Prostate cancer is the second leading cause of cancer death for American men. Annual or biennial PSA screenings are recognized as part of a patient – physician strategy to significantly lower deaths associated with prostate cancer. In the face of that, over the last 10 years Kaiser Permanente decided to suspend routine PSA screening for male patients.
If you are a male Kaiser Permanente member between ages 50 to 69 and you have been diagnosed with advanced or metastatic prostate cancer, please call us for a free, legal consultation. Your cancer may have been treatable if Kaiser had acted in collaboration with you in the diagnostic process.
At Walkup, Melodia, Kelly & Schoenberger, we have been prosecuting failure to diagnose prostate cancer claims and have been representing the injured, including Kaiser members, for over 40 years.
About Prostate Cancer and Annual Prostate Cancer Screening (PSA)
One in nine men will be diagnosed with prostate cancer during his lifetime, with the average age at diagnosis around 66. Six out of ten cases are diagnosed in men 65 or older.
Prostate cancer occurs when cells in the prostate gland begin to grow out of control. While prostate cancer can be a serious illness, it is no longer an automatic death sentence; early detection and treatment significantly reduces morbidity and mortality.
In 1994, the Food and Drug Administration approved a prostate cancer screening test for men who did not show prior symptoms. The test checks the levels of prostate-specific antigens (PSA) in the blood and aids in the early detection of most prostate cancers. PSA screening has helped reduce annual deaths from prostate cancer by half.
In recent a study involving 400,887 Kaiser Permanente patients, annual PSA screening not only proved to be useful but reduced deaths from prostate cancer by 64 percent for men ages 55 to 75. The men in the study did not have a history of prostate cancer, were tested consecutively for five years, and followed up for 12 to 16 years. The study was also the first to analyze different intervals and age groups in PSA screening to find which worked best.
Kaiser’s stated reasoning on abdication of PSA screening is that it results in too many false positives – where cancer may be present, but it is not serious enough to qualify for a follow-up with one of their doctors. However, treatment and monitoring cost Kaiser money and time, and so while the issue of false positives can be solved by active surveillance for low-stage cancers, Kaiser has opted against PSA screening as a whole.
How Kaiser Has Failed Patients
The general consensus among doctors and health care providers regarding PSA screening is that doctors and patients should have a shared decision-making discussion with patients ages 50 to 69, on whether or not to proceed with PSA screening. This way, the patient plays an active role in the decision impacting – and potentially saving – his life. This standard of practice conflicts with Kaiser’s 2010 decision to unilaterally stop PSA screening and discussing the availability of the test with their patients. Screening and shared decision-making for all members is expensive, and Kaiser made a choice to not involve their patients in the decision in order to save money.
Since the policy change, PSA-based screening and biopsy rates in the Kaiser Permanente health system declined sharply and prostate cancer detection fell by 54 percent. This resulted in nearly 2,000 fewer cases of prostate cancer being detected. At the same time, diagnosis’ of metastatic cancer rates increased significantly, resulting in 75 more advanced possibly lethal cancers in members.
When Kaiser reasoned that PSA screening resulted in too many false positives and was not necessary, it failed to protect the men whose lives could have been saved by detecting the cancer early through screening and receiving treatment. Studies show that monitoring early cases of prostate cancer through PSA screening and repeat biopsies can help those who need treatment receive it in time – particularly those with slow-growing cancers.
While overdetection can be problematic, the absence of screening and the failure to diagnose prostate cancer has irreversible consequences for the health plan members who are affected.
Other Factors in Misdiagnosis or Failure to Diagnose Prostate Cancer
Even when screening does occur, medical professionals can fail to diagnose prostate cancer. In its early stages, prostate cancer presents symptoms that a doctor may diagnose as an enlarged prostate rather than cancer. These symptoms include:
• Frequent urination and the urge to urinate at night
• Weak or interrupted urine flow or the need to strain to empty the bladder
• The urge to urinate frequently at night
• Blood in the urine or seminal fluid
• New onset of erectile dysfunction
• Discomfort or pain when sitting, caused by an enlarged prostate.
In other cases, a doctor may correctly suspect prostate cancer but fails to follow up with regular PSA screenings in the future or the biopsy results are never communicated to the patient. Any delay or failure in diagnosing prostate cancer can allow the cancer to grow and spread, making it more difficult or impossible to treat.
Unique Issues in Handling Kaiser Cases
All medical negligence cases involving Kaiser Permanente are unique in that they are handled through private arbitration, not in court. Since 1978, Kaiser has required a private arbitration procedure for all claims against Kaiser employees and Permanente Medical Group doctors. These cases involve a completely unique set of rules and guidelines that are unknown to most. We highly recommend that Kaiser members work with law firms that have experience handling these types of cases within the Kaiser Permanente arbitration system.
The Kaiser medical malpractice attorneys at Walkup, Melodia, Kelly & Schoenberger are experienced in how private arbitration works and have successfully settled and arbitrated over 400 claims for Kaiser patients and members since adoption of arbitration in 1978. We understand the complications involved in Kaiser cases. Call or email us today.