Case Study Points out Easily Misdiagnosed Cancer

		Gastroenterology Medicine News Archive Featured in the Media JeffNEWS

With the increase in specifically tailored therapies for individual cancers, Jefferson doctors suggest that making a proper diagnosis takes on even greater significance.

In a case study published online in the journal Digestive Diseases and Sciences, researchers at Thomas Jefferson University Hospital in Philadelphia report on a

66-year-old man who had symptoms identical to those of primary rectal cancer—stomach pains, bloating, weight loss and constipation.

A series of tests and rectal exam confirmed a hard mass in his anal canal. Yet, as preparations and tests were conducted to remove the mass, it was determined by endoscopic biopsies that the man actually had prostate cancer.

“The treatment of cancer has progressed in such a way that we now know that therapies must be tailored to the specific cancers. Not all cancers respond or react the same way to the same treatment which is why it is important to differentiate the type,” says

David Kastenberg, M.D., principal author.

The researchers say that they weren’t completely surprised. “This is an extremely unusual but not unheard of presentation,” Dr. Kastenberg, who is clinical assistant professor of Medicine (Gastroenterology and Hepatology) at Jefferson Medical College of

Thomas Jefferson University, says. “One explanation may be that prostate cancer is often diagnosed at an earlier stage than rectal cancer. Signs and symptoms are of limited value in establishing an accurate diagnosis in patients with prostate cancer involving the rectum because the symptoms are so similar.”

Once diagnosed, the two cancers respond to separate and different treatments, Dr. Kastenberg explains. For rectal cancers, for example, optimal treatment is chemotherapy and radiation therapy followed by surgery. Prostate cancer can represent a locally advanced disease that has spread—in this case into the rectum—or a metastatic disease that is spreading throughout the body. Local and metastatic disease are managed differently.

With over 230,000 new diagnoses and 30,000 deaths each year in the United States, prostate cancer is the most common cancer occurring in men. Most cases are diagnosed in the prostate gland.  Rectal involvement (when the prostate cancer appears in the rectum) can occur in up to 11 percent of these with prostate cancer.

It is for these reasons, the researchers say, that it is important to confirm the diagnoses before initiating treatment.