There are several types of liver cancer, with some being more predominant than others. If your liver cancer was diagnosed later than it should have been by your doctor, you may be eligible to take legal action.
You may have a case if:
You may be able to pursue a medical malpractice claim for a delayed liver cancer diagnosis if all four of these elements are present:
Breach of standard care: Your doctor departed from accepted liver cancer surveillance or diagnostic protocols. This could include not following hepatology guidelines for cirrhosis surveillance, ignoring radiologist recommendations for follow-up imaging, or failing to investigate abnormal test results appropriately.
Measurable delay: There was a significant time gap (often 60-90 days or longer) between abnormal findings or red-flag symptoms and definitive testing or specialist evaluation. This delay must be documented in your medical records.
Outcome change: Earlier diagnosis would likely have meant detection at a lower stage (localized versus regional or distant disease) with significantly different treatment options and survival rates. For example, a delay that allowed cancer to progress from localized (37% five-year survival) to regional (13% survival) or distant (3% survival) disease.
Actual damages: The delay resulted in measurable harm such as more invasive treatment, loss of eligibility for potentially curative options like transplant, reduced survival chances, additional medical costs, lost earnings, or increased pain and suffering.
If you believe these four elements apply to your situation, you should speak with a medical malpractice attorney as soon as possible to evaluate your case.
When a late liver cancer diagnosis may be medical malpractice
A late diagnosis may rise to malpractice if a reasonably careful doctor, under the same circumstances, would have ordered imaging, labs, referrals, or follow-up earlier, and doing so would likely have allowed earlier liver cancer detection. In New York, plaintiffs generally must prove that a standard of care existed, that the provider deviated from that standard, that this deviation was a substantial factor in allowing the cancer to progress, and that it led to actual damages such as more aggressive treatment, reduced survival, disability, or death.
New York law allows patients to sue for a delayed liver cancer diagnosis when a provider violates accepted medical standards, that delay meaningfully worsens staging, treatment options, or survival outlook, and the patient suffers measurable physical, financial, or emotional harm as a result. In New York cancer cases, Lavern's Law also provides a specific discovery-based statute of limitations for negligent failures to diagnose malignant tumors, which can be critical in late-diagnosis liver cancer claims.
Liver cancer remains one of the more lethal cancers in the United States, so showing that a delay caused progression from a more treatable to a more advanced stage is often central to case evaluation.
Common ways liver cancer diagnosis is delayed
Recent hepatocellular carcinoma (HCC) research highlights recurring delay scenarios that frequently lead to malpractice claims:
Missed or ignored imaging follow-up
In cirrhosis or chronic hepatitis, guidelines recommend regular liver imaging (typically ultrasound every 6 months, often with alpha-fetoprotein testing) to look for small tumors. Delays occur when:
- Radiologists recommend repeat MRI or CT in a defined interval but the ordering clinician does not schedule it
- Lesions identified as "concerning" are not re-imaged as recommended
- Incidental liver masses found on CT or MRI done for other reasons are not followed up
- Recommended surveillance imaging for high-risk patients is not ordered at all
These failures have been documented in both malpractice decisions and liver-cancer delay studies as common causes of late diagnosis.
Abnormal labs not acted on
Studies of HCC delays describe cases where abnormal alpha-fetoprotein (AFP), liver enzymes, or other liver tests are obtained but no diagnostic imaging or hepatology referral follows, despite guideline recommendations to evaluate suspicious results.
Common failures include:
- Relying on an AFP value alone without combining it with imaging
- Ignoring elevated liver enzymes in high-risk patients
- Not following up on abnormal results with appropriate specialists
- Failing to recognize patterns of worsening liver function tests
Evidence shows that not combining labs with imaging can miss early cancers and contribute to later, more advanced diagnoses.
Delayed specialist referral or testing
For at-risk patients (chronic hepatitis B or C, cirrhosis, alcoholic liver disease, metabolic-associated fatty liver disease), hepatology and oncology sources emphasize timely referral to liver specialists and prompt diagnostic imaging when surveillance tests are abnormal.
