This case involves a patient who was diagnosed with a brain tumor in 2006. The patient was being followed by a medical oncologist who was monitoring the primary malignancy and tracking the progression of the tumor. There was a brief period of time in which the physician did not order follow-up imaging to evaluate for possible recurrence of the primary tumor. In 2012, the patient was diagnosed with a secondary mass in the patient’s kidney, which then had to be removed.
Question(s) For Expert Witness
- 1. What could have been done differently to prevent this outcome?
Expert Witness Response E-004792
There is no standard therapy for recurrent brain cancer. Patients who were spared radiation therapy or chemotherapy commonly undergo these therapies at recurrence. There are numerous agents being used in cases of primary treatment failure, as well as many ongoing clinical trials. Current avenues available include antiangiogenic agents, tyrosine kinase inhibitors, convection enhanced delivery of chemotherapeutic agents or toxins, cancer vaccines, and stereotactic radiosurgery. In any event, the patient should have had follow-up imaging to determine if there was any metastatic spread from the primary malignancy. Feedback provided by a medical malpractice expert witness.