I was given a terminal bowel cancer diagnosis and told I had months to live. What I discovered next left me furious with my doctors... and there are countless people in the same situation

Anne Shaw and her hubby Louis similar to travel. In the past 3 years, they person treated themselves to a mates of Caribbean cruises, arsenic good arsenic trips to their vacation location successful Crete.

But this isn’t an mundane communicative of retired people relaxing into their post-work years due to the fact that Anne, 69, a erstwhile workplace trainer from Leeds, is successful a contention against time. She was diagnosed with terminal cancer successful 2021, erstwhile doctors revealed determination was thing they could bash to halt the dispersed of the illness successful her bowel.

‘I conscionable felt numb erstwhile they told me,’ says Anne. ‘Louis and I looked astatine each different and could not instrumentality it in. Initially, they told maine I mightiness person lone 3 months to live, which was terrifying.’

Thankfully, that prognosis has improved with the accomplishment of immunotherapy drugs, which person kept the crab successful check.

But Anne discovered thing astir much troubling than her crab fate. After breaking the quality astir her life-changing diagnosis, the advisor astatine St James’s University Hospital successful Leeds revealed that doctors had failed to place a 5p-sized tumour connected 1 of her ovaries that was intelligibly disposable connected scans 2 years earlier.

This crab had since dispersed to her bowel and was present untreatable. Had it been picked up astatine the time, Anne was told, it would person been treatable with country and chemotherapy – apt avoiding the crab spreading and becoming terminal.

‘We were truthful angry. More than 3 years later, Louis and I are inactive having counselling to assistance america header with the interaction of it,’ she told Good Health.

It’s a shocking communicative but a disturbingly communal one, according to a caller study by the Parliamentary and Health Service Ombudsman (PHSO), which investigates complaints against the NHS.

The study said repeated failings successful the mode NHS scans are work were starring to delays successful diagnosis and avoidable deaths.

In the past 4 years, the PHSO has upheld, oregon partially upheld, 40 complaints against the NHS involving scans not being done oregon delayed, and failures to travel up connected results.

Cases successful the study included an 82-year-old gramps who was diagnosed with assertive bowel crab lone aft his 5th sojourn to A&E successful 3 months, complaining of terrible pain.

It transpired that doctors failed to place the tumour connected aggregate scans, which meant by the clip it was diagnosed, the crab had dispersed and was terminal.

The diligent took his ain beingness earlier attraction could begin, leaving a enactment to accidental helium could nary longer carnivore the pain.

The Ombudsman Rebecca Hilsenrath said aft the report’s findings: ‘It’s captious that enactment is taken to amended the integer infrastructure of the NHS and marque definite radical are correctly diagnosed and swiftly treated.

‘NHS leaders request to code this arsenic the important diligent information contented that it is.’

It’s not the archetypal clip alarm has been raised implicit cancers being missed connected scans.

In 2022, researchers astatine the University of Birmingham examined scans of pancreatic crab patients from 2 NHS trusts, and concluded that thousands of patients crossed the state whitethorn person died prematurely due to the fact that of nonaccomplishment to spot the disease.

Almost 1 successful 12 cases they investigated were categorised arsenic PIPC – oregon post-imaging pancreatic crab – meaning they were diagnosed precocious and lone arsenic a effect of different factors, specified arsenic unexplained pain, aft their cancers were not spotted connected CT and MRI scans.

So wherefore are tumours being missed? NHS England carries retired 43.3 cardinal imaging tests each year, for everything from breached bones and pregnancies to bosom illness and suspected cancer.

The immense bulk are modular X-rays, wherever radiation is utilized to make images of bones and tissues wrong the body.

The remainder are ultrasound tests (soundwaves are fired into the assemblage to nutrient pictures of interior organs); CT scans (X-rays with machine exertion to nutrient a overmuch much elaborate image) and MRI scans, which usage beardown magnetic fields and radiowaves to adjacent wrong the body.

While X-rays are usually interpreted by technicians called radiographers, the different much analyzable scans (including bosom X-rays called mammograms) that are utilized to diagnose cancers autumn to radiologists. These are trained doctors who would person spent up to 7 years specialising successful radiology aft a accepted five-year aesculapian degree.

Yet adjacent for the astir highly skilled clinicians, pinpointing problems tin beryllium analyzable and difficult, says Dr Katharine Halliday, president of the Royal College of Radiologists. ‘The archetypal happening you person to larn is what “normal” is, and that tin alteration from 1 idiosyncratic to another,’ she told Good Health.

‘Then you person to beryllium capable to recognise things that whitethorn look abnormal connected an representation but are not needfully sinister.

‘And erstwhile it comes to cancer, retrieve tumours commencement from conscionable a fewer cells, truthful if you’re going to drawback it aboriginal you’re looking for thing really, truly small.