Documented reasons for delay include:
- Providers not adhering to American Association for the Study of Liver Diseases (AASLD) diagnostic guidelines
- Inappropriate tests being ordered instead of recommended imaging
- Providers not recognizing the significance of abnormal findings
- Failure to refer patients with known risk factors for regular surveillance
- Administrative delays in scheduling appointments or tests
These failures were significantly associated with diagnostic delays beyond 60 days in large HCC studies.
Primary types of liver cancer
Here are the primary types of liver cancer (metastatic cancer* and benign tumors** not included), as provided by the American Cancer Society:
Hepatocellular carcinoma: Cancer develops in the main liver cells called hepatocytes. It accounts for about 75% of all liver cancer incidents in the US.
Intrahepatic cholangiocarcinoma: Cancer develops in parts of the bile ducts within the liver. Contributes to roughly 10% to 20% of all liver cancer incidents in the US.
Angiosarcoma and hemangiosarcoma: Rare instances wherein cancers begin in cells lining the blood vessels of the liver caused by direct exposure to toxic substances. They can also be complications brought on by a hereditary genetic disorder.
Hepatoblastoma: A rare type of liver cancer that develops in children 4 years old or younger.
Recent estimates by the American Cancer Society expect 41,630 new cases of liver cancer in 2024, 2,240 of which will be in New York. This means that about 6 individuals in New York will be diagnosed with liver cancer on any given day in 2024.
*Cancer in the liver caused by advanced cancers originating from other organs
**Tumors that grow slowly and do not spread to other parts of the body
Liver cancer misdiagnosis
Liver cancer is the sixth most common cancer in the US. Various factors, including genetics, lifestyle, and environmental factors, can influence an individual's risk of developing liver cancer. Here are some risk factors identified by the National Cancer Institute:
- Hepatitis B Infection
- Hepatitis C Infection
- Cirrhosis
- Aflatoxin B1 Consumption
- Non-alcoholic Steatohepatitis (NASH)
- History of Heavy Alcohol Use
- History of Cigarette Smoking
In the context of liver cancer, individuals with such risk factors should be given extra consideration by their doctors. Healthcare providers are guided by standard screening protocols to ensure that the conditions of high-risk patients are closely monitored. Failure to diagnose and prescribe treatments early constitutes medical malpractice.
In a recent study about liver cancer late diagnosis, it was found that nearly 1 in 5 liver cancer patients were diagnosed late by at least three months. This period is enough for the tumor to grow significantly. Researchers found these to be the contributing factors:
- Doctors misinterpreting test results
- Inaccurate test results
- Mismanagement of patient information
- Improper screening test execution
These are only some forms of malpractice that could occur throughout your journey. With in-depth investigation, medical malpractice lawyers can accurately pinpoint what malpractices were done, and which professionals can be held liable.
Liver cancer staging guide
There are two prominent staging systems used when describing cancer, both of which you may be familiar with. They are the TNM System (by the American Joint Committee on Cancer) and the SEER System (by the National Cancer Institute).
TNM System
This system helps healthcare professionals determine prognosis, guiding prescriptions and recommendations. The TNM system considers three factors, each determining the overall stage (0 to 4). These three factors are:
T stands for Tumor: It ranges from 0-4. The bigger or more spread out, the higher the rating.
N stands for Node: This considers the number of lymph nodes within an affected area. Its value varies from 0 to 3 depending on how far it has spread.
M stands for Metastasis: It describes whether the cancer has spread to distant organs. It's only rated as 1 or 0 (yes or no, respectively).
SEER System
This system, on the other hand, is simpler and used primarily for cancer registry reporting and epidemiological studies. It categorizes cancers into five main stages:
In situ: Abnormal cells are present but have not spread to nearby tissue. Equivalent to Stage 0 in the TNM System.
Localized: Cancer is limited to the organ of origin. Equivalent to Stage 1 or 2 in the TNM System.
