(INFOVALLEY) - It is a norm for people to feel afraid when they talk about cancer. According to World Health Organization (WHO), cancer is a leading cause of death worldwide[i] [ii]. Imagine a scenario when a doctor informs a patient that he or she has been diagnosed with cancer. The news might be unbearable for some, they might feel worried, stressed out, lost, scared, angered, sad, and confused. The family will likely react the same, they will be worried and start to feels that they may soon lose their loved ones.
What if the “cancer patient” is actually cancer free and they are just as healthy as anyone else? This question keeps escalating over the years where people are misdiagnosed for having cancer while they are not.
Misdiagnosis can be defined as the incorrect assessment of a patient’s illness type or stage. Researcher at The Johns Hopkins Hospital in Baltimore reviewed 6,000 cancer patients’ tissue samples in the country and they found one out of every 71 cases was a misdiagnosed; as an example, a biopsy was labeled cancerous when it was not. Furthermore, one out of five cancer cases was misclassified[iii].
In a joint study between Best Doctors and the National Coalition on Health Care (NCHC), entitled Exploring Diagnostic Accuracy in Cancer, 21 cancers were named for the most often misdiagnosed or mischaracterized conditions and the top five conditions by considerable margin was Lymphoma, followed by Breast Cancer, Sarcomas, Melanoma, and Cancer of Unknown Primary Site.
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| Table 1 |
From the statistic it is understandable that the main issue leading to misdiagnosis is lack of diagnostic information. Diagnostic information is crucial as it is one of the main determining tools in medical diagnosis. The information that required for medical diagnosis varies, from clinical information, medical history, genetic information and few others. Thus if the doctors lack any of these information the diagnosis may become a questionable result.
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| Table 2 |
The doctors agreed that the improvement needs to be done in terms of upgrading the information resources including pathologic, genetic, radiology, and clinical information. One of the major contributions to the cause of misdiagnosis is insufficient or no genetic (genomic) information available at the time of diagnosis. As suggested by the doctors, new or more resources for tumor genetic testing should be readily accessible, because more absolute and accurate result on the cancer conditions could be obtained.
New dimension of genetic screening is now starting to take over the market in the form of genetic predisposition testing. Genetic predisposition test identifies individuals who are genetically predisposed to certain health problems. The physician will be able to ‘peak’ into the patient’s genetic make-up and take the necessary steps to help prevent the conditions from manifesting. A genetic predisposition test is considered as one-step-ahead initiative in health screening compared to biochemical based markers that will detect a disease when it has manifested, in the cases of discussion, cancer that is already present in the body. However, tumour marker levels are not always altered in people with cancers, especially in the early stages of cancer. At times, the cause of the elevated levels of biochemical markers can also due to other causes and factors. For example, the level of the tumor marker CA 125 can be high in women with gynecologic conditions other than ovarian cancer. The genetic predisposition test caters for the wellness sector and therapeutic lifestyle interventions with periodic screenings that helps for cancer diagnosis and cancer prevention altogether.
In cases where cancer is already present at an early stage, genetic tests plays a role to determine the condition, level and seriousness of the cancer accurately. This will create a better decision making in determining the types of treatment a patient should undergo, be it surgery, radiation, chemotherapy or endocrine therapy. In addition if it is surgery, radiation, or endocrine therapy, the test will help to ascertain the type of the treatment that should be performed. For the fact from the study, the genetic test will be able to reduce the chance of misdiagnosis by 20.3 percent and will increase the diagnostic accuracy rates in cancer cases by 17.8 percent. This effective cancer screening will avoid a late detection, economic lost and loss quality of life.
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Cancer is preventable. Will and effort in undergoing early screening and seeking for second or maybe third opinion, matters. Don’t take things for granted. Prevention is better than cure.
By Ahmad Fakri Hilmi, iGene Sdn. Bhd., KL
[iii] Misdiagnosed
cancer not uncommon – ABC News, http://abcnews.go.com/WNT/story?id=131047&page=1
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