Delayed diagnosis of prostate cancer
Seventy-year-old Mr M attended his local GP surgery as he noticed blood in his urine. The nurse found a trace of blood when analysing the results of a urine dipstick test. The test was repeated two weeks later and there was still a trace of blood, so she sent the MSU to be screened. There were no red cells and nothing else was seen so nothing else was done about the complaint.
A year later, Mr M returned to his local practice for another test and more blood was found in his urine, as well as ongoing urinary frequency. The MSU tested negative for infection except for one blood but was filed as OK.
Four months later Mr M went to see his GP and said there was blood in his urine but the MSU and dipstick tested negative. The Prostate Specific Antigen (PSA) blood test was done along with a rectal examination which revealed that the prostate was smooth but enlarged. There was then a two-week wait for a urology appointment made due to elevation of the PSA.
At the clinic Mr M was diagnosed with prostate cancer. Mr M was very angry with the delay in diagnosis and filed a complaint against the nurse and the GP.
- Have a robust system for dealing with results, especially when they are borderline.
- Make sure you are aware of guidelines in respect to management of asymptomatic haematuria.
- Know how to deal with PSA results and parameters for referral in different age groups.
- Keep an open mind on differential diagnoses.
- Be aware of Medical Council guidance on how to respond if something has gone wrong.