Thankfully testicular cancer is a relatively rare form of cancer, but it still affects approximately 2,400 people in the UK each year and is unusual in that most commonly patients are young men, aged 15 to 49. Treatment usually involves surgery to remove the affected testicle (known as orchidectomy) and then is often followed by chemotherapy, which in itself can have lasting side effects.
Chemotherapy aims to treat testicular cancer by stopping the cancer cells reproducing and therefore inhibiting the spread of the cancer, but can damage the immune system, increase risk of organ damage and impact on fertility. However, the Institute of Cancer Research, London and University Hospitals Birmingham NHS Trust have jointly undertaken a study into trying to reduce the side effects of chemotherapy for testicular cancer which has had promising results. 246 patients took part in the study, receiving just a single cycle of chemotherapy rather than the standard two. The results showed that the single cycle was just as effective and has been described as “a shorter, kinder and cheaper” treatment approach. This appears to be strong evidence that the number of chemotherapy cycles used to treat testicular cancer can be reduced in a safe manner, thereby lessening the side effects and improving quality of life after cancer.
Penningtons Manches Cooper represents patients with claims arising from delayed diagnosis of cancer or sub-standard oncology treatment. The firm’s clinical negligence team sees examples of both how the diagnosis of cancer affects people, and its impact on their lives subsequently. Experiencing cancer means not only undergoing the treatment for it, but also living with and after the disease. The life-long effects can be psychological as well as physical, even with successful treatment; fear of recurrence is common.
When an oncology clinical negligence claim is valued, the impact of the injury that has resulted from negligent medical care is considered in a holistic manner and financial losses are investigated and calculated. Damages (compensation) can be claimed for both the physical and psychological injury, and also the past and future financial losses. The financial losses may include a loss of earnings if the patient has had to take time off work to undergo treatment, been too ill to work, or indeed may not have been able to get back to work at all following treatment. Where there is a loss of earnings, there may also be a loss of pension contributions, which will ultimately give rise to a lesser pension than that person would have achieved otherwise.
Very commonly the cancer patient will have received care from family and friends and even though that care is likely to have been given voluntarily, it still has a financial value that can be claimed for. Conversely, a cancer patient may not be able to continue caring for children or elderly parents as they would have done otherwise, and the replacement care put in place can be valued and claimed for.
For some people, the journey after cancer treatment can be as emotional and difficult as the treatment itself. Cancer patients report feeling great sadness, fear, anxiety or anger after their treatment has concluded. This is unsurprising given the serious life decisions that patients have potentially had to make. It may be that professional therapy and support can help and, in an oncology clinical negligence investigation, it is important to consider whether psychiatric expert evidence is required to look at treatment options and recommendations. The cost of any therapy or treatment can be included within the claim and then accessed by the patient in the private sector.
In all oncology clinical negligence claims, it is necessary to look at the extent of the injury caused by the negligent medical treatment, as it is often the case that sub-standard medical care has increased the severity and impact of the injury, but not caused the cancer itself. It may therefore be that even with adequate medical care, the patient would have still required surgery and potentially chemotherapy too.
An example of this is a case in which a 17 year old man suffered a delay in diagnosis of testicular cancer. By the time of diagnosis and surgery, he required removal of his lymph nodes as well as the affected testicle. The need for the lymph node dissection caused him loss of ejaculatory function, which in turn caused him a psychological injury and impacted on his relationship with his partner. However, he would have required removal of his testicle and chemotherapy in any event, even if he had been diagnosed sooner. On the balance of probabilities, the chemotherapy would have left him infertile regardless of the delay in diagnosis. This man received damages equating to approximately £42,000 for his injuries.
Alison Johnson, a partner in the clinical negligence team at Penningtons Manches Cooper, comments: “Placing a financial value on a clinical negligence claim relating to cancer is not straightforward. Looking at an individual’s circumstances both during and after cancer treatment is very important and can involve obtaining a substantial amount of expert evidence. Studies such as the testicular cancer study into the effectiveness of a single cycle of chemotherapy are essential and will help change clinical practices, hopefully reducing side-effects and changing lives for the better.”