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Old 12-30-2011, 07:32 PM   #1
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Had my first colonoscopy and worried about pathology report that just came back...

I am a 45 year old female who has no history of cancers personally or on either side of my family tree. I have had ongoing anemia without an exact reason why, so was given an endoscopy and a colonoscopy (first time for both). The endoscopy came back fine. The colonoscopy found one 5 mm tubular adenoma, negative for high-grade dysplasia or malignancy. I won't be able to see the doctor for a month, though I did talk to the nurse who said that he is going to put me on a 5-year interval for a second colonoscopy.

I have tried to research and understand what I am dealing with. I get that the adenoma is considered pre-cancerous, and that once it is out that it cannot turn into cancer. What I am concerned about is waiting five years to re-check! I know polyps are supposed to be slow-growing, but is five years TOO LONG?? What if I am prone to developing polyps and I am one that develops them quickly? Should I insist on being seen earlier and if so, how much earlier?? Also, should I be worried or relieved based on what I have just described with my pathology report???

Thanks for any words of wisdom

 
Old 01-04-2012, 11:23 AM   #2
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Re: Had my first colonoscopy and worried about pathology report that just came back..

A 5mm tubular adenoma is very tiny and yours showed no evidence of any dysplasia which would be a precancerous condition. A polyp itself is not considered precancerous. Most polyps are benign and stay that way. Because we don't know which ones might develop cellular changes leading to cancer, polyps are removed when found. Was your polyp sessile (flat) or on a stalk? Since there is no history of colon cancer in your family, it is highly unlikely that you would suddenly develop a fast growing polyp which is a characteristic of a genetic mutation (Lynch Syndrome) colon cancer. Most random colon cancers take about 7 years to develop from a polyp. The fact that only 1 polyp was discovered is good. However, usually when a polyp is found and removed, the next colonoscopy is scheduled for one (1) year later. If that one is clear, then the next could be done 5 years later.

Leslie

Last edited by LESLIETOO; 01-04-2012 at 11:28 AM.

 
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Old 01-04-2012, 06:32 PM   #3
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Thanks, Leslie, for your response! I am hoping that there wasn't another one in there that the doctor couldn't see (which is one of my fears). I am going to ask about having another colonoscopy at the 1-year mark which would be the time they could see if anything was missed or if there is anything new. I'm guessing if something was missed, it woudl have been because it was too small at the time to see. Anything of any size would have been seen, I would think. If it is that small, then 1 year isn't too long to wait since as you have said, they take a long time to grow!

Mine was considered 'semi-sessile', so I guess that's a combination between the flat ones and the ones with stalks??

One thing I am confused about. i thought because it was an adeononma it was automatically considered PRE-cancerous, and that the no dysplasia just meant that it wasn't likely to develop into cancer (but it STILL is considered a pre-cancerous polyp). Please help me understand this ))

Overall I have a good report, then??

Quote:
Originally Posted by LESLIETOO View Post
A 5mm tubular adenoma is very tiny and yours showed no evidence of any dysplasia which would be a precancerous condition. A polyp itself is not considered precancerous. Most polyps are benign and stay that way. Because we don't know which ones might develop cellular changes leading to cancer, polyps are removed when found. Was your polyp sessile (flat) or on a stalk? Since there is no history of colon cancer in your family, it is highly unlikely that you would suddenly develop a fast growing polyp which is a characteristic of a genetic mutation (Lynch Syndrome) colon cancer. Most random colon cancers take about 7 years to develop from a polyp. The fact that only 1 polyp was discovered is good. However, usually when a polyp is found and removed, the next colonoscopy is scheduled for one (1) year later. If that one is clear, then the next could be done 5 years later.

Leslie

 
Old 01-05-2012, 06:26 AM   #4
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Your report was definitely a good one.

The definition of an adenoma is: A benign epithelial tumor having a glandular origin and structure. To call an adenoma precancerous when there is no dysplasia noted would be the same as looking at any mole and saying it is precancerous. All precancerous means is that there is a possibility but not necessarily a likelihood that a cancer can develop from it. The only colon polyps that never turn cancerous are the ones labeled hyperplastic - they are sort of like internal skin tags. The reason I asked about sessile vs. polyps on a stalk is that sessile polyps are harder to detect and more likely to become cancerous than a polyp on a stalk. My colon cancer was hereditary-HNPCC and developed from a sessile polyp located in the cecum (upper right colon). Because of its hereditary nature, I go for colonoscopies once a year.

Leslie
Lynch Syndrome HNPCC (PMS2 mutation)
2003 Stage III colon cancer - right hemicolectomy and chemo
1995 Stage I endometrial cancer TAH BSO (total hysterectomy)

Last edited by LESLIETOO; 01-05-2012 at 06:30 AM.

