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Mistaken cancer diagnosis stems from pathology problem

Larry ReeceHAMILTON, Ont. – Larry Reece (pictured), 46, is demanding answers from two hospitals after he was incorrectly diagnosed with terminal cancer and told to start chemotherapy. The Hamilton man wants to know why the hospitals stood by the misdiagnosis even after he underwent additional tests in the United States that indicated he did not have cancer.

For months, doctors in Canada and the U.S. argued over Reece’s diagnosis of stage-four lung cancer. On Oct. 3, his Canadian physicians admitted they had made a mistake; he was told by Hamilton Health Sciences he was actually suffering from sarcoidosis, a rare but treatable lung disease that can look like cancer.

Reece is relieved, but wonders if his pathology slides were switched with those of another patient. “This is a terrible thing and what’s in our heads now is whether they got the samples mixed up. Is there somebody out there that has cancer but doesn’t know it yet?” he wondered.

In October, Reece formally complained to St. Joseph’s Healthcare Hamilton’s Firestone Clinic, where he was diagnosed, and Hamilton Health Sciences’ Juravinski Cancer Centre, where he was referred.

Both health centres told the Star they acknowledged “the gravity” of Reece’s case and are investigating what happened. St. Joseph’s Healthcare Hamilton chief of staff Dr. Hugh Fuller said a comprehensive review had been launched into Reece’s case.

Hamilton Health Sciences is also investigating, and its chief medical executive, Dr. Richard McLean, said: “This is a complex case and we appreciate the gravity of the situation.” Both organizations said they would discuss the findings of the reviews with Reece.

Reece was a non-smoking, previously healthy man who developed a cough in early 2013. Unable to shake the cough a year later, he underwent a CT scan at the Firestone clinic and was told “with 99 percent certainty” he had sarcoidosis.

He underwent a lung biopsy in May and the results painted a much more sinister picture: stage-four lung cancer that had spread. Reece was told by his doctor that most patients die within 12 months. He was then referred to an oncologist at the Juravinski Hospital, who suggested he start chemotherapy as soon as possible. “I was completely shocked and did not feel like I was dying,” Reece said. He refused chemotherapy and went to his company, Thermo Fisher Scientific, for help.

For the past 25 years, Reece has worked as a distribution data analyst for Thermo Fisher Scientific, which specializes in healthcare and scientific research. The company has a program that supports employees battling cancer and provides funding for further testing.

The organization’s former chief medical officer, U.S.-based genetic expert Dr. Paul Billings, studied Reece’s medical records and took up his case.

Billings, who is now the chief medical officer at the University of California, Berkeley, disagreed with Reece’s cancer diagnosis and said he had many sleepless nights worrying about what would happen. He feared chemotherapy could weaken Reece’s immune system, making it more likely to be ravaged by sarcoidosis, Billings told the Star.

He sent Reece and his first tissue sample to Roswell Park Cancer Institute in Buffalo, N.Y., for further tests. Doctors told Reece the sample tested positive for cancer, but his biopsy results showed he did not have cancer.

His blood sample was also sent to Guardant Health in California for a breakthrough test that can analyze a patient’s cancer genomics and came back negative. The results of both tests were sent to Reece’s Hamilton-based doctors, Billings said.

Reece said doctors at Juravinski Hospital told him on Aug. 13 that he still had cancer. By this stage it was almost six months since Reece had been diagnosed, yet he had not lost weight or suffered from symptoms typical of advanced cancer, Billings said he told Hamilton doctors.

“Finally, the hospital re-biopsied him and found nothing,” he said.

When doctors at Juravinski told Reece the results, he said they added that he could be “the one in a million where an error has occurred.” Reece was told he had sarcoidosis — a disease that has an average mortality rate of one to five percent, compared with the 99 percent mortality rate for stage four lung cancer.

Billings believes there are only three explanations for the misdiagnosis:

• Reece had cancer and it mysteriously disappeared without treatment, which he said was highly unlikely.
• The pathologists misread his tissue sample.
• His sample was mixed up with another patient’s.

“Mistakes happen in the lab. It’s very rare, but they do happen,” Billings said. This was a “very unusual case” that highlights a serious need for hospitals to safeguard against lab errors.

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1 Comment responses

  1. Avatar
    November 20, 2014

    It seems like there is an awful lot of finger pointing going on in this article: lots of speculation with very few facts. For example, rather than categorizing this as a “pathology problem”, do we know that this is not a “operating room” problem? After all, is that not where the lung biopsy was taken? Could it not be possible that a specimen mix-up due to poor specimen labeling occurred whereever the specimen was taken? Even if it turns out that this is not a “pathology problem”, this is what will remain on people’s minds. Unfortunate, but avoidable incorrect conclusion, if better journalism were in place.

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