Bonetumor.org - The Web's Most Comprehensive Bone Tumor Resource

If you have found it difficult to find a physician with the knowledge required to treat your bone or soft tissue tumor, you are not alone. These unusual and complicated conditions are not routinely treated by most physicians.

If you would like to consider having a consultation by Dr. DeGroot, we invite you to contact our offices via e-mail for information on how this can be accomplished.

Delay in diagnosis of tumors remains a major source of concern for patients and physicians alike. Early on, the symptoms of these tumors mimic those of common sprains, strains, bumps and bruises. Tumors can be misdiagnosed, missed, or mistreated for weeks, months, and even years. Unfortunately, errors in diagnosis, inadequate examination, missed diagnosis, and mistreatment in these tumors can have serious consequences.

The causes of diagnostic delay are many. The early symptoms may be vague and misleading. Initial radiographs may be normal or the findings may be so subtle that they escape detection. A doctor, a radiologist, or another caregiver might miss the importance of an early abnormal finding. Sometimes the caregiver takes a sketchy medical history or performs an incomplete physical examination, and as a result the whole course of treatment is set off in the wrong direction.

Lack of suspicion on the part of the caregiver, inappropriate reassurances that the symptoms are not worthy of real concern, and lack of adequate imaging studies are common reasons for delay. Sometimes there were "red flag" symptoms or findings that should have been heeded. Even well-trained radiologists, pathologists, orthopedic surgeons and other physicians can miss the diagnosis or misinterpret a test or imaging study. However, many caregivers lack experience and training in these problems and therefore fail to consider a cancer, tumor, or sarcoma in the differential diagnosis.

Delay in diagnosis of cancer can happen to children as well as senior citizens, to men and to women, to persons with primary bone or soft tissue cancers as well as to persons who have a musculoskeletal manifestation of a cancer that started elsewhere in the body, such as the breast or the lung.

Delay in diagnosis of musculoskeletal tumors and cancer is not something that necessarily happens to poor physicians performing low-quality care. It also happens to intelligent, well-trained, caring, compassionate physicians who become trapped by the many pitfalls that lie in the path to a correct diagnosis.

Patients can contribute to delay in the diagnosis of their own medical problems. Some individuals fail to seek out medical care in the face of an obvious problem because of their fear of bad news, or because they may feel that nothing good can come of the treatment process. Patients may fail to return for scheduled follow-up appointments or they do not heed their doctor's advice to seek additional consultation. The sources of delay are often multiple and complex.

The important thing is to begin the correct treatment immediately once the real diagnosis is discovered. It is important to focus on the good that can be done in the present and in the future rather than the bad that has occurred in the past. A delay in diagnosis does not mean that the tumor cannot be fully treated and cured. Issues related to the delay can and should be worked out later once the treatment in on track.

The author of this site has a great deal of experience in evaluating and managing diagnostic delay where it relates to tumors of the musculoskeletal system. Dr. Degroot has been a contributor to regional, national, and international orthopedic meetings and publications on the subjects of delay in the diagnosis of musculoskeletal tumors. Please contact Dr. DeGroot if you require assistance with these issues.