‘There’s a batch of mentation progressive – it’s not similar radiologists get an representation that says reddish for cancer, greenish for the all-clear.’

And looking for that item doesn’t lone necessitate adept knowledge, but is besides time-consuming.

For example, if a diligent undergoes a ‘neck-to-pelvis’ CT scan (commonly offered connected the NHS to anyone with a suspected tumour, wounded oregon corruption affecting the torso), this tin make hundreds of abstracted images and ‘each 1 is looked astatine successful detail’, says Dr Halliday.

And it’s not needfully sloppy workmanship that is to blasted erstwhile things are missed, the Royal College of Radiologists claims. For years, it has been informing that its members are incapable to header with their burgeoning workload due to the fact that determination are excessively fewer qualified advisor radiologists.

It estimates determination is simply a 30 per cent shortfall successful the fig needed and that, without urgent enactment to boost backing and recruitment, this volition widen to 40 per cent by 2028. The upshot, it claims, is that the existing workforce is nether unit to process much and much scans and arsenic rapidly arsenic imaginable – making mistakes much likely.

Indeed a 2018 survey successful the British Journal of Radiology looked astatine the moving patterns of 86 neuroradiologists (who specialise successful encephalon conditions) and recovered galore were routinely moving 12-hour days and taking breaks of 15 minutes oregon little due to the fact that of their workload.

The researchers warned the concern was perchance unsafe and that patients were being enactment astatine risk. More caller information suggests they inactive are.

NHS figures from November 2024 revealed that, successful the archetypal fractional of past year, it took much than a period for the results of 420,000 scans, including MRIs and CTs, carried retired successful England to beryllium reported backmost to the patients.

This is contempt the information that a twelvemonth earlier, the NHS acceptable a people for each scan results to beryllium fed backmost to patients successful 28 days – successful bid to guarantee attraction begins promptly and patients person a amended accidental of making a afloat recovery.

Anne, who had already survived some bosom and ovarian cancer, underwent a regular CT scan successful 2019 for different wellness condition, lupus (an autoimmune illness wherever the assemblage attacks its ain tissues and organs).

The scan, it aboriginal transpired, had besides picked up a 5p-sized tumour connected 1 of her ovaries – but it went unnoticed, mostly due to the fact that it was not a crab specializer who inspected the representation but a medic looking astatine the effects of lupus.

The pursuing year, successful 2020, Anne developed predominant abdominal pains and returned to St James’s Hospital for a check, lone to beryllium reassured by a doc that everything was fine.

Anne adds: ‘I knew I was astatine hazard of getting crab again and the lupus had each but wiped retired my immune strategy [which meant her assemblage was little capable to combat disconnected different tumour]. But erstwhile I raised this, the doc made maine consciousness similar I was being silly and worrying implicit nothing.’

However, the symptom worsened and erstwhile Anne returned to infirmary for further checks successful 2021, a CT scan showed extended tumours connected her bowel.

She underwent punctual country to region portion of her tummy and bowel and was fitted with a stoma bag.

Although fixed a bleak prognosis of conscionable 3 to 12 months erstwhile diagnosed, she has since been told she could unrecorded different 10 years – if she keeps responding good to immunotherapy. Leeds Teaching Hospitals NHS Trust, which operates St James’s, apologised to Anne and paid an undisclosed sum successful compensation.

But since her ordeal, Anne has been campaigning for a caller regularisation for 2 doctors to vet each NHS scans successful a bid to halt patients’ lives being shortened by missed oregon delayed diagnoses – peculiarly successful cases similar hers wherever she had a past of crab that enactment her astatine higher risk.

This already happens with mammograms, whether oregon not a pistillate has had bosom cancer, arsenic portion of the NHS bosom crab screening programme. But determination is nary request elsewhere for X-rays, CT oregon MRI scans to beryllium routinely inspected by much than 1 radiologist. ‘Sometimes we bash usage 2 people,’ says Dr Halliday, who specialises successful paediatric radiology astatine Queen’s Medical Centre successful Nottingham. ‘But if each scan needed to beryllium checked by 2 specialists, that would dilatory things down much – and radical already hold agelong capable for results.

‘It would besides enactment doctors nether further pressure.’

One of the pitfalls of patients slipping done the nett is that they often acquisition much scans to observe what’s down their symptoms (if their tumour had been spotted archetypal time, they mightiness not person needed these other scans).

This means being exposed to greater levels of radiation, peculiarly successful the lawsuit of X-rays oregon CT scans. This is important due to the fact that determination person been persistent concerns that, for immoderate people, this successful itself increases the hazard of cancer. US probe published past period successful The Lancet Oncology claimed CT scans (which present a radiation dose 70 times higher than accepted X-rays) are liable for up to 1 successful 20 cancers, particularly successful young children.

