There are tests that enable the detection of some types of cancers, for instance prostate cancer, prior to the time the patient shows symptoms. The thought is to detect the cancer in the beginning stages while treatment is likely to cure the cancer instead of waiting until the cancer advances and spreads at which point there is currently no known cure. The first test is the digital examination. During this examination the doctor uses a gloved finger to physically examine the prostate gland for any signs of enlargement, hardening, or the existence of growths, any of which could be a sign of cancer. The second test is the PSA blood test which measures the level of prostate specific antigen in the man's system. A PSA above 4. ng/ml is generally thought to be abnormal. Because prostate cancer raises the PSA level when prostate cancer advances physicians normally advice a biopsy when the PSA test comes back high.

When an issue other than prostate cancer causes the PSA level to climb the elevated PSA is called a "false positive." A biopsy has risks, such as the risk of infection and the risk of excessive bleeding. Because of these two issues some physicians suggest that male patients follow a plan of "watchful waiting." With this strategy the doctor tracks the man's elevated PSA over a period of months or even years. During this time some doctors advise that the patient try non cancer related treatments, for example, for infection, based on the theory that when the PSA is high due to something other than prostate cancer such treatments may bring the PSA back to normal levels.

The problem with this method is that the doctor might wait too long without doing any further tests to evaluate if the high PSA level is because of prostate cancer. When waiting results in the spread of the cancer beyond the prostate capsule then the patient will no longer have treatment options that can eliminate and cure the cancer. Men with prostate cancer who have a PSA level below 10 ng/mL have between 70 to 80 percent possibility of having organ-confined disease, as opposed to 50% for those with PSA levels 10 to 50 ng/mL, and only twenty five percent with higher PSA levels

If the prostate cancer is not diagnosed until it has spread beyond the capsule, a man has roughly a fifty percent chance that the cancer will progress. If the cancer spreads to the bone or to distant organs before it is found, the man typically has only a two to three year life expectancy. Treatment possibilities might include hormone therapy, radiation therapy, orchiectomy , and possibly chemotherapy. In time, treatment might cease to be effective and the cancer will again continue to progress. When treatment ceases to be effective, prostate cancer is fatal. This year, an estimated ninety thousand men will die in the U.S. due to metastatic prostate cancer.

It is for this reason that physicians typically suggest that a biopsy ought to be ordered if a male patient’s blood test indicates a PSA level above 4. ng/ml. Since the biopsy consists of samples, it is possible that the biopsy may yield a false negative, missing the cancer. This is why doctors in addition ordinarily advise that biopsies be redone every few months should the PSA levels remain elevated, even after treatment for other possible causes.

However, if you or a member of your family were among those whose doctor heldup the diagnosis of prostate cancer until it metastasized, you should contact an experienced medical malpractice attorney right away. The doctor might be liable under a malpractice claim.