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When possible, surgeons needs to remove enough tissue to make sure that they get the surrounding microscopic cancer, too, as well as the larger tumor Contact Now

Cancer surgery is successful when there are clean margins, but when the surgeon stops short it can spell trouble

When possible, surgeons needs to remove enough tissue to make sure that they get the surrounding microscopic cancer, too, as well as the larger tumor

I attended an interesting deposition today in a pending medical malpractice wrongful death case. The witness was a surgeon who is serving as an expert witness for our client, the plaintiff. The defense attorney repeatedly used the term “invisible cancer” while questioning the expert.

The case involves the tragic death of a young mother from colon cancer. She got diagnosed before the cancer spread (metastasized). That means that, for this type of cancer, surgery and chemotherapy offered her an excellent outlook and normal life expectancy.

Some cancers are operable and others aren’t. An operable cancer is one where a surgeon can take the patient to the operating room and resect (cut out) the tumor. Sometimes it’s possible for the surgeon to resect the whole tumor, and other times it’s not. One of the deciding factors is whether the cancer mass is accessible to the surgeon without damaging vital organs, blood vessels, or nerves.

In this case, I took the deposition of the colon-rectal surgeon who performed the surgery. He explained that the tumor was a few centimeters away from the middle colic and superior mesenteric veins. Based on this fact, our surgery expert testified that there was ample room for the surgeon to access the tumor and resect the whole mass with clean margins.

Clean margins are extremely important for successful cancer treatment, so let’s discuss what they mean.

Part of a cancerous mass is grossly visible to the naked eye and can be felt by the surgeon’s hands—cancer feels hard and normal tissue feels softer. There’s also part of the cancer that can’t be seen or felt, though—it’s microscopic or invisible, as the defense lawyer liked to put it at today’s deposition.

To achieve clean margins, the surgeon must remove not only the grossly-visible cancerous tumor itself, but also extra heathy tissue surrounding it to ensure that all the microscopic cancer is also removed.

In this case, the defendant surgeon testified that he intended to resect all of the cancer and that he didn’t see anything during the surgery that would stand in his way to prevent him from doing so. Unfortunately, he stopped short and didn’t resect enough of the surrounding healthy tissue to get clean margins. As a result, he left microscopic cancer in this poor lady’s colon, which continued to grow. By the time this patient had recovered from her surgery and was eligible to begin chemotherapy, the retained microscopic cancer had metastasized and spread to other parts of her body.

As part of our careful investigation of this case, Painter Law Firm also hired an oncology expert (cancer specialist) to review the medical records. This expert explained that if the surgeon hadn’t stopped short, then the patient would have likely survived with standard chemotherapy. Chemotherapy isn’t as effective, though, in treating metastatic cancer as it is in treating a patient who had a tumor that was completely resected. Instead, this patient suffered through treatment, but died from metastatic cancer, leaving behind a grieving family.

I should also mention that clean margins aren’t only important in cancer surgery. They’re also important when a biopsy, or sample of suspicious tissue, is taken for gross and microscopic examination to look for cancer. The biopsy needs to be large enough to include all the edges of a spot on the skin, for example, to rule out melanoma cancer.

If you’ve been seriously injured because of poor cancer diagnosis or surgical treatment, then contact a top-rated Houston, Texas medical malpractice lawyer for help in evaluating your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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