Regional: Cancer has spread to nearby lymph nodes, tissues, or organs. Equivalent to Stage 3 in the TNM System.
Distant: Cancer has spread to distant parts of the body. Equivalent to Stage 4 in the TNM System.
Unknown: For cases that need further examination.
Example of diagnosis
Say someone with liver cancer was diagnosed with Hepatocellular carcinoma, Stage 3A (T3a, N0, M0). What does this mean? Let's break this sample diagnosis down.
Under the TNM System:
- T3a: Multiple tumors, with at least one tumor larger than 5 cm
- N0: No regional lymph node metastasis
- M0: No distant metastasis
With all these characteristics considered, the final diagnosis that would be provided is STAGE 3A. Number stages can be subdivided further under this system, with subdivisions varying depending on the type of cancer.
Under the SEER System:
With all characteristics considered, this specific case will be categorized as Regional Cancer.
Survival rates for liver cancer
Studying liver cancer incidents from 2013 to 2019, the American Cancer Society provides us with the 5-year relative survival rate* of liver cancer in various stages.
*percentage of patients who are still alive 5 years after their cancer diagnosis
| SEER Stage | 5-Year Relative Survival Rate |
|---|---|
| Localized | 37% |
| Regional | 14% |
| Distant | 4% |
| All Stages Combined | 22% |
Getting an early diagnosis is the most effective way to beat cancer. Through it, patients can receive treatments immediately. Survival rates plummet when cancers are detected late. As such, professionals involved in medical malpractices must always be held accountable.
What you must prove and what records matter most
What you must prove
To establish a medical malpractice case for delayed liver cancer diagnosis in New York, you must prove four core elements:
Standard of care: What reasonably competent physicians or specialists would have done in similar circumstances. This includes use of semiannual ultrasound with or without AFP for high-risk patients, appropriate follow-up of imaging findings, and adherence to liver-cancer diagnostic guidelines.
Breach: That the provider failed to meet this standard. For example, not ordering imaging after abnormal labs, ignoring a radiologist's recommendation for repeat MRI, or failing to refer a cirrhosis patient for HCC surveillance.
Causation: New York courts require proof that the breach was a substantial factor in causing harm. In delayed cancer diagnosis cases, this often means showing a loss of chance for a better outcome due to progression from an earlier to a later stage.
Damages: Physical harm (more extensive surgery, ineligibility for transplant, metastasis), reduced survival, and economic and non-economic losses arising from the delay.
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Timeline-based explanation
For delayed liver-cancer diagnosis, cases typically follow this pattern:
- Initial risk and symptoms: Patient has known risk factors (cirrhosis, chronic hepatitis) or symptoms (weight loss, abdominal pain, jaundice), and the standard of care calls for surveillance or diagnostic work-up at that point.
- Missed opportunity: An abnormal lab, imaging, or clinical note appears in the record, but guideline-consistent action is not taken (no timely follow-up imaging, no referral, no biopsy or advanced imaging).
- Later diagnosis at advanced stage: The tumor is eventually found at a larger size or metastatic stage, with fewer curative options and worse 5-year survival, as reflected in SEER and American Cancer Society data for localized versus regional versus distant liver cancer.
- Resulting harm: Expert testimony ties the missed opportunity to the later advanced staging, demonstrating that earlier intervention would likely have allowed resection, ablation, or transplant with substantially better survival probabilities.
