Male patients are likely to possess a lack of understanding of prostate cancer, their own chances for the cancer, and the ways in which they can figure out whether they have prostate cancer. Many male patients are not aware of what it means to test for prostate cancer or that screening should be undertaken prior to when they manifest symptoms. They simply put their belief in their physician to let them know what they have to do to stay healthy.

Delayed diagnosis of prostate cancer cases are all too common. One typical medical error that is at the root of these cases takes place when the male patient’s primary care physician (1) orders a PSA blood test, (2) finds that the individual has a high PSA level, but (3) does not inform the patient, does not refer the patient to a specialist, and fails to order a biopsy to confirm whether the elevated PSA is because of prostate cancer. The case below shows this problem.

A physician, an internist, found out that his male patient had a PSA of 8. (a level above a 4.0 is generally viewed as high). The physician said nothing to the patient. The doctor failed to refer the patient to a specialist. The doctor did not order a biopsy. Two years later the doctor repeated the PSA test. This time it had gone up to 13.6. Again, the doctor did not inform the patient. Again, the doctor did not refer the patient to a urologist. And again, the physician did not order a biopsy. Two years later the physician repeated the PSA test. It was not until three years after first learning of the patient’s raised PSA level that the doctor finally told him that he probably had cancer. By the time he was diagnosed he had metastatic prostate cancer and surgery was not one of the treatment options. Instead the man underwent radiation therapy and hormone therapy in an attempt to impede the further progression of the cancer. The law firm handling this matter reported that the lawsuit proceeded to mediation and settled for $600,000.

But not following up after noting abnormal test results creates a situation in which those patients who do have prostate cancer may not discover they have it until it has spread beyond the prostate, restricting the patient’s options for treatment, and substantially decreasing the chances that the patient will be able to survive the cancer.

As the above lawsuit demonstrates doctors sometimes comply with the guidelines by performing screening for prostate cancer yet if the test results are abnormal they fail to follow through.