Imagine a conversation with a doctor that goes as follows: Patient: "Doctor, I am spotting blood in my stool." Doctor: "You probably just have hemorrhoids." However, some time later this individual discovers that the bleeding was in fact caused by a cancerous tumor in the colon. He or she now has advanced colon cancer that has progressed to the lymph nodes or even to a different organ, such as the liver or the lungs. How does this happen and what options does the person and his or her family have if it does?

The first thing to note is that most physicians agree that when someone complains of rectal bleeding or blood in the stool a colonoscopy needs to be performed so as to establish the source of the blood. The colonoscopy helps establish if the blood is from colon cancer or something different like hemorrhoids. However merely supposing that the blood is the result of hemorrhoids risks a delay in diagnosing a cancer.

Colon cancer is a disease that progresses over time. As it advances it gets harder to treat successfully. For instance, while it is contained inside the colon treatment normally involves surgery to remove the tumor and adjacent parts of the colon. Chemotherapy is frequently not part of the treatment of stage 1 and stage 2 unless it may be given to a person who is young as a preventative measure. With surgery, someone with stage 1 or stage 2 has a good chance of outliving the disease for at least five years after diagnosis. The relative 5-year survival rate is more than ninety percent for stage I and seventy three percent for stage II.

Once the cancer reaches stage 3, it has spread outside the colon. At this stage treatment calls for both surgery and chemotherapy (perhaps with other medications ). The relative 5-year survival rate for stage 3 is fifty three percent. If it gets to stage 4, the relative 5-year survival rate is lowered to roughly eight percent. Treatments such as surgery, chemotherapy, radiation therapy, and other medications may or may not still be effective. When treatment ceases to be effective, the disease becomes fatal. Approximately 48,000 men and women will die from colon cancer this year alone.

If the patient with rectal bleeding undergoes a colonoscopy and the tumor is discovered before it has spread to the lymph nodes or to other organs, it can often be taken out in the course of the colonoscopy if it is sufficiently small or by surgically extracting the section of the colon containing the tumor. Hence the additional time before diagnosis and treatmenet may be sufficient for the cancer to get an advanced stage. When this is the case, the patient will have to undergo additional treatments and will have a greatly decreased likelihood of living for at least five years beyond diagnosis. Based on the laws of the jurisdiction in which the doctor caused the delay, this may give rise to a claim for medical malpractice, or in the most severe case, for wrongful death.