Melanoma cancer diagnosis, treatment, and malpractice

Recently, a number of new clients have hired Painter Law Firm to investigate medical malpractice cases regarding undiagnosed cancer. Each of these cases is tragic, involving a patient who sought treatment early, but was incorrectly told that everything was fine.

Hearing this type of story over and over again reminded me of a malignant melanoma case that I handled many years ago. In that case, a man noticed a small area of discoloration on one of his thumbs. He said that it initially looked like a small black speck, but after it seemed to grow a bit, he went to see a dermatologist.

Types of skin and nail biopsies

The dermatologist was concerned enough about this man’s thumbnail to do a punch biopsy, which involves using a tool with the circular blade to cut out and around a suspicious area, to be sent to pathology lab for analysis.

Dermatologists often start with a punch biopsy, but there are other options as well. Under the standard of care, the doctor must ensure that an adequate tissue sample is removed for laboratory analysis. While the punch biopsy removes the least tissue, an incisional biopsy removes more, but only the most irregular part of a mole or growth to be sent to a laboratory for analysis. An excisional biopsy is even more extensive, and the entire mole, growth, or suspicious area is cut out or removed, along with a small border of normal-looking skin.

In the case I was talking about above, the dermatologist sent the punch biopsy sample to a pathology laboratory for analysis. Unfortunately, the dermatologist had taken a rather small punch biopsy. This sometimes happens by mistake, and dermatopathology experts testified that the standard of care a laboratory to notify the physician that a larger sample as needed.

As you might have guessed, in this man’s case, the pathology laboratory did not do so. As a result, both the dermatologist and the patient believed that there was no problem. Sadly, what started as a small speck in the thumbnail quickly spread through his thumb, into his hand, up his arm, and into the lymph nodes in his armpit, metastasizing through his whole body. At that point, treatment was not an option, and it was not long before he passed away.

Spotting melanoma

The Mayo Clinic has an excellent article with photos of melanomas that can be used for comparison purposes and self-examinations.

When doing self-examination of skin and nails, the American Academy of Dermatology advises patients to look for spots that have any of these ABCDE characteristics:  Asymmetry, Border irregularity, Color changes, a Diameter of over a quarter of an inch, and Evolving or changing over time.

Getting treatment

Based on my experience as a Houston, Texas medical malpractice lawyer, I think it is a good idea for every adult to have a relationship with a dermatologist, including regular visits. Dermatologists are trained to perform head-to-tell inspections of your skin, and make notes in your medical record about potentially problematic areas, which can be monitored on future exams.

If a dermatologist is concerned about an area of your skin, he or she may recommend one of the biopsies that I discussed earlier. If a biopsy results in a finding of melanoma, the dermatologist will assign a stage to it, using the Roman numerals I to IV. As the Roman numerals grow larger, the cancer is more severe. The different stages are defined largely based on the thickness of the melanoma tumor and whether it spread. The thicker, or deeper, the melanoma, the more serious it is. Similarly, it is not a good sign to find that the melanoma has spread.

We are here to help

If you or someone you care for has been the victim of misdiagnosis of melanoma or another cancer, then call the experienced medical negligence lawyers at Painter Law Firm, in Houston, Texas, for a free consultation about your potential case. Our telephone number is 281-580-8800.


Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas, where he files medical malpractice and wrongful death lawsuits on behalf of patients and their families. He has been repeatedly recognized by H Texas magazine and Houstonia magazine as one of Houston’s top lawyers. He is a frequent speaker and writer about the complexities and challenges of medical malpractice cases for plaintiffs under Texas law, and puts that knowledge to work on behalf of his clients.

Robert Painter
Article by

Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys 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 for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.