagnosis.

Lung cancer has one of the worst prognosis of all human cancers. It is typically diagnosed late, not due to medical misadventure, but because the symptoms of lung cancer manifest themselves late in the illness.

At best, just 15 per cent of one type of lung cancer is suitable for potentially curative surgery at diagnosis. In addition, tumours appear as shadows on a chest X-ray and can be difficult to detect.

Of the 5,835 chest X-rays and 67 CT scans re-examined by the review, some six per cent showed either a cancer or another unreported finding. By international standards, it suggests the consultant's error rate was in the normal range. It is a reminder that medicine is not an exact science and that even with the best equipment and expertise, errors will occur. But these caveats offer scant consolation to the families who have watched loved ones suffer because of a late diagnosis.

A particular strength of this report is the holistic approach adopted by lead author Prof MX Fitzgerald, Emeritus Professor of Medicine at UCD. He met privately with all the families and has relayed their anger and other feelings to the HSE. Facilitating such an in depth narrative for the survivors of the tragedy is an important step.

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However, compared with previous reports into breast cancer scandals carried out by the Health Information and Quality Authority, the review lacks forensic depth.

The delay in starting the inquiry is clearly unacceptable and many of the clinical governance issues raised in the report are similar to those highlighted by Ms Justice Harding Clark in her examination of the practice of Dr Michael Neary in the same region.

Coupled with this week's decision by the Minister for Health not to implement a planned cervical cancer vaccine programme, it suggests prevention is not high on the health agenda.