"I lost my partner to bowel cancer after repeated misdiagnoses"

About: Ealing Hospital / Colorectal surgery London

(as other),

My partner saw two different GPs at our local practice, with a six month gap in between with diarrhea, weight loss and blood in his stool. His symptoms were dismissed as minor, no further investigations were ordered, and so his condition was left for a full year before a proper diagnosis was made. He was finally taken more seriously, and urgently referred to hospital for more tests. However, by this time he had stage 3 bowel cancer, and after chemotherapy and two major surgeries he died seven months later. He was 28.

The first GP diagnosed a “likely internal pile” with no onward referral for investigation. They advised my partner to return if “++ bleeding/pain/masses”. This advice was not very helpful and I feel he should have been told to return if bleeding persisted at all, heavy or not. As it was he felt the small amount of blood found in his stools over the next few months was nothing to worry about.

He returned for the second visit 6 months later regarding his ongoing diarrhea and bleeding. He had lost more weight and was experiencing significant pain. The doctor noted that my partner thought he had IBS because a sibling had the same condition, and prescribed Fybogel and suggested a food diary to find trigger foods. The doctor did not carry out any examination to check whether my partner’s layman's self diagnosis was accurate, no ongoing monitoring was discussed, nor were any further investigations requested. My partner was left feeling that his condition was not medically significant and he should not worry about it.

It was not until he saw a third doctor and presented with emergency symptoms of anaemia and a raised temperature that he was rushed to hospital where they carried out a colonoscopy and after a month’s stay discovered he had bowel cancer, which was so advanced it had eaten through his bowel wall. An operation was carried out to remove a section of his bowel and he came home after a further month’s stay. He then saw an oncologist who recommended 6 months worth of treatment but the cancer returned within 4 months with metastasis to the liver and abdomen. A second operation was carried out somewhat successfully but the cancer continued to spread and my partner tragically lost his life in November at a local hospice.

I feel that there were missed opportunities by the GPs for monitoring and further investigations which could have picked up the cancer in its much earlier stages when it may well still have been survivable.

It is not my intention to make trouble for the GPs involved or to ask for compensation. I feel very strongly that my partner's relatively early age at onset is what left him undiagnosed: I fear his GPs assumed that he was too young to have bowel cancer and dismissed this possible diagnosis when making their differential diagnoses. I have heard lots of similar stories about other people being misdiagnosed due to their age too. Maybe GPs need to make onward referrals for colonoscopy, or at the very least make a monitoring plan for patients with a similar presentation so that further possible unnecessary deaths are prevented in the future as bowel cancer is a curable disease if caught early enough.

I believe these safeguards need to be put in place urgently to help stop this awful loss from happening again to another family. Clinical guidelines for younger people with cancer symptoms are needed urgently.

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Responses

Response from NHS North West London

I'm very sorry to hear about your experience here. From your description there is clearly an opportunity to improve the care your partner received and learning so that other people don't suffer.

It would be very helpful if you could contact me in confidence so that I can follow this up.

Mark Spencer, Medical Director for Quality (mark.spencer@nhs.net)

David Finch, Area Medical Director

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Response from Beating Bowel Cancer

We’re very sorry to hear about your partner’s experience, our sympathies are with you.

I’m from the charity Beating Bowel Cancer and we’re working to raise awareness of the condition in all age groups. As you point out, being diagnosed at an early stage is vital. Sadly too many people are diagnosed in later stages and we know much more needs to be done to improve this.

If you would like to speak to someone, our nurses can be contacted via our helpline on 08450 719 301 or email nurse@beatingbowelcancer.org. More information about the charity can be found on our website: www.beatingbowelcancer.org.

We’re always keen to hear of patients experiences around GPs and cancer referrals, so if you’d like to get in touch to discuss further, please email me on elspeth.mcausland@beatingbowelcancer.org.

Best wishes,

Elspeth

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