A 37-year-old patient sought help for what seemed like routine abdominal pain—only to later learn he had an aggressive, nearly untreatable cancer. Would earlier intervention have saved him?
Posted in Case Studies on Thursday, June 19, 2025
Background
In June 2021, 37-year-old Patrick Thames visited Taylor Family Chiropractic Clinic with complaints of persistent pain in the right lower quadrant of his abdomen, unintentional weight loss, and a hunched-over posture that he attributed to intense pain. He believed these symptoms could be linked to Crohn’s disease, which he mentioned during his intake.
Initial Chiropractic Visit
During his initial consultation, Jason Dafney, DC, performed a thorough musculoskeletal and postural examination, along with a detailed patient history. The intake form, completed by Mr. Thames and his mother, revealed no family history of colon cancer. He denied any significant gastrointestinal changes, such as diarrhea or blood in the stool.
Dr. Dafney noted significant spinal and postural dysfunction, especially in the lumbopelvic region, likely due to compensatory muscular guarding from abdominal discomfort. The psoas muscle on the right side was notably hypertonic, and his forward-flexed posture was indicative of pain adaptation. Based on the clinical presentation and absence of red-flag symptoms like acute distress or neurological deficits, Dr. Dafney initiated conservative chiropractic care, including spinal adjustments, soft tissue mobilization, and therapeutic exercises.
Ongoing Visits: July–November 2021
Mr. Thames returned for follow-up care throughout the summer and fall. During this time, he received additional chiropractic treatments targeting core stability and pelvic alignment. His postural improvements were intermittent, and while he initially reported some symptom relief, flare-ups continued. In September, he experienced another spike in pain. Dr. Dafney started to consider the spike could be from a pathological source and noted if the symptoms persisted, a referral for a CT scan should be considered. This consideration was contained in Dr. Dafney's notes, but there was no indication it was ever discussed with Mr. Thames.
By November, Mr. Thames stated that his symptoms had lessened, and Dr. Dafney documented a notable improvement in pain intensity and mobility. The patient was advised to return in three months, but he did not follow up.
Deterioration and Emergency Care
In April 2022, Mr. Thames presented to the emergency room with worsening, generalized abdominal pain. He had not returned to Taylor Family Chiropractic Clinic or seen any other healthcare provider since his November visit.
Delayed Diagnosis
In May 2022, he was hospitalized. Multiple CT scans were performed, which initially indicated a perforated appendix but showed no clear signs of cancer. After draining an abscess, a colonoscopy was eventually performed in early June, revealing a cecal mass. A right hemicolectomy followed, confirming mucinous adenocarcinoma that had invaded adjacent structures, including the psoas muscle—one of the key postural muscles chiropractic care often focuses on.
The advanced cancer had likely been developing for months, possibly even at the time of his first chiropractic visit, and explained his hunched posture and right-sided muscular dysfunction. By the time of diagnosis, the cancer had spread to nearby organs and lymph nodes. Despite surgery and chemotherapy, Mr. Thames was diagnosed with Stage IV cancer and given less than two years to live.
Legal Action
Mr. Thames’s legal team argued that had he been referred for imaging or even had a colonoscopy—especially when flare-ups persisted—his cancer could have been detected at a more treatable stage. Although defense experts argued that the cancer was already advanced during the first visit and that his symptoms didn’t initially demand urgent referral, the core issue became informed consent.
The court determined that Dr. Dafney failed to discuss the possibility of a gastrointestinal origin or refer Mr. Thames to a medical specialist for advanced diagnostic evaluation. As a result, the case was settled for $1.3 million, primarily due to the failure to inform the patient of the option to pursue additional medical diagnostics, such as a colonoscopy.
What Can We Learn?
- Informed Consent Is Not Optional
Even if symptoms appear to be musculoskeletal in origin, patients must be informed of all reasonable differential diagnoses and their corresponding diagnostic pathways. This includes potential referrals for medical imaging or specialist consultation when symptoms fall outside the typical scope of chiropractic care.
- Recognize Visceral Red Flags
Chiropractors must remain vigilant for signs that indicate a non-musculoskeletal origin of pain—especially when symptoms are persistent, progressive, or nonresponsive to conservative care. A patient presenting with localized abdominal pain, postural adaptation, and systemic signs like weight loss should prompt consideration of a referral.
- Document Thoroughly and Refer When in Doubt
Documentation should include any discussion about the limits of chiropractic treatment and the rationale behind any decision to refer—or not refer. Erring on the side of caution with a referral may not only help catch a serious condition earlier but also protect the provider legally.
Conclusion
This case underscores the critical importance of clear communication, documentation, and collaboration with medical professionals. As chiropractic providers, your role in integrative care includes recognizing when a patient’s presentation warrants co-management or further medical evaluation—especially when symptoms extend beyond the spine and musculoskeletal system.