Cancer and its effects on Medical
Mal-Practice Claims
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Mal -Practice Defense Orthopedic Surgeons |
Mal- Practice Defense OB/GYN |
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MEDICAL MALPRACTICE CANCER
II. CANCER
Cancer is discovered by various tests and examinations. Sometimes symptoms occur which prompt the need for medical attention and other times an individual has no symptoms to indicate a cancer is present. On physical examination a tumor may be felt as a lump underneath the surface of the skin or mucous membrane. Instruments such as the cystoscope, proctoscope, or bronchoscope can be used to visualize certain internal organs without requiring major surgery. A surgical procedure called a biopsy may be performed, in which a sample of tissue is removed from the body for microscopic examination. A biopsy is considered the most accurate and dependable way to diagnose cancer. Incisional, excisional, and needle or aspiration biopsies may be performed, depending on the size, location and suspected diagnosis of the lesion. Laboratory examination of the cells removed by biopsy determines whether a tumor is malignant or benign. X-Rays, CT (computed tomography) scans, radioactive isotopes, and ultrasound may also be used to assist in the diagnosis.
When cancer is diagnosed, it is important for the physician to determine the stage of the disease in order to plan the best treatment and to make a judgment about the likely outcome.
Medical Malpractice
Self/Insurance Plan
Florida Hospital Accepts Self Insured Plan
Surgeons/ Physicians pay huge amounts of premiums to insurance companies. With ICC, you can cut that in half |
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requests for this page world-wide.
ICC UNDERWRITERS has a Insurance plan specifically for doctors who want to keep their mal- practice rates under control specifically in areas of :
Orthopedic Surgeons
Cardiovascular Surgeon
Neurologist OB/GYN
ICC is not out to make a profit from doctors like insurance companies are. ICC, under the self-Insurance plan is only paid for administrative fees. This drastically reduces physicians' cost.
If you have an interest in creating a self insured plan, please fill out the response form and a representative will contact you directly to explain how to become self- insured. Or, call ICC at 1 (316) 683-0170.
A Self-insurance plan is the alternative to paying high insurance rates. ICC will help you meet state liability and hospitals requirements.
Call ICC today and keep what is rightfully yours.
Dan Martinez CEO
Your cost will be less than what you are paying now.
ICC UNDERWRITERS
Provides a Self/Insurance Plan Designed
Specifically for Doctors
ICC Underwriters a Division of Insurance Claims Consultants
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ORGANIZATIONS |
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INTRODUCTION |
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TYPE OF SERVICES |
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PERSONNEL |
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NEWSLETTER |
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RESPONSE FORM |
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RISK PROFILE |
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EMPLOYMENT |
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MAL PRACTICE |
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LINKS UNDER ICC |
A. Introduction and General Concepts
1.
Development of Cancer2.
Risk Factors3. Types of Cancers
4. Diagnosis
5. Classification and Staging
6. Metastasis
7. Treatment
8. Record Review Checklist
Record review for cancer will focus on the physician's actions in screening, diagnosis, and treatment. Some general considerations are present no matter what type of cancer is involved. The physician is expected to know risk factors for cancer of various sites, the common presenting symptoms of cancer, recommended screening guidelines, and to perform appropriate tests and examinations in an attempt to diagnose cancer at the earliest stage possible.
a. History
1. The documentation of symptoms as described by patient to include
length of time with symptoms? Fear of a cancer diagnosis delays some patients from seeking medical advice. Symptoms will vary from none to severe, depending on the site of the cancer, whether any organs are involved, and the stage and extent of the cancer.
Any changes in eating habits, loss of appetite, difficulty in swallowing, change in bowel or bladder habits? Further examination is warranted when persistent changes in normal bodily functions occur.
2. Any risk factors present? Some risk factors are known to increase the likelihood of developing particular cancers while others are suspected. All possible risk factors should be identified including exposure to known carcinogens such as tobacco use; occupational exposure to toxic substances; daughter of a mother who took DES when pregnant; repeated exposure to sunlight over a long period of time; diet high in fat; obesity; drug or hormone use; radiation exposure.
3. Documentation of any family history of cancer to include identification of the site and outcome of any family member with cancer? There is an increased risk of developing certain types of cancer such as melanomas and breast cancer when a family member has experienced it.
4. Previous history of cancer in this person? If so, site and outcome documented? Previous episodes of cancer may put a person at increased risk of another cancer experience.
b. Physical Examination
A careful examination is essential and can help distinguish between benign tumors, inflammatory lesions and cancers.
1. Thickening, lump or nodule noted in any site? Any pain associated? When first noted? Size at discovery? Any change in size? The time needed for a cancer to develop can be quite long.
2. Presence of wart or mole noted? Any obvious changes in size or appearance? Any sores found on the body? Progressive healing of sores occurring? Sores that do not heal can indicate cancer, and some lesions or moles may be pre-cancerous and require treatment or close observation.
