Cancerous polyp ascending colon invasion into lamina propria - Cancer: Colon Message Board

BE 123 · 05-17-2009, 12:36 PM

HX: Father then age 50 had 2.2cm cancerous polyp in ascending colon removed, pathology showing nests of high grade dysplasia plus areas of microinvasion into lamina propria/unclear margins. GI specialist recommended partial colectomy.

Only after consulting with several other docs did father opt for biannual screenings instead of colectomy even though margins not clear.

Stage T0 or TIS (in situ) even though microinvasion into LP. CT scan from chest down clean.

Second colonoscopy 4 months later showed no residual problems in colon. OK, we're happy about that, but my concern is whether this microinvasion has the potential to be clinically significant later. I understand invasion into the lamina propria has very little chance of spreading to lymph nodes but I did find a few peer-reviewed journal articles suggesting it can manifest in lymph nodes or metastasize elsewhere due to lymphatics being present in neoplastic and/or inflammatory LP. This happens more often in "pendunculated" adenomas but not being a doctor I have no idea what shape the polyp was and his lab reports give no indication.

So, what is the best way to determine with the highest degree of certainty possible whether his situation has been successfully managed? Would this be via PET scan?

Can anyone assist? Anyone been in this situation and how was your case managed and how are you doing now? Many thanks.

p.s. NO family hx of colon cancer in dad's family. PLEASE get regular screenings. We (mother and I) had been on his case for years to get screened but his life used to be all about work.

idunno · 05-18-2009, 04:05 AM

Did they remove part of your dads colon or only the polyp? Ron.

BE 123 · 05-18-2009, 04:03 PM

Ron, only the polyp was removed. Does no good to remove part of the colon now (as was the original plan) since there is no evidence of residual disease at the follow-up scope; we are concerned about the slim possibility of lymph node involvement. Thank you for your reply.

idunno · 05-19-2009, 02:06 AM

I am a bit surprised that they did not take the area around the polyp. Usualy with colon cacer the suspicious area is removed in a field. The field cosists of the colon with clear margins on each side of the suspect area and the supporting flange all the way down to the fatty tissue. The flange contains the blood supply to that piece of colon plus the regional lymph nodes. All of the removed nodes are then checked for ca. For instance I had 14 inches of colon removed the cancer was through the colon wall. The field removed contained 13 regional nodes six of which had ca in them. Because of the lymph involvement I then had chemo.
Because your dads biopsy showed displasia which is just a fancy word for pre-cancerous cell changes they may have decided that there was no cancer involved and that no further action is required. All you can do is stay vigilant and have the recommended tests when they are scheduled. Best of luck,Ron.