How Failure to Perform PSA Tests & Digital Rectal Exams May Lead to Delayed Diagnosis

Using effective screening methods such as PSA Tests and DREs is important for catching early signs of prostate cancer and treating them immediately. The American Cancer Society projects that approximately 313,780 new cases of prostate cancer will be diagnosed in 2025, which further underscores the need to carry out proper screening protocols.

When healthcare providers neglect to perform or misinterpret PSA tests and digital rectal exams (DRE), patients may experience dangerous delays in diagnosis. As such, victims may be eligible to pursue a medical malpractice claim for compensation. 

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PSA Tests and Digital Rectal Exams

Prostate-Specific Antigen (PSA) testing is a blood test that measures the levels of PSA, a protein produced by the prostate gland. Normal PSA levels are typically considered to be below 4 nanograms per milliliter (ng/mL), although this threshold can vary based on age and individual health factors

Elevated PSA levels may indicate the presence of prostate cancer. However, they can also be caused by other benign conditions, such as benign prostatic hyperplasia. So it’s important to recognize that not all elevated PSA levels signify cancer. Which is why doing a PSA test alone is not enough to catch prostate cancer.

On the other hand, the Digital Rectal Examination (DRE) is a physical examination in which a healthcare provider manually assesses the prostate gland for any abnormalities in size, shape, or texture. Despite being traditionally used as a screening method for prostate cancer, recent studies suggest that DRE may not effectively detect early-stage cancers. 

The most worrying part of their findings is that DRE missed many early cancers, with PSA testing identifying four times more cases than DRE among men aged 45. While DRE can still play a role in prostate health assessments, relying solely on this method may leave some cancers undetected until they progress to more advanced stages. 

This reality can be distressing for patients and their families, as delayed diagnosis often leads to more aggressive treatments and poorer outcomes. Hence, a combination of both of these tests is imperative in detecting prostate cancer along with other diagnostic tests such as imaging tests (MRI), genetic testing, and a prostate biopsy.

How Screening Failures Lead to Delayed Diagnosis

Healthcare professionals have a legal responsibility to advise and cover all aspects of a prostate cancer screening for at-risk individuals. Instances in which they may fail their duty of care include (but are not limited to) the following scenarios:

  • Failure to conduct routine PSA tests for high-risk men. Research indicates that only about 37.1% of men receive regular prostate cancer screenings (55-69 years old). This statistic suggests that a significant portion of men may not be offered these tests by their providers. This oversight can allow prostate cancer to progress undetected.
  • Improper test administration. Even when screenings occur, the accuracy of results can be compromised. For example, a PSA test can show a false-positive result. Not only does this lead to unnecessary biopsies, it may subject patients to aggressive treatments that exacerbate their health.
  • Misinterpreting relevant diagnostic results. Healthcare providers may overlook critical aspects when interpreting PSA test results. Factors such as PSA velocity, age-specific ranges, and correlations with digital rectal exam (DRE) findings are a few examples. 
  • Failure to monitor adequately or order follow-up testing. Timely follow-up is crucial when abnormal results are found, with studies showing that longer follow-ups also lowers the number of screening and diagnosis needed. As such, any misses or delays in follow-up testing can lead to cancer progression and poorer patient outcomes.

The Consequences of Delayed Diagnosis

Lower Survival Rate

Delayed diagnosis due to screening failures can have severe consequences for patients. The 5-year survival rate for localized prostate cancer is over 99%, but this figure drops drastically down to 37% for advanced cases where the cancer has metastasized due to late detection. This stark contrast highlights the critical importance of timely diagnosis in improving survival outcomes.

Complications from Late-Stage Treatment

When prostate cancer is diagnosed at a later stage, the treatment options become more aggressive and complicated. Patients may face:

  • Increased risk of surgical complications. Advanced cancer often necessitates more extensive surgeries, which carry greater risks and may even be irreversible.
  • More intensive radiation therapy. This can lead to greater side effects and longer recovery times.
  • Higher likelihood of hormone therapy. Such treatments can result in significant hormonal imbalances and associated side effects.

Financial Burden of Advanced Cancer Treatment

The financial implications are equally concerning. Annual treatment expenses just for a prostate cancer patient for their initial, continuing, and end-of-life care are as follows:

Medical ServicesOral Prescription
Initial Care
1st year of diagnosis
$28,108.5$312.3
Continuing Care
every subsequent year
$2,602.6
annually
$312.3
annually
End-of-Life Care
last year before demise
$74,227.3$5,829.9

Treating advanced-stage cancer can be three to four times more expensive than treating it in earlier stages, not accounting for lost wages and reduced earning capacity. This economic strain can affect not just patients but also their families and communities, leading to broader societal impacts.

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Establishing a Claim for a Delayed Prostate Cancer Diagnosis

In pursuing a medical malpractice claim, skilled attorneys will strive to prove these four key elements for a delayed prostate cancer patient:

Duty of Care – Was there an appropriate doctor-patient relationship?
Breach of Duty – Did your doctor fail to uphold their legally sworn responsibilities?
Causation – Did your doctor’s mistakes directly cause you suffering/injury?
Damages – What did these mistakes cost you (medically, financially, emotionally, etc.)?

After identifying and establishing these elements, one can initiate a medical malpractice lawsuit. However, proving these elements is not an easy task. We at Porter Law Group can assist in gathering evidence, officially filing your case, and negotiating fair compensation for both your economic and non-economic damages.

Contact a Medical Malpractice Attorney Today

If you or a loved one has suffered due to a healthcare provider's failure to properly screen for prostate cancer, the Porter Law Group can help. Our experienced medical malpractice attorneys understand the complexities of delayed diagnosis cases and work tirelessly to secure the compensation you deserve.

We offer free consultations and work on a contingency fee basis - meaning you pay nothing unless we win your case. Contact us at 833-PORTER9 or email us at info@porterlawteam.com to schedule your consultation and learn about your legal options.

Last Updated on 
February 3, 2025
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