3. Unusual bleeding or discharge present? Abnormal bleeding must be evaluated further.
4. Nagging cough or hoarseness noted? These can be symptoms of cancer and warrant further examination.
5. Any unexplained recurrent pain, recurrent fevers, steady weight loss, repeated infections, nausea, confusion, difficulty breathing (dyspnea), edema, fatigue should be evaluated for a possible malignant explanation.
6. Indigestion or difficulty in swallowing? These may be indicative of late cancers of the esophagus or stomach.
c. Diagnostic Procedures
. Any screening tests done? Specific recommendations for screening tests have been developed for particular types or sites of cancer. These may include a Pap smear, mammogram, chest x ray, and various laboratory tests including Genetic testing1
2. Blood test results? While there is no general blood test which will distinguish malignant growths from benign, a blood sample can be tested to help identify some specific cancers, and may help in the diagnosis of leukemias.
3. Surgical biopsy for diagnosis performed? If cancer is suspected, a biopsy is the most important procedure in establishing a firm diagnosis. A biopsy should be done before any surgical operation intended for cure. The surgeon is responsible for obtaining enough tissue so that the pathologist may determine whether the lesion is benign or malignant.
4. Pathological examination performed? The positive diagnosis of cancer is based on microscopic study of the form and structure of the tissue, called histologic examination, by a competent pathologist. Major treatment should not be undertaken without histologic or cytologic confirmation of cancer. However, there are some lesions which are considered pre-cancerous and should be cared for before malignant changes occur.
d. Staging
TNM classification system used? List any procedures performed and the results. Efforts should be made to determine whether the cancer has spread, and to which sites, before an appropriate treatment plan is adopted. Whether metastases have occurred is determined by various methods including X-Rays, radioisotope and CT (CAT) scans, ultrasound, and laboratory blood tests. Liver and bone marrow biopsies may also be done. The lung, liver, bone and brain are common sites of metastasis. The search for metastases is the most important single factor in treatment decision-making. For most cancers, discovery of metastatic spread significantly alters the prognosis and long-term survival prospects.
e. Treatment
1. Surgery performed as treatment? For surgical treatment, the entire tumor as well as a margin of normal tissue along the edge of the tumor is removed. Adjacent lymphatic vessels and nodes are also removed to eliminate cancer cells that might have spread along this route. Because surgical treatment requires the removal of some normal tissue surrounding a tumor, surgeons must be familiar with the characteristic invasion patterns of various types of cancer. Examination of the primary tumor and any lymph nodes removed must be done to determine whether any cancer cells are present. Surgical treatment decisions should be made after considering alternative procedures and obtaining informed consent. The choice of surgical treatment is based on numerous factors including the type of cancer, whether local lymph nodes are involved, prognosis, the persons age, work requirements, and available resources. All options are not equivalent for all persons, and individual wishes must be considered.
2. Consultation with other specialists done? Especially for unusual procedures, or those not frequently performed by the surgeon, consultation is appropriate. A medical oncologist is a specialist in the medical treatment and/or management of cancer, and is often an appropriate consultant for the surgeon to utilize.
3. Chemotherapy or radiotherapy treatment instituted? Radiation therapy can be very effective for managing specific organ metastases and can provide relief of pain. Chemotherapy is used mostly for the management of widespread (systemic) metastases. The particular drugs used, or type of radiation therapy given, depends on the specific type of cancer, its location, whether it has spread and the goal of treatment. In many cases a combination of surgery, radiation and chemotherapy will be used.
B. Breast Cancer
10. Breast Cancer, Generally
11. Description and Function of Breast
12. Risk Factors
13. Signs and Symptoms
14. Diagnosis and Metastasis
15. Classification and Staging
16. Treatment
17. Record Review Checklist
18. References
C. Lung Cancer
Lung Cancer, Generally19.
20. Description and Function of Lungs
21. Risk Factors and Causes
22. Signs and Symptoms
23. Types of Cancer
24. Diagnosis and Staging
25. Treatment
26. Record Review Checklist
27. References
D. Colon and Rectal Cancer
28. Colon and Rectal Cancer, Generally
29. Description and Function of Colon and Rectum
30. Risk Factors
31. Diagnosis
32. Staging and Classification
33. Treatment
34. Record Review Checklist
35. References
E. Gynecologic Cancer
36. Gynecologic Cancer, Generally
37. Description and Function of Reproductive Organs
38. Types of Gynecologic Cancer
39. References
F. Prostate Cancer
Prostate Cancer, Generally40.
41. Description and Function of Prostate Gland
42. Risk Factors
43. Signs and Symptoms
44. Diagnosis
45. Classification and Staging
46. Treatment
47. Record Review Checklist
48. References
G. Skin Cancer
Skin Cancer, Generally49.
50. Description and Function of Skin
51. Types of Cancer 0051CC
52. Risk Factors
53. Signs and Symptoms
54. Diagnosis 0054CC
55. Classification and Staging
56. Treatment
57. Record Review Checklist
58. References
H. Glossary
