How do people develop stage 4 cancer without noticing until it’s too late?

By Clare Absher, R.N. | Family Caregiver | Founder of CarePathways.com

As a nurse for over thirty years I have reflected on this question with regard to certain patients who are suddenly faced with an unexpected diagnosis of stage 4 cancer. However, when my dear husband Jeff went undiagnosed with stage 4 prostate cancer for over a year, I now can sadly and humbly shed some light on this quandary.

First, understand that its highly unlikely that symptoms go unnoticed by a person with late stage cancer. Jeff was keenly aware that something was wrong when he suffered worsening lower back pain and severe urinary problems. Other folks with stage 4 cancer will have different symptoms depending on the nature of their cancer. However, I still expect that most persons with stage 4 cancer will notice something is seriously awry with their health.

I believe that more often than not my husband and others share similar causes attributing to their delayed diagnosis. While not a club you wish to belong, sharing even catastrophic experiences is invaluable. Jeff’s story is sad as so many others because lives could have been spared.

Aloof, skeptical, and even arrogant doctors were responsible for their share of mishaps on Jeff’s declining path. Jeff sought out care initially from three different urologists all of whom did not find significant findings suggestive of prostate cancer. His slightly elevated PSA blood results were attributed to inflammation and treated with antibiotics. If one of the first three urologists he went to see had performed a simple prostate biopsy he might be alive today.

When Jeff’s symptoms worsened, he surrendered to an extensive evaluation by countless physicians at Cleveland Clinic for a couple of months. This included poking and prodding by urologists, neurologists, gastroenterologists, and proctologists among others. In retrospect I recall that all the physicians seemed to be looking for some rare disease and not focused on the picture right in front of them. While maybe crystal clear now, at the time we were caught up in the onslaught of CT scans, MRIs, and invasive diagnostic tests.

Moreover, Jeff was accused by one physician of being a drug seeker. Another doctor suggested that his symptoms were psychosomatic or fabricated. Still another claimed that he had been seen by every department except OB/gyn and they simply had no more medical attention to offer him.

We left Cleveland Clinic with no more answers then we had come with except a remote possibility of Lymes disease. We saw an expert in this field and he confirmed that it was likely Lymes disease that was causing Jeff’s deteriorating health. Hope was lost however after an extensive course of oral and intramuscular injections showed no improvement. Perhaps if this doctor had not misdiagnosed Jeff precious time would not have been wasted.

Jeff passed away almost 8 years ago on May 16, 2011. It still infuriates me to recount the blunders made by trusted professionals for over a year. I believe many of whom to this day had a hand in Jeff’s avoidable and painful death. His delayed diagnosis was a result of mishaps, indifference, insensitivity, and even skepticism on the part of our medical system. It was ultimately our trust in the medical community that caused Jeff’s beautiful life to be ended abruptly and in a most agonizing way.