Abstract
A number of reports have been given that indicate that many individuals both children and adults alike are misdiagnosed with the lymphoma disease. Studies indicate that the patients are either diagnosed at a later stage of development of tumor cells or are diagnosed promptly. Misdiagnosis occurs as a result of resemblance or similarity of symptoms that lead to the development of lymphoma diseases. The symptoms are similar to a number of other diseases such as tuberculosis, Leukemia, influenza, strep throat, mononucleosis and upper respiratory infection and others. This research paper highlights the problem of misdiagnosis and lays out strategies to establish how often misdiagnosis occurs in the United States as well as the contributing factors. This is achieved through the use of current background information, research design and data collection tools.
Key words: Lymphoma, Leukemia, Malignant Tumors, Cancer of the blood.
Misdiagnosis of Lymphoma in Children and Adult
Introduction
Lymphoma is defined as a collection of blood cancers that begin in the lymph glands. There are two types of lymphoma known as non-Hodgkin lymphoma and Hodgkin’s disease. Hodgkin’s disease occurs in rear cases. Lymphoma occurs as a consequence of mutation or change of the form of lymphocytes found in the lymph glands. Lymphocytes are infection-fighting white blood cells acting as a body defense mechanism against diseases and infections. When these cells mutate or change, they initiate unrestrained growth of cancer cells. These cancer cells increase in size until they form malignant tumors in the lymph glands. Misdiagnoses of lymphoma occur mainly due to the symptoms being similar to those of other conditions, diseases and disorders. Leukemia, influenza, strep throat, mononucleosis and upper respiratory infection are a few examples of diseases and conditions that have similar symptoms with lymphoma. Misdiagnosis can also occur as a result of prompt diagnosis due to appearance of early symptoms to some people (Hingorjo& Syed, 2008).
Research problem
In the United States, a number of cases are reported yearly where misdiagnosis of lymphoma diseases occurred as a result of negligence or physicians not being sure of the symptoms. Both children and adults alike are facing the problem of misdiagnosis of lymphoma which brings dire consequences in their lives. Some of the victims of misdiagnosis of lymphoma end up dying since the right diagnosis come in too late when the disease is incurable. A few cases have been reported where the patients even sue the doctors who misdiagnose them. The aim of the research is to find out whether misdiagnosis of lymphoma occurs as often as it is claimed or not. It also tries to find out the contributing factors for misdiagnosis of lymphoma.
Current Background
The complexity of the disease is wide in the sense that benign disorders which include ordinary infections are likely to be inferred as malignant lymphoma. These symptoms may lead to a patient being subject to chemotherapy or surgery. The whole procedure of diagnosis of lymphoma encompasses histopathological findings on biopsy with an inclusion of other procedures such as invasive or non-invasive methods to determine the extent of the disease. Due to the fact that the process of diagnosis being involving, physicians tend to carry out diagnosis of other diseases and conditions with similar symptoms. This may lead to late diagnosis of lymphoma. However, when proper diagnosis has been done, an appropriate therapeutic plan is implemented to cure it (Pilch, 2001).
Lymphomas are mostly curable if they are treated at an early stage of development. Early treatment requires that the person is diagnosed early as well. However, for the success of therapeutic plans, proper staging and evaluation is important. This is made possible by categorizing them into stages which makes it possible for the therapeutic plan to work. It can be observed that proper diagnosis and treatment is quite involving and perhaps that could be a contributing factor as to why there are increased cases of misdiagnosis (Hingorjo& Syed, 2008).
The disease is reported to occur more in children than in adults. The most prevalent is the Burkitt’s lymphoma which attacks children with the age of 4-20. Many of these children affected are boys. Burkitt’s lymphoma rarely attacks girls. The reason for the gender disparity is unknown. In addition, this disease does not appear to be caused genetically. It has also been found out that the greater percentage of patients with lymphoma diseases are children as compared to adults (Hingorjo& Syed, 2008).
The disease is also found in a number of people suffering from HIV/AIDS. This is because the immune system of the HI/AIDS patients is trying to replace the dead lymphocytes and it consequently multiplies too fast. It is estimated that approximately 2% of people with AIDS develop Burkitt’s lymphoma in the United States. The study also reveals that, the majority of these people are diagnosed with Burkitt’s lymphoma when it is at stage four. This is a stage where the development of the malignant tumors has spread to other organs of the body and it becomes difficult to locate the starting point of the tumor. At this stage, the disease is often incurable (Hingorjo& Syed, 2008).
A study conducted indicated that lymphoma diseases are misdiagnosed at an early stage. These individuals are treated with other diseases that have similar symptoms as lymphoma for quite some time before they are properly diagnosed with lymphoma. This could be the reason as to why lymphoma has a growing percentage of patients in the United States. This is despite the fact that the numbers of patients who are diagnosed with lymphoma are relatively small. It is also reported that the cancer cells of lymphoma have the ability to duplicate themselves in every fourteen hours. It is apparently obvious that lymphoma is a growing killer cancer disease which is dominant in children (Zukerberg, Harris & Young, 1991).
