Imagine you are a male and you go to your physician for your yearly checkup. Imagine the doctor orders blood tests, including a PSA test which is used for the early detection of prostate cancer. So far, so good. This is how to determine whether a male without any symptoms of prostate cancer might in fact have it. Imagine the tests came back outside the normal range
Still, a number of physicians do not suggest male patients who are asymtomatic to screen for prostate cancer. They argue that screening has little, if any, value. One factor, nevertheless, continues to be constant. If the result of a screening test is abnormal the patient should be told of the results and either be referred to a specialist or be told about the option for diagnostic testing, such as a biopsy. Again, though, some physicians also believe that, at least under certain circumstances, a male patient diagnosed with prostate cancer does not have to undergo treatment immediately and only has to carefully monitor the cancer.
Should this happen, the cancer becomes incurable before the patient turns symptomatic and is finally diagnosed. However, if a physician noted that the patient's prostate was enlarged or there was a nodule on the gland and the PSA test results showed high levels of the antigen and the physician did not tell the man about the abnormal results, the patient would likely believe that meant there was no need to follow up.
If the patient does in fact have cancer, not informing the patient that he may have cancer will lead to a delay in his diagnosis.
A delay might, in turn, give the cancer time to metastasize. When a cancer metastasizes treatment can at best slow down the continuing growth of the cancer and lower the effects (including pain) of the cancer. Under such circumstances, that patient and his family might be able to pursue a failure to diagnose malpractice claim against the doctor.
Screening tests could have false positives. This means that some patients with abnormal screening results will not have cancer. Yet doing screening tests for cancer is meaningless without follow up as it provides the patient an incorrect sense of security thinking he has no cancer as the physician tested him and said nothing to him that the screening tests demonstrated he might have cancer. Physicians commonly agree that there is a requirement for follow up when the results of screening tests come back as abnormal.
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