What records to collect
Medical documentation is critical in reconstructing delay and causation in liver cancer cases. Here are the key records you should gather:
Imaging records
- All liver-related ultrasounds, CT scans, MRIs, PET scans, and associated radiology reports, particularly noting any recommendations for repeat imaging or further evaluation
- Prior non-liver imaging (abdominal CT for other reasons) where a liver lesion or abnormality was mentioned but not acted upon
- Dates when imaging was recommended versus when it was actually performed
Laboratory results
- Serial liver function tests (AST, ALT, alkaline phosphatase, bilirubin), AFP levels, and any other tumor markers, to show abnormal trends and dates when intervention was indicated
- Records of provider communication about abnormal labs, including patient portal messages, letters, or visit notes indicating whether the results were discussed or followed up
Referral and consultation notes
- Primary-care, gastroenterology, hepatology, and oncology visit notes showing when symptoms, risk factors, or abnormal tests were documented and whether referrals were made
- Documentation of missed or cancelled appointments and any rescheduling delays, which have been identified as contributors to delayed diagnosis
Pathology and staging records
- Biopsy reports, surgical pathology, and staging documentation (SEER or Barcelona Clinic Liver Cancer stage) to compare likely stage at the time of the missed opportunity versus at actual diagnosis
- Treatment plans showing what options were available at each stage
Damages documentation
- Treatment records showing escalation from potentially curative options (resection, transplant, ablation) to palliative or systemic therapy, supporting the argument that delay foreclosed better treatments
- Billing records, disability records, and employment documentation to substantiate financial losses associated with the delayed diagnosis
- Documentation of pain, suffering, and quality-of-life impacts
Legal considerations for compensation
In New York, 1,154 medical malpractice claims were filed in 2023 alone. These claims were compensated with $500,684 on average. However, this figure also covers minor cases. For more tangible figures, refer to some of our recent wins.
When looking for compensation, all damages incurred by the misdiagnosed patient are considered. Apart from medical bills, victims can also account for emotional damages and lost wages.
Four main elements should be determined before a medical malpractice claim can be established. They are as follows:
Duty of Care: Is there an appropriate doctor-patient relationship?
Breach of Duty: How did your doctor fail to uphold their sworn responsibilities?
Causation: Does your doctor's mistakes directly cause your suffering?
Damages: How much did the mistake cost you (emotionally, medically, financially, etc.)?
Your legal counsel will help you gather all relevant evidence for your claim. They can establish your claim after a thorough investigation.
Statute of limitations and Lavern's Law
New York's Civil Practice Law and Rules Section 214-a, as amended by Lavern's Law, governs time limits for failure-to-diagnose cancer cases, including liver cancer. The statute provides that an action based on negligent failure to diagnose a malignant tumor may be commenced within two years and six months of the later of the date the patient knew or reasonably should have known of the negligence and injury, or the last treatment date where there was continuous treatment for the same condition, subject to an outside cap measured from the malpractice date.
This discovery-based rule is particularly important in liver cancer cases because patients may not immediately realize their diagnosis was delayed. However, it's critical to speak with an attorney as soon as you suspect malpractice, as exact deadlines depend on the specific facts of your case.
Next steps for a free case review
If you believe your liver cancer was diagnosed late due to medical negligence, taking prompt action is essential. Here's what you should do:
- Gather your medical records: Request copies of all relevant medical records, including imaging reports, lab results, consultation notes, and treatment plans. The records checklist above will help you identify what's most important.
- Document your timeline: Write down a timeline of your symptoms, doctor visits, test results, and when you were ultimately diagnosed. Include any instances where you felt concerns were dismissed or follow-up was delayed.
- Note your damages: Keep records of all medical expenses, lost wages, and how the delayed diagnosis has impacted your life and treatment options.
- Contact the Porter Law Group: Reach out for a free, no-obligation consultation. We'll review your case, explain your legal options, and help you understand whether you have grounds for a malpractice claim.
Time is important in these cases due to statute of limitations rules, so don't delay in seeking legal advice. The sooner we can review your case, the better we can preserve evidence and protect your rights.
FAQs
Can I sue for a delayed diagnosis of liver cancer?
Yes, you can sue for a delayed diagnosis of liver cancer in New York if you can prove medical malpractice occurred. New York recognizes malpractice claims for negligent failure to diagnose cancer where a provider's deviation from accepted standards substantially contributes to disease progression and harm.
