Cancer of the head and neck can affect the mouth, tongue, tonsil, throat (oropharynx), salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx (voicebox), and lymph nodes in the neck. Cancers of the brain, eye, thyroid gland, scalp, skin, muscles, and head bones occur in the head and neck are not usually included in this group. Over 100 people are diagnosed each day with this condition in the U.S. Unfortunately, the diagnosis is often delayed, resulting in dire outcomes. An article published today in the Journal of the American Medical Association (JAMA) explains why this is frequently the case.
The JAMA article, entitled “Low Awareness of Head and Neck Cancers” explains that patients often fail to promptly report signs and symptoms of head and neck cancers due to lack of information about the disease. Patients are not aware of risk factors or the signs and symptoms. Add to this the fact that the Oral Cancer Foundation reports that this is the eighth year in a row where the incidence of the disease has increased.
However, as a medical malpractice attorney, what I found most interesting about the JAMA article is that there no medical guidelines recommending that physicians screen for the disease. The primary risk factor for head neck cancer is smoking. There are guidelines recommending that physicians screen smokers for lung cancer. So why not head and neck cancer?
Under Ohio law, a claim for medical negligence arises if a physician fails to practice within accepted standards of care and the substandard care causes injury. In this setting, injury is caused when substandard care leads to a delay in diagnosis and treatment. When cancer remains undiagnosed, it will spread from the primary site (head and neck) to lymph nodes and other vital organs, like the lungs, liver and brain. This process is called metastasis. As the cancer spreads, the patient’s prognosis worsens. This is called staging. Stage at diagnosis is a key consideration in determining whether a delayed diagnosis caused harm.
While it currently may not be possible to bring a lawsuit for a physician’s failure to screen patients for head and neck cancer, there may be additional ways in which such a claim may be brought. Here are a few: (1) if the patient reports signs or symptoms of head and neck cancer to a doctor, and the doctor doesn’t listen or gives false reassurance without conducting a proper examination; (2) if test results are misread or misreported by a pathologist; (3) if test results are lost or not communicated to the patient. These same acts of negligence may support a claim for dental malpractice since dentists are trained to diagnose certain head and neck cancers.