I seek input from well-informed sources about likely range of outcomes for diagnosed colon polyps condition.?
I’ve turned 50 y.o. this year, conscientiously had a physical exam (all OK) and routine referral for colonoscopy screening. I have no symptoms of illness, am pretty healthy; but what I expected to be a routine colonoscopy actually found many polyps and prompted Dr. to make a referral for labs. Dr’s report said "The large number and variety of polyps is unusual." and that "genetic testing is indicated." Dr. had me back twice more, each time looked around in my colon and removed many polyps. The three colonoscopy procedures during past four months have found about 50 polyps, mostly pre-cancerous "adenomas" – tubular and tubulovillous per pathology reports; but no dysplasia nor carcinoma at present). Most polyps found have been fairly small, a couple 1.0-1.5 cm. Still some small
sessile polyps remain at present. After 3rd colonoscopy Dr. counseled that consideration should be given to genetic testing, "and ultimately colectomy may be needed." Dr. referred me for "FAPKM" genetic testing, they drew my blood and have sent it off to Mayo Clinic. This "FAPKM" testing seems pretty specialized – they are looking for a specific genetic mutation that might inhibit my colon from suppressing polyps. I have no known family history of colon polyps, no family history of colorectal cancer. Everything I’ve read seems
to indicate that a colon with 50 pre-cancerous polyps is serious,
whether the cause is genetic or "sporadic," and leaves me with the impression the colectomy option may (eventually?) be more likely needed than not.
While I await test results I wonder, can anyone here explain likely range of outcomes for someone with my current condition?
Tagged with: adenomas • cancer • carcinoma • colon polyps • Colonoscopy • colorectal • current condition • dysplasia • family history • four months • genetic mutation • genetic testing • mayo clinic • pathology reports • physical exam • pre cancerous polyps • referral • sessile polyps • symptoms of illness • test results
Filed under: Colorectal Cancer
Denisedds (88)
Basically they are testing you for familial adenomatous polyposis (FAP). The inherited polyposis syndromes are subdivided into 2 groups depending on whether the polyps are adenomas or hamartomas. The adenomatous polyposis syndromes are familial adenomatous polyposis (FAP), Gardner syndrome, and Turcot syndrome. Hamartomatous familial polyposis syndromes include Peutz-Jeghers syndrome, juvenile polyposis syndrome, Cowden disease, and Ruval-Caba-Myhre-Smith syndrome. FAP typically develops around the age of 40 and if untreated will eventually lead to malignancy. In FAP sometimes tumors are found in other parts of the body as well (hence the need to test for it). Yes you are right, colectomy is the standard of care and is probably the best way to go if you have FAP since there is no way the polyps (due to the large number) can be removed individually and also the fact that they will almost inevitably turn into malignancy. Also another important thing to consider, is that adenomas greater than 1 cm, contain a substantial (>25%) villous component, or have high-grade dysplasia are considered advanced neoplasms and carry an increased cancer risk.