The consequences of early or proper diagnosis of lymphoma disease in both adults and children alike are many. Mostly, it may be difficult or impossible to treat a full grown or developed cancer cell. This will eventually lead to death since there is little progress on containment of the situation. In exceptional cases, a few individuals are reported to miraculously recover after being diagnosed with non-Hodgkin’s lymphoma at stage three or four of development. Early correct diagnosis is recommended for proper treatment. In some cases, non-Hodgkin’s lymphoma may lead to development of other cancers in the body due to tissue ruptures occurring during the growth of the cancer cells (Acton, 2011).
Hypothesis
Misdiagnosis of lymphoma in adults and children is a common occurrence in hospitals, health facilities and with health professionals. In order to establish the difference between cancers of the blood and other cancers, doctors and health experts have to carefully consider all the symptoms and carry out proper diagnosis and avoid prior assumptions. Lack of skills or clinical knowledge among the health professionals could be a contributing factor for the increasing number of non-Hodgkin’s lymphoma cases or it is negligence.
Research design
The research will incorporate both qualitative and quantitative methods. The advantages of using mixed research methods is that quantitative research, repeatedly, improves on the strength of research instruments and gives a numerical dimension to analysis when addressing phenomena. Also, quantitative method can abridge human experience, statistically, resulting in easy data analysis. In addition, qualitative method enables the researcher to get answers to questions, collect evidences and can also produce findings that exceed the immediate boundaries of the research study. On the other hand, the disadvantages of mixed method approach are the complexity of data analysis if one is not proficient in integrating the two results to give a conclusion. The mixed research method is also expensive and time consuming. The research will constitute 3 hospitals and 1 health facility selected randomly in the United States. These hospitals and the health facility will act as sites where the study will be conducted. Data analysis will involve the use of analysis of variance as well as t-tests for the quantized data. The qualitative data will require interpretation of the contextualization of the information provided by the participants. Based on the interpretation of the findings from the research, it will be advisable for the government and the health organizations to intervene where necessary. This may include using more programs to create awareness to the public as well as to the doctors.
For instance, if it is found out that 2 out of 15 people in a population of patients with diseases, disorders and infections that have similar symptoms like lymphoma are diagnosed with lymphoma diseases, then inferential data analysis can be done. Quasi experiment is interpreted by the use of regression discontinuity design approach to produce unbiased estimate of the treatments. Depending on the outcome of the results, the inferential interpretation will be done to determine a form of intervention needed for the focus group. This inference can also be applied to the rest of the population since the selected sample is a representative of the whole population. The research design will also figure out if the problem of the research is approved or not. The success of the research methodologies used depends on the precision of the parameters of the experiment.
Data collection
Data collection methods include the use of interviews. The survey can also be conducted using semi-structured interviews and/or focus groups to figure out what are some possibilities and what are some patient and physician characteristics that might be correlated with misdiagnosis of lymphoma versus correct diagnosis. The data collected can then be included in the survey.
Another methodology is the use of questionnaires. The questionnaires contain queries of the symptoms that are likely to result to lymphoma and how to detect lymphoma related symptoms in children. The questionnaires must be brief which require precise answers. This information can be obtained from hospital databases or by choosing a sample of people randomly as a representative of the population. The data collected from these sources must be reliable in order to give accurate information for the research experiment.
What I hope to learn
The necessary steps that the hospitals, health facilities and clinics have made together with other organizations in avoiding misdiagnosis of lymphoma should also be established. It is through conducting this research or study that one can be absolutely sure of the challenges that are facing the health sector with regard to misdiagnosis of lymphoma. The information gathered after this study will give insight on what needs to be done to remedy the situation. Therefore, this can then be proposed to the respective authorities to implement the action plans.
Conclusion
The complications associated with lymphoma disease are as a result of having similar symptoms to other many diseases, disorders and infections. However, some cases of misdiagnosis of lymphoma diseases are reported to occur due to negligence or ignorance of some health professionals. It is therefore important that many studies be conducted on the diseases in order to establish exact symptoms that could clearly differentiate the development of lymphoma at an early stage from the rest of the diseases.
References:
Acton, Q. A. (2011). Lymphoma: New Insights for the Healthcare Professional: 2011 Edition. Atlanta, GA: Scholarly Editions.
Hingorjo, M. R. & Syed, S. (2008). Presentation, Staging and Diagnosis of Lymphoma: a Clinical Perspective. Ayub Med Coll Abbottabad Journal, 20(4), 100-103.
Pilch, B. Z. (2001). Head and Neck Surgical Pathology. Philadelphia, PA: Lippincott Williams & Wilkins.
Zukerberg, L. R. Harris, N. L. & Young, R. H. (1991). Carcinomas of the urinary bladder simulating malignant lymphoma. A report of five cases. The American Journal of Surgical Pathology, 15(6), 569-576.
