The claimant’s wife was diagnosed at the age of 40 in 2006 with cancer of the left breast which was treated appropriately with surgery, radiotherapy and endocrine treatment.
Three and a half years later, in September 2009, she started to develop pain in her left upper arm and shoulder and had abnormalities in imaging of her shoulder, both on a bone scan and CT scan. At that time she was referred for rheumatological review and was initially seen in rheumatology in March 2010, at which time she had been experiencing pain for six months.
An X-ray in July 2010 was suspicious of metastatic disease with a sclerotic lesion in the shoulder. This was initially seen in rheumatology and subsequently oncology and further investigation was done with a bone scan, showing increased uptake in the shoulder, compatible with an abnormality. A PET scan in November 2010 confirmed abnormal uptake in the left shoulder. Differential diagnosis was unclear and included Paget’s disease but malignancy could not be excluded.
She was subsequently treated as if this was Paget’s disease or a mechanical problem and sadly no further investigations for cancer were undertaken at this time. She subsequently re-presented in March 2014 with widespread metastatic disease and died some three months after her confirmation of metastatic bone disease having received no palliative treatment or support.
It was alleged that an earlier diagnosis would have led treatment (endocrine with discontinuation of tamoxifen). The claimant’s wife would have been monitored with regular scans which would have picked up the development of further metastatic disease at an earlier stage. This would have allowed earlier use of radiotherapy to minimise pain and improve function.
It was accepted that her disease was not curable but she would have been spared considerable pain both in relation to her shoulder and subsequently her sciatic pain. Had she been recognised as having metastatic disease this pain would have been identified as attributable to her bone metastases at an earlier stage and managed pro-actively. If her cancer had been diagnosed in November 2010 and managed from that point her quality of would have been better and she would have had active cancer management and pain control and would have been better able to do normal activities of daily living including housework/chores and would have required less care from the claimant and her mother and stepfather.
The earlier recognition of metastatic disease would have meant that supportive teams (e.g. Macmillan/Marie Curie nurses) would have had an input into her care, thereby reducing physical pain and increasing emotional support to her and her family. In addition, her GP would have been aware of her diagnosis and been in a better position to manage her symptoms and support the family.
A settlement was reached in the total sum of £45,000.
Date of Judgment/Settlement: 12.16
Claimant Solicitor: Helen Neville