 
Old 01-05-2012, 06:44 AM   #5
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Thank you, Leslie, that makes perfect sense! I wish some of the medical information I have seen explained it so well So if mine was semi-sessile, I guess that's a cross between the two? While mine was in fact semi-sessile, it was also tubular, so i am not as worried about the fact that the sessiles are usually more likely to become cancerous since the tubular ones seem to be less potentially dangerous (that is HUGE for me NOT to worry, as I have worried myself sick ever since getting that report!). I am going to talk to the doctor about having it done in a year vs. five years, though, as I definitely would have more peace of mind that way . So are you a colon cancer survivor, then?? Just getting continuing colonoscopies to make sure no new polyps have formed?? It's GREAT that you are staying on top of it. Supposedly if a polyp is removed, that prevents cancer in THAT polyp (though you would want to check for others, of course). I hope I have that right! I am still trying to learn!

Quote:
Originally Posted by LESLIETOO View Post
Your report was definitely a good one.

The definition of an adenoma is: A benign epithelial tumor having a glandular origin and structure. To call an adenoma precancerous when there is no dysplasia noted would be the same as looking at any mole and saying it is precancerous. All precancerous means is that there is a possibility but not necessarily a likelihood that a cancer can develop from it. The only colon polyps that never turn cancerous are the ones labeled hyperplastic - they are sort of like internal skin tags. The reason I asked about sessile vs. polyps on a stalk is that sessile polyps are harder to detect and more likely to become cancerous than a polyp on a stalk. My colon cancer was hereditary-HNPCC and developed from a sessile polyp located in the cecum (upper right colon). Because of its hereditary nature, I go for colonoscopies once a year.

Leslie
Lynch Syndrome HNPCC (PMS2 mutation)
2003 Stage III colon cancer - right hemicolectomy and chemo
1995 Stage I endometrial cancer TAH BSO (total hysterectomy)

 
Old 01-05-2012, 07:03 AM   #6
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Re: Had my first colonoscopy and worried about pathology report that just came back..

I am an 8 1/2 year survivor of Stage III colon cancer and have been NED (no evidence of disease) since my hemicolectomy in July 2003. The reason I go for yearly colonoscopies is that having HNPCC, I am likely to develop a 2nd new colon cancer and the HNPCC colon cancer grows much more quickly than the random colon cancer. A cancer can develop in as little as 1 - 1 1/2 years from a polyp, whereas a random colon cancer may take 7 years or longer to develop from a polyp. Thus the frequent surveillance in my case.
Leslie

Last edited by LESLIETOO; 01-05-2012 at 07:04 AM.

 
Old 01-05-2012, 07:30 AM   #7
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Over eight years with NED?!?!? AWESOME!!!!! )) Congrats! And also, kudos to you for being diligent about your screenings. I work in another area of health, and so many people just don't do the preventive things that they need to do. GOOD FOR YOU for being proactive ) Would I know if I had HNPCC and needed yearly colonoscopies vs. a longer interval to keep tabs on any 'random' polyps/potential cancers??? It is wonderful to hear that you are doing so well!

QUOTE=LESLIETOO;4904921]I am an 8 1/2 year survivor of Stage III colon cancer and have been NED (no evidence of disease) since my hemicolectomy in July 2003. The reason I go for yearly colonoscopies is that having HNPCC, I am likely to develop a 2nd new colon cancer and the HNPCC colon cancer grows much more quickly than the random colon cancer. A cancer can develop in as little as 1 - 1 1/2 years from a polyp, whereas a random colon cancer may take 7 years or longer to develop from a polyp. Thus the frequent surveillance in my case.
Leslie[/QUOTE]

 
Old 01-05-2012, 09:32 AM   #8
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Is there a history of colon, rectal, endometrial, ovarian, pancreatic or renal pelvic cancers in your family? Has any relative had more than one of those cancers? That would indicate a possibility of a genetic cancer. In my case, having had both endometrial and colon cancer was a red flag to the possibility of HNPCC, as was my family history - grandmother colon cancer, father pancreatic and parotid cancer, aunt renal liposarcoma. The first step is to test a tumor for microsatellite instability, if that tests positive, then further genetic testing is recommended.
If you have another polyp next year, and since you are in your 40's, then you might worry about the possibility of HNPCC. But at this time there is nothing to be concerned about.
Leslie

 
Old 01-06-2012, 02:50 PM   #9
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Re: Had my first colonoscopy and worried about pathology report that just came back..

Hi, Leslie -

There is NO family history of any cancers, except my grandfather who died at 75 of lung cancer (he was a very heavy smoker). I can see why you were alerted to possible HNPCC, though I guess in other cases where it isn't clear cut it's just hard to know. I will have to just wait and see how the next test goes. I don't really know what else to do. Though waiting is horrible (( I am going to try to not be stressed about this. Wish me luck!

Quote:
Originally Posted by LESLIETOO View Post
Is there a history of colon, rectal, endometrial, ovarian, pancreatic or renal pelvic cancers in your family? Has any relative had more than one of those cancers? That would indicate a possibility of a genetic cancer. In my case, having had both endometrial and colon cancer was a red flag to the possibility of HNPCC, as was my family history - grandmother colon cancer, father pancreatic and parotid cancer, aunt renal liposarcoma. The first step is to test a tumor for microsatellite instability, if that tests positive, then further genetic testing is recommended.
If you have another polyp next year, and since you are in your 40's, then you might worry about the possibility of HNPCC. But at this time there is nothing to be concerned about.
Leslie

 
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