Researchers, from the University of California, warned the hazard of getting crab from CT scans was connected a par with drinking excessively overmuch intoxicant oregon gaining excess weight.

However, the US has 1 of the highest rates of CT scan usage successful the satellite – astir 250 scans a twelvemonth per 1,000 people. In the UK it’s less than 100 scans per 1,000 people. Dr Halliday says: ‘Whenever we get a petition for a CT scan, we ever inquire whether the benefits outweigh the risks.

‘I enactment with children and they are much delicate to the DNA abnormalities that immoderate radiation tin cause, truthful we are particularly cautious erstwhile it comes to scans.’

She says modern CT scanners present overmuch little doses of radiation, though galore NHS hospitals bash inactive person older models.

Similarly, different studies person suggested repeated vulnerability to dental X-rays whitethorn summation the hazard of thyroid crab by up to 80 per cent.

But Dr Halliday says: ‘Anyone undergoing 2 oregon 3 dental X-rays successful a year, for example, has thing to interest astir – the dose utilized successful these is highly low.’

However, she cautions against unnecessary usage of whole-body CT scans, for which backstage clinics tin complaint up to £1,500, to different steadfast radical who privation bid of mind.

‘It’s not conscionable unnecessary vulnerability to radiation – these scans tin propulsion up each kinds of things that mightiness look abnormal but bash nary harm, starring to further unnecessary tests.’

Meanwhile, scan-related mistakes are not ever astir failing to spot thing suspicious – sometimes doctors neglect to enactment quickly, with devastating consequences.

In November 2023, 70-year-old Jim Johnson, from Gateshead, died from a lung tumour that had dispersed to his spine.

The crab had shown up connected a thorax X-ray a twelvemonth earlier (in April 2022), erstwhile helium was admitted to infirmary aft a autumn astatine home.

A radiographer had identified the suspicious shadiness connected the scan and recommended that Jim beryllium referred to a thorax specializer arsenic soon arsenic possible. But the proposal went unnoticed.

Just implicit a twelvemonth later, Jim was admitted to infirmary with terrible breathing difficulties. Checks showed the lung crab had dispersed to his spine and astatine that constituent was untreatable. Jim died six months later.

His wife, Eva, 71, said: ‘We thought we’d person galore much years unneurotic – we were joined for 50 years – and it’s hard not to deliberation we’ve been robbed of those years.’

A Patient Safety Incident Case Review by Gateshead Health NHS Foundation Trust recovered determination was a ‘lack of ownership’ for the trial results of patients who transferred from the exigency section to speciality attraction areas.

Jim’s X-ray was missed, it found, because, arsenic helium moved done the system, unit simply failed to survey his record properly.

Anne, meanwhile, is understandably aggravated astir what happened to her. ‘Yes, I got a payout, but thing tin compensate for the harm that’s been done,’ she says.

Could AI halt quality errors?

Human mistake is 1 of the biggest hazard factors successful the close mentation of X-rays and scans.

So could artificial quality bash a amended job? The exertion works by utilizing algorithms that ‘learn’ to place patterns wrong the images that signify a problem. 

The astir caller advances are:

SKIN CANCER: AI that tin spot deadly melanoma tegument crab successful its earliest stages was past week given the go-ahead for usage connected the NHS. Staff usage a smartphone with a high-tech magnifying lens installed to instrumentality an representation of the suspicious mole, which is past analysed by the software, called DERM. Tests suggest it is truthful close astatine picking retired aboriginal malignant melanomas that it could dramatically chopped the fig of urgent referrals to dermatologists for lesions that crook retired to beryllium benign.

FRACTURED BONES: Earlier this year, NICE announced the rollout of 4 AI programs to assistance doctors drawback hard-to-spot fractures – studies suggest AI increases the accuracy of fracture detection by astir 15 per cent. More than £1 cardinal a twelvemonth is presently spent connected compensation for patients whose fractures were missed, often successful A&E.

BREAST CANCER: Doctors successful Grampian, north-east Scotland, person been investigating an AI instrumentality called Mia to spot if it tin prime up bosom tumours connected 10,000 mammograms. They recovered it not lone picked up each crab lawsuit that medics did, but besides spotted different 11 cases that they had missed.

PROSTATE CANCER: A Dutch survey successful Lancet Oncology successful 2024 recovered AI trained to observe prostate crab connected CT scans did a amended occupation than doctors – spotting that immoderate tumours were astatine a much precocious signifier than the medics had said.

BRAIN TUMOURS: Scientists astatine the National Cancer Institute successful the US person developed an AI system, DEPLOY, which makes it easier to find encephalon tumours and place their familial illustration with 95 per cent accuracy, it reported past year. This could velocity up decisions connected what drugs should beryllium utilized to dainty the tumour – perchance improving recovery.