Need advice - what's is son's risk?

bryancarson said:

Hi. I was 29 when I was diagnosed with stage 3 colon cancer. My oncologist told me that when I have children, their first scope needs to be 10 years prior to my diagnosis. So, that would make them 19. Other than that, talk to him about diet choices, etc. Colon Cancer is very hereditary and he needs to be watched - so do his children. This is a super preventable disease, so with watching for symptoms and regular colonoscopies, he will be fine.

HI
I was diagnosed at 39. I don't have any children to pass this disease on to , but my sister has 2 daughters. A family friend who is a doctor told my sister that her girls should also have a scope 10 years prior to my diagnoses. I'm gald to hear that some doctors are on the same wave length. I wouldn't hesitate in encouraging your son to talk to his doctor about getting checked out.
Good luck,
Carolyn

Hi, and welcome!
I don't think anyone is likely to say what a relative's individual risk is, but as others have said there are some standard guidelines - for example, a first-degree relative should be checked out from ten years earlier than the age at which the cancer was diagnosed (because colorectal cancer can be very slow growing, so it might have been present for several years).

However, if you can, find out a bit more about your ex's family, because HNPCC (Hereditary non-polyposis colorectal cancer) could be a possibility - don't just look for colon cancers, if his family shows other cancers particularly bladder, kidney, gall bladder, urinary tract and stomach, they can all be related.

Do you know where in the colon your ex had his tumour - if it's on the right (appendix) side, that also points to HNPCC.

If HNPCC isn't found, your son could expect to be checked from about age 40 - but if he has ANY suspicion of a problem earlier, he MUST nag his doctor for a colonoscopy.

If there is evidence of an HNPCC pattern, ideally your ex should be DNA-tested - but this might be difficult. The reason for confirming HNPCC, is that screening should start from young adulthood and should be done more frequently as polyps turn cancerous more quickly in this form.

Colon cancer is 90%+ curable if found at stage I - most aren't, but any found in screening should be at stage I or II.

Be aware that there are several different screening approaches available:
FOBT (blood in stools); a useful, cheap test - home kits are available in the UK and probably in the US. This will find any blood in the stools, but often gives false positives.

Barium Enema: a fluid is injected which coats the lining of the bowel, and x-rays taken. This may show up polyps or tumours, but is not ideal - however, it's cheap and quick.

Sigmoidoscopy: a flexible probe is inserted into the rectum and descending colon - this allows the final part of the colon, where about 75% of tumours occur, to be examined directly. However, this is only a partial test and absence of a tumour in this test does not necessarily mean the patient is clear elsewhere in the colon. Useful if the patient has seen blood on the stools, as that is likely to have come from that end of the colon.

Finally, colonoscopy: this is the gold standard, giving a very high accuracy rate, it examines the whole colon, and polyps can be removed at the same time. The problem with this is it's expensive (highly-trained doctors are needed to avoid injury) and sedation is needed.

Given the curability of early-stage colorectal cancer, your son should try whatever means he can to get the best checks he can. Unfortunately, insurance companies play a numbers game, and will probably not pay for tests until he's 40 (unless HNPCC can be shown - don't know what they'd do then).