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MEDICAL MALPRACTICE, CANCER AND THE MEDICAL ONCOLOGIST

The medical oncologist is a physician who has received specific training in the broad area of cancer management. This training includes an internship and residency in internal medicine followed by several years in post-doctoral training in the area of oncology. This is frequently combined with training in hematology that requires three years of post-doctoral work.

Cancer is increasingly a multidisciplinary discipline requiring input from a multiplicity of specialties and it is the responsibility of the medical oncologist to integrate the numerous physicians involved and oversee the complete treatment program. The medical oncologist does not specifically perform surgery or radiation therapy but should have training in their relative contributions to the overall treatment of cancer patients.

Diagnosis:

In evaluating whether a specific case of cancer diagnosis and treatment is consistent with the accepted standard of care there are several general principles to be considered. Was the physician aware of established signs of cancer and was sufficient attention paid to those signs? An example would be an abnormal lump in the breast or unexplained bleeding from a body orifice. While the role of the evaluation of these signs may be important, it is not, in and of itself sufficient reason to indicate that there is a genuine problem with the care.

Treatment:

A major consideration is whether or not the cancer itself is treatable. Would treatment alter the natural course of the disease? There may be significant errors in the diagnosis of the cancer. However, for certain types of cancers there are few good therapies available. A central issue is whether or not a delay in the diagnosis of cancer would alter the treatment approach. There are certain malignancies that when diagnosed later in the course of that cancer require more aggressive treatment. For example colon cancer diagnosed early would utilize surgery. If diagnosis is made at a later stage in addition to surgery lengthly chemotherapy would need to




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