Everything you need to know about stomach cancer and potential medical negligence in diagnosis.

Stomach Cancer

On average, about 550 people are diagnosed each year in Ireland with stomach cancer, also called gastric cancer. It affects men more than women and typically it arises in middle age or later. Like other areas of healthcare, sometimes opportunities are missed to diagnose and treat stomach cancer earlier than it ought to be diagnosed and treated and when that happens, some patients may wish to seek an independent opinion from an independent doctor on whether the delay in their care fell below an acceptable standard of care and whether that delay caused significant harm.
It is in these circumstances that we, as medical negligence solicitors, become involved. Our job is to find an answer to these two questions, as efficiently as possible, and then advise our client on what if any legal issues then arise. 
The team of medical negligence solicitors at Cian O'Carroll Solicitors has extensive experience in many types of delayed diagnosis or delayed treatment of cancer , including stomach or gastric cancer.  Over the past decade and more, we have assembled a network of leading international independent medical experts who are willing to review medical records, give a forthright and independent opinion on the care provided and if necessary, appear in court as expert witnesses to stand over their opinion should legal proceedings be justified. 
Drawing on such experts and applying our own experience in medical negligence law, we are able to help our clients navigate the legal process so that they can vindicate their legal rights arising from any failure to diagnose or treat their stomach cancer. ​

What is stomach cancer and what are its symptoms?

Stomach cancer, also known as gastric cancer, occurs when malignant cells in the stomach form a tumour, which can change how your stomach works and cause issues for you. Stomach cancer can be difficult to diagnose, and unfortunately is often missed, as the symptoms can be similar to other common conditions. Symptoms of stomach cancer include stomach discomfort, heartburn, indigestion, feeling full or bloated, nausea, difficulty swallowing, nagging stomach pains, poor appetite, weight loss, blood in your bowel movements or dark coloured stool, tiredness or jaundice. If any of these conditions are ongoing (particularly if they last for more than 4-6 weeks) then according to the Irish Cancer Society, a person should be checked by their GP.

Testing for stomach cancer

Tests for diagnosing stomach cancer can include general health checks with your GP (to include a consideration of your medical history and health habits, a physical examination, blood tests and the taking of stool samples), as well as onward referral to hospital for an endoscopy (passing a long tube with a camera down your throat and into your stomach to examine it and take samples of anything that seems suspicious), an endoscopic ultrasound (a type of ultrasound probe that is passed into your body through your mouth to take ultrasound pictures from inside your body) or a barium meal (drinking a special liquid that is visible on x-rays which can then help to detect any abnormalities in your oesophagus, stomach or part of your bowel when you swallow).  
While there is no national screening programme for stomach cancer, factors such as gender, age, diet and family or medical history can affect your risk of developing stomach cancer. Your GP will also keep a closer eye on you if you have any conditions that might further increase your risk for stomach cancer such as chronic gastritis, gastric polyps, the Epstein-Barr virus or a condition related to persistent gastric reflux called Barrett’s oesophagus. Stomach cancer can also be hereditary and so it is important that a full personal and family medical history is taken by your GP. ​

Treatment for stomach cancer

Depending on the stage of the cancer, treatment options can include surgery, chemotherapy, radiotherapy or other targeted therapies. Surgery is the most common treatment and will usually be a partial gastrectomy (removal of part of your stomach) or total gastrectomy (removal of your whole stomach) aiming to remove the tumour. Sometimes a bypass surgery will be performed, which rather than aiming to cure the cancer will aim to relieve the symptoms by creating a way for food to ‘bypass’ the blockage caused by the tumour and go directly into your bowel and give you a better quality of life.

Potential medical negligence ​

Cian O’Carroll Solicitors has seen that serious failures and delays in the diagnosis of stomach cancer amounting to medical negligence can and do occur. Remember, the law is quite protective of the medical professions in Ireland and the courts will only be critical of medical care where it is established, in the opinion of medical experts (not lawyers) that the no other doctor would have made this mistake if exercising ordinary care. That is a very low bar for doctors to avoid liability for errors. 
Any one, or a combination of the following failures, may result in a diagnosis being missed or delayed, which can allow the cancer to grow and spread:

• a failure by a GP to conduct a full and proper examination;
• a failure by a GP to refer you for further testing;
• a failure by a hospital to carry out appropriate testing; 
• a failure to correctly interpret test results; or 
• a failure to follow up with appropriate treatments in a timely manner.

Such failures may lead to a need for more invasive treatments, a reduced chance of survival and unfortunately may even lead to unnecessary premature deaths. If you have any concerns in relation to any of the above types of failures, you may wish to investigate the matter further. ​

Case Study

Our firm previously acted for a woman who was referred by her GP to her local HSE hospital for investigation of ongoing stomach pain. While there, she had an endoscopy during which a biopsy was performed. The sample was sent to a laboratory for testing and the report noted the presence of an infiltrating diffuse adenocarcinoma – a glandular cancer of the stomach. Unfortunately, no special marking or highlighting of this very serious finding appeared on the report and the referring consultant failed to read the report in full with the consequence that the woman was not referred for care until a year later when the National Cancer Register contacted to the consultant in question to make statistical enquiries as to whether the patient was still alive. 
Over the course of the year-long delay, the cancer had advanced and she suffered spread of the cancer to other parts of her body, resulting in her death despite undergoing life-changing treatments including the removal of most of her stomach, extensive lymph node removal and numerous chemotherapy and radiotherapy treatments. Her family were devastated by her loss. 
Our client’s case was primarily that the hospital committed medical negligence in failing to act adequately in time or at all in response to the diagnosis of gastric cancer by the laboratory, which caused a year-long delay in her treatment.
Expert opinion was that it was likely that had our client been treated promptly, she would have been node negative (i.e. the cancer would not yet have spread to the lymph nodes from where it then spread to other parts of her body). As a result of the delay in diagnosis and treatment our client now had only a 40% chance of a 5 year survival but if she had had prompt treatment she would have had had a 70% chance of surviving for 5 years and 65% chance of surviving for 10 years and that the treatment required would have been much less invasive. 
While the Defendant admitted that there had been a breach of duty in not diagnosing our client’s cancer from the biopsy report, it initially argued that such a breach did not cause our client’s injuries and disputed what the effect would have been had the cancer been diagnosed the year earlier, in particular her loss of chance of survival. 
During the course of the legal proceedings that followed our initial investigations, we learned that the cancer had spread and this changed everything with regard to her prognosis. She was unfortunately now presented with an incurable cancer that had spread well beyond the primary tumour in her stomach. 

Given the urgency of the matter we applied successfully to the High Court to have the case treated with special priority. This was successful and we obtained an urgent trial date within weeks. Shortly after this application, the Defendant admitted liability and invited us to join them in pre-trial mediation of the remaining issues. The case was settled at mediation with an admission of liability, an apology to the woman who was at that time still alive and damages close to €1m together with all her legal costs.

This was a particularly tragic case and represents yet another example of the State putting a gravely ill person through unnecessary stress and hardship for a number of years only to ultimately admit liability at the eleventh hour.