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adenomas polyps in latest Colonoscopy

darcher's picture
darcher
Posts: 255
Joined: Jun 2017

   They found two adenomas polyps in the colonoscopy Wednesday.   These are the precancerous veriety.  I don't know what to make of this. I guess I really need to change my lifestyle and get rid of every bad habit, stress, and what ever else might be contributing to cancer trying to get me again.   I went through some hell this past year and I don't know if that contributed to it or not but I suspect it did.

I figured something wasn't right since my bathroom trips weren't really improving much.  The polyps were removed which was a hell of a lot better than getting told they found a tumor.   The one good thing is there was no after procedure pain.  Last year when I did this it hurt like hell about an hour after the procedure. I was told they switched to CO2 versus air for inflating the colon.  This time nothing hurt and I didn't even fart, lol.  We went to red lobster right after. I didn't think too much of it because the biopsy wasn't done and having a polyp or two isn't the end of the world, or is it?   I didn't think so because when I had the kidney stones back in my early 40's I remember they made mention they were concerned about the polyps I had.  I should have heeded that warning.

I saw the pictures and where the tumor was it was as clean as can be.  The two polyps were very small but were of the adenomas veriety.  One could be barely noticed and I wouldn't have had the doctor not circled it.  They want me back in a year for the next one which I'm ok with since these procedures are a lot easier than a tumor to deal with.  One was in the ascending colon and the other in the descending colon.

 Has anyone had this so soon after cancer treatment?  My chemo ended April 29.  I'm now wondering what the PET scan in October is going to show since it looks everywhere.

 

SandiaBuddy's picture
SandiaBuddy
Posts: 470
Joined: Apr 2017

I had one polyp in the first colonoscopy.  I asked what was the chance that they missed it in the first colonoscopy (where they identified the big tumor) and both the colonoscopy doctor and my surgeon said it was very possible (there seemed to be an indication of even "likely," that they had missed it with all of the confusion and blockage in the first colonoscopy).  They told me it was not cancerous, so I am not too concerned at this time.  I have another colonoscopy (1 year) coming up in November.  If colon cancer takes ten years to develop and they can clip the polyps, why worry?  If I have a ten year life span, I will be happy.  I think it is the cancer in other places we really need to worry about now.  My surgeon says if the cancer returns, I have a 60% chance it will be in the liver (probably site specific for where the original tumor was located).  That concerns me a lot more at this point in time.

darcher's picture
darcher
Posts: 255
Joined: Jun 2017

   That was my first thought, where else might it be with the liver at the top of the list.  If these polyps were missed first time around and I guess it's possible given how small they are with one of them being so tiny it was only caught because the doctor really knew what to look for.   I may contact them and see if I can get the PET scan pushed up sooner from October.  Having something on the liver is not good and I'd like to get it rectified as soon as possible if that's the case.  Have you had a follow up PET scan yet?  

SandiaBuddy's picture
SandiaBuddy
Posts: 470
Joined: Apr 2017

No, no one has mentioned a PET scan yet, I think it is probably an insurance issue.  Frankly, I am in no big hurry to find out if I have cancer in another location (other than the usual suspects--liver, lungs, colon) as I want to enjoy ignorant bliss for a little while.  It is highly unlikely I would accept chemo again, and I would listen to what surgery is available, but there is a fair chance that I will just live my life without further treatment.

Mikenh's picture
Mikenh
Posts: 775
Joined: Oct 2017

I'm a bit surprised that you had a colonoscpoy so soon after finishing chemo. Maybe it's an annual thing from diagnosis? I wasn't expecting that one. The scariest thing for all of us is recurrence. I hope that they got it all out and that your scans are clean.

darcher's picture
darcher
Posts: 255
Joined: Jun 2017

  I thought it was kinda soon for a colonoscopy but maybe that's how it's done, about a year from initial detection.  It's only been a month and a week or so since I finished chemo.  My cancer anniversary is coming up in 5 days.   At least I made it this far.  

ron50's picture
ron50
Posts: 1675
Joined: Nov 2001

My last scope was a little later than it should have been , despite my howls of protest. It was three years from my previous one and produced 4 tuular adenomas between 4 and eleven point 5 mm. He said with my history of aggressive cancer I was very lucky that theywere all precancerous. I'm on two yearly scopes from now on. Ron.

steveja
Posts: 37
Joined: Apr 2017

My 1st colonoscopy  removed 4 polyps, but found 5 (including the bad boy).  A second colonoscopy the top-gun colonoscopist 3 weeks later, removed the bad-boy and 4 more !!  Then I had a partial colectomy ng a weel later since the margins of the cancerous polyp were too small.

So I had a colonoscopy a year later, from the top-gun and he found one 12mm sessile serrated on the right-side.

After reading a lot of papers, it's clear that colonoscopists miss a lot of polyps - maybe 25%!!!   They tend to miss sessile (flat) ones,  smaller adenomas, and polyps on the right-side colon.

