This case involves a fifty-two-year-old female who presented to her primary care provider with complaints of weakness and fatigue that severely impaired her daily functioning. She saw many doctors and most attributed these changes to menopause given that her menstrual periods had been irregular over the same time period. The patient experienced significant weight loss of 10 lbs over the previous six months that was not attributable to diet or exercise. This factor led doctors to pursue more aggressive diagnostic measures that revealed colon cancer. A right hemicolectomy was performed to remove the tumor and although the CT scan showed no lesions in the liver, the surgeon biopsied a suspicious site. Pathology reports indicated a moderately differentiated adenocarcinoma that had seeded the entire peritoneum.
Question(s) For Expert Witness
- 1. Could an earlier diagnosis have altered this woman's prognosis?
Expert Witness Response E-000029
The approximate five-year survival rate for colorectal cancer patients in the United States (all stages included) is 65%. Survival is inversely related to stage; patients with stage I have a 95% five-year survival rate, and those with stage III have only a 60% survival rate. For patients with metastatic, stage IV disease, the five-year survival rate is estimated at approximately 10%. A recent study by Chua et al found that approximately one in every three patients who undergo resection for colorectal liver metastases become actual five-year survivors. Of those, approximately half survive ten years and are cured of colorectal liver metastases.