VA says “miscommunication” led to veteran waiting months for chemotherapy after being diagnosed with colon cancer

Posted at 11:38 PM, Sep 22, 2017
and last updated 2018-08-09 01:41:16-04

Newly appointed VA Secretary David Shulkin promised more transparency, better accountability and improved healthcare for veterans.

This promise followed years of controversy over wait times in VA centers and hospitals nationwide.

The VA’s Office of Inspector General found veterans nationwide were dying as they waited months or even years for appointments.

Has anything changed? Opinions appear to be mixed.

Colorado Springs veteran Alan Cornell had colon cancer surgery last year. Following surgery, doctors stressed the importance of chemotherapy.

A News 5 Investigation found Cornell waited months to start chemo because of “miscommunication” and paperwork delays. As Cornell waited for the VA to approve his care, he says his cancer worsened.

Doctors confirmed the chance of Cornell living 5 or more years is less than 30-percent.

“People need to be upset about this and mad as hell about this,” Cornell said.  “I contacted you because you were the only way I could get this out. I’m trying to reach out to as many veterans as I can.”

Cornell hopes by sharing his story, top VA officials will take a second look at the care it provides for its veterans.

In September 2016, Cornell showed up at Penrose Hospital with abdominal pain. It later turned out to be colon cancer.

Doctors performed surgery and recommended chemo.

“Everybody (medical staff) was stressing that I needed to get it (chemo) done now and start now,” Cornell said. “Months just kept rolling by and it wasn’t happening.”

Despite having VA facilities in Colorado Springs and Pueblo, neither offer chemotherapy treatment. News 5 learned the only VA center capable of administering chemo is in Denver.

“They (the VA) said come up here,” Cornell said. “I said no. There’s no reason for me to drive 90 miles when I’m 5 minutes away from being treated here (in Colorado Springs). That’s stupid!”

Cornell is homeless, making travel difficult so he decided to apply for the “CHOICE” program.

The “CHOICE” program allows veterans to receive care outside of the VA. Approval would have allowed Cornell to start chemo at Rocky Mountain Cancer Center in Colorado Springs, but he hit several road blocks.

Medical records obtained by the I-TEAM show Cornell applied for “CHOICE” in October 2016.

Timeline of Cornell’s care: 

October 21, 2016: Applied for “CHOICE”

November 14, 2016: “CHOICE” says Cornell is “likely not eligible” to enroll in program

November 23, 2016: Paperwork processed again for “CHOICE” program and approved under Geoburden

December 2, 2016: Health Net authorization number provided.

December 29, 2016: Chemo scheduled

More than 8 weeks had passed since Cornell applied for “CHOICE”, and more than 12 weeks had passed since his surgery.

Cornell says by the time he got chemo scheduled through the “CHOICE” program, it was too late.

“The first round of chemo did not work so they had to change what they were giving me,” Cornell said.

We took Cornell’s case straight to the top, and sat down with Dr. Harold Dillon, the Deputy Chief of Staff for the VA of Eastern Colorado.

Chief investigative reporter Eric Ross asked, “Mr. Cornell wasn’t able to start chemo until after December 29—3 months after he applied for CHOICE. Is that acceptable?”

“Based on several issues with miscommunication with the ‘CHOICE’ program and our facility trying to contact the patient and the patient trying to contact the ‘CHOICE’ program, those communication barriers led to an additional delay of probably 4 weeks which is understandable but not acceptable.”

“Unfortunately, Mr. Cornell’s cancer has spread,” Ross said. “He believes had be been able to start chemo immediately and not had the hurdle of going through the ‘CHOICE’ program, the outcome might have been different. Do you agree?”

“There’s really not any literature that says if you have chemo at 4 weeks verses 6, 8, 10 or 12 weeks that it reduces your risk of occurance by ‘x’ amount,” Dillon replied. “Those statistics don’t exist.”

Dillon says generally speaking, cancer patients can start chemo treatment as early as 4 weeks after surgery, but reiterates chemo doesn’t guarantee the cancer will go away. Rather, it can increase the number of years someone is projected to live.

If colon cancer is detected during Stage 1 and is treated properly, the liklihood of that individual living 5 or more years is about 90-percent.

Ross asked Dillon whether he believed the VA did all it could to help Cornell.

“From our perspective, there may have been some misunderstandings of what really was available in the “CHOICE” program and outside of the program, what we could have done through non-VA care,” Dillon said.

Ross replied, “An ‘I’m sorry’ or an apology doesn’t sit well when you’re talking about veterans and health care.

“I think the quality of care we provide is above what’s provided in the community to our veterans,” Dillon said.

While Dillon says the VA has hired new nurses and primary care physicians, built new medical facilities and purchased new medical equipment, News 5 found no plans to bring chemo treatment to VA centers in southern Colorado.

Ross asked, “The VA moved into a brand new facility in Colorado Springs. Why can’t you bring a chemo center down here?”

“We did move into a clinic that we have outgrown,” Dillon said. “We don’t have the staff and facilities to do it. It’s a difficult pill to swallow but space is a limitation in Colorado Springs.”

This news doesn’t sit well with Cornell, who says the VA is dropping the ball on treating veterans with cancer, pointing to delay after delay.

“All you have to do is approve someone’s treatment,” Cornell said. “The paper comes across your desk and you see that it’s urgent but yet you’re going to set it to the side and say he doesn’t need to be treated now. Without this coming out and more people speaking up, people are going to die after me and that’s what I’m concerned about.”

Dr. Dillon wants to emphasize the importance of colon cancer screenings which are recommended for people over the age of 50.

According to Dillon, Cornell was 56 when he walked into the hospital and was diagnosed with colon cancer. Dillon adds that if Cornell had been screened for colon cancer years earlier, they may have been able to remove a polyp. Unfortunately, this didn’t happen. Regardless, it doesn’t change the fact that Cornell waited months get approved for chemotherapy through the “CHOICE” program.

Ross asked Dillon whether there were any plans to have future discussions on expanding chemo treatment at VA centers in southern Colorado. Dillon said there are no upcoming meetings scheduled related to this topic at this point in time.

Tests to detect colon cancer:

*Virtual Colonoscopy

This test uses a CT scan to show a 3-D model of your colon. The exam can reveal polyps or other issues without placing a camera inside your body.

*Barium Enema

These X-rays give your doctor a look at the inside of your colon and rectum. It’s another way to find polyps and tumors.

*Flexible Sigmoidoscopy

-Doctors will use a tube to look inside your rectum and the bottom part of your colon.

*Fecal Blood Tests

The fecal blood test can show whether you have blood in your stool, which can be a sign of cancer.

*At-home DNA Kit

-An exam called Cologuard looks for blood or suspicious DNA in your stool sample. If irregularities are found, you may still need to follow-up with a colonoscopy. Consult with your doctor.

Cancer by the numbers: 

# of veterans living in southern Colorado with cancer: 63

# of veterans living in southern Colorado with cancer who seek treatment through “CHOICE”: 44

*Numbers were provided by the VA’s Freedom of Information Office and are estimates. 

Getting to and from appointments at the VA: 

Traveling can be tough for veterans who are homeless or don’t have a vehicle. The DAV provides free transportation to and from appointments. For more information, click here.