SandiaBuddy's picture
SandiaBuddy
Posts: 470
Joined: Apr 2017

Interesting.  Thanks for sharing that perspective.

darcher's picture
darcher
Posts: 255
Joined: Jun 2017

   This guy was good and it helped that I was completely emptied out.  Here it is 5 days later and I'm still not full enough to make a number 2.  The oncologist told me that since so many nerves were cut from surgery that I need to be full top to bottom just to go, like a conveyer belt or assembly line.  That will pass but it takes a long time.  There were quite a few pictures he had and surprisingly my colon was clear from small intestine to rectum. From what I was told, a lot of times what causes polyps to be missed is not being emptied out all the way. It sucks having to drink that stuff but it does what it's supposed to if it's used per instructions. 

  On the first one last year the hardest part was avoiding the temptation to eat something which I admit I cheated and had chicken soup but this time I was too nervous to be thinking about anything but being empty. Now I'm waiting to hear back from them about PET scan rescheduleing to an earlier date.   Maybe I'm being paranoid but finding these scared the hell out of me and has me concerned there might be something else lurking somewhere.  I have two little ones that I need to be around for.  Yeah, the idea of chemo again is horrible but the alternative of death is even worse.  So, maybe here we go again.  We'll see what happens.

Twinzma
Posts: 125
Joined: Jan 2018

You're in my prayers Darcher. Your posts are so helpful and insightful, a true inspiration. Easy to say but don't let the fear overcome you. You are strong and empowered thus you will prevail no matter the outcome of the results.

 

Ruthmomto4's picture
Ruthmomto4
Posts: 510
Joined: May 2013

They could have missed it the first time or even if they grew that fast i wouldn’t panic unkes they find more in a year. Even then they are pre cancerous so they won’t get a chance to be cancer since you are right on top of checking and screening. Of course you will worry but hopefully in time you will be less worried.

beaumontdave's picture
beaumontdave
Posts: 805
Joined: Aug 2013

Are you taking the baby aspirin?  Even with the two liver resections, these last ten plus years have been clean. I've changed little since before diagnosis, and might be a bit more sedentary from sore feet and basic aging, but still work and exercise sporadically.  My diet's similar to what it was, with a bit less red meat and more fruits and veggies. I keep bananas, grapes, apples etc. so if someone decides it's pizza night, I can still add something healthy.  My point is the only real consistant change was and is taking the low-dose aspirin everyday, and the statin, so my belief is the aspirin protects the colon and the heart/stroke risk, with the statin fighting against artery-hardening. Genetics obviously can play a big role, but mine show susceptibility to CRC with my dad getting it, and my aunt, his sister dying from it.  My mom's father died of a MI[heart] when he was 51, and mom had a quad-bypass at 60. So far, so good, but who knows?  I figure the upside to all this downside, is we get checked, a CT every year for me, and a colonoscopy every five years, plus blood work every six months, so at least we're being monitored. It doesn't stop the worry, but with time, spreads it out a bit. Now I have to go to my 6-month onc. visit, which never worries me, because he doesn't order the blood panel until after we meet.  What do we talk about?  The weather, how good I feel, parking.  SMH..................................................Dave

ron50's picture
ron50
Posts: 1675
Joined: Nov 2001

Is stay vigilant and do whatever you can to lower your risk. I've always thought//suspected that colon cancer and other digestive tract disorders ran in my Dads side of the family.  My cousin Bill came in to see me yesterday. He had some bad news. He lost his 48 year old daughter to colon cancer two weeks ago.So who knows it may be from Mums side of the family. Unfortunately it is not always possible to remove all risk factors. I cannot take aspirin at all because I take warfarin.  I have a lot of auto-immune problems that requires me to take strong immume suppressants twice a day. (cyclosporine) Because of the cyclo I have to have six monthly checks for skin cancers. My skin ca doc told me that if a heart transplant patient taking cyclo as an anti rejection drug lives for eighteen months past the transplant they are most likely to die from some form of cancer. I have already had several basal cell carcinomas removed. 

       It is a bit of a sweepstake as to what gets me first , cancer ,heart failure or kidney failure. Such is life. Wishing you all good health. Ron.

plsletitrain
Posts: 245
Joined: Jul 2017

Cancer really puts us into a limbo.  My lung nodule which has been there since my emergency colon resection was been monitored for over a year and I just hated it that I'm glad my onco suggested for me to undergo VATS to remove the nodule.  I'm praying its benign although its characteristics point to it being a met.  But at least start with having it removed first then I'll cross the bridge when I get there.

I guess we really have to have aggressive monitoring especially that we have little ones.  I take PET CT scans every 6 months and I try to keep a healthy lifestyle although its really hard to stay religiously fit.  I sometimes cheat with my food.  But we gotta to do what we gotta do.  Push for the PET scan to be done soon.  It will help both physically and mentally for us.

steveja
Posts: 37
Joined: Apr 2017

>>Cancer really puts us into a