Lavern's Law specifically addresses failure-to-diagnose cancer cases, giving patients additional time to bring suit once they discover the error, within defined statutory limits. To succeed, you must show that your doctor departed from accepted medical standards, the delay meaningfully worsened your staging or treatment options, and you suffered measurable physical, financial, or emotional harm as a result.
What is the late stage of liver cancer?
Late stage liver cancer generally refers to cancer that has spread beyond the liver itself. Large registries such as SEER categorize liver cancer as localized, regional, or distant. "Late" or advanced disease generally corresponds to:
Regional spread: Cancer has spread to nearby structures, tissues, or lymph nodes. This is equivalent to Stage 3 in the TNM system, with a 5-year survival rate of approximately 13-14%.
Distant metastasis: Cancer has spread to distant organs or parts of the body. This is equivalent to Stage 4 in the TNM system, with a 5-year survival rate of only 3-4%.
In contrast, localized liver cancer (confined to the liver) has a much better 5-year survival rate of about 37%. The dramatic difference in survival rates highlights why early detection is so critical and why allowing cancer to progress to a later stage through diagnostic delays can constitute significant harm in malpractice cases.
How much compensation for a delayed cancer diagnosis?
Compensation for a delayed cancer diagnosis varies widely depending on the specific facts of your case, but can be substantial when delay has allowed progression to incurable or metastatic disease. Public reports of liver-cancer-related malpractice verdicts show that jury awards can reach several million dollars when delay is proven.
New York has no statewide statutory cap on medical malpractice damages, so compensation is based on your actual losses. Damages may include:
- All medical expenses related to the delayed diagnosis and resulting advanced treatment
- Lost wages and reduced earning capacity
- Pain and suffering
- Loss of enjoyment of life
- In wrongful death cases, compensation for the family's loss
Thoroughly documenting your medical costs, lost earnings, and life impact is critical to maximizing your recovery. The Porter Law Group can help you understand what your specific case may be worth during a free consultation.
When cancer spreads to the liver, how long to live?
Survival time when cancer spreads to the liver depends on whether it's primary liver cancer or metastatic cancer from another organ.
For primary liver cancer, recent SEER data and American Cancer Society estimates indicate overall 5-year relative survival around 22% in the United States. However, outcomes vary dramatically by stage:
- Localized liver cancer: 37% five-year survival
- Regional disease: 13-14% five-year survival
- Distant disease: 3-4% five-year survival
For metastatic disease to the liver from other primary cancers, survival depends heavily on the original cancer type and available treatment options, but liver involvement is generally associated with limited prognosis. This is precisely why showing that a diagnostic delay allowed cancer to progress from a more treatable to a less treatable stage is central to causation arguments in malpractice litigation.
If you believe a delayed diagnosis allowed your liver cancer to progress to a more advanced stage, reducing your treatment options and survival chances, you should speak with a medical malpractice attorney about your rights.
Other organizations supporting people with liver cancer
American Liver Foundation (ALF)
ALF is a national organization with a division serving the Greater New York area specifically. They provide education, support, and research funding for all liver diseases, including liver cancer.
Memorial Sloan Kettering Cancer Center (MSKCC)
A world-renowned cancer center located in New York City. They provide comprehensive care for liver cancer patients, including research and clinical trials.
Weill Cornell Medicine
Located in New York City, Weill Cornell Medicine provides expert care for liver cancer patients, including innovative treatments and clinical trials.
NYU Langone Health
Offers a multidisciplinary liver cancer program, providing personalized care and support services.
Roswell Park Comprehensive Cancer Center
A nationally recognized cancer center located in Buffalo, NY that provides care and support for liver cancer patients from across the state.
CancerCare
CancerCare is a national organization with offices in New York, providing free support services, including counseling, education, and financial assistance to liver cancer patients and their families.
Liver Cancer Alliance
This national organization provides education, support, and advocacy for liver cancer patients and their families, and has resources available for those in New York.
New York Cancer Foundation
This non-profit organization, based in New York City, provides financial assistance and support services to cancer patients, including those with liver cancer, in the New York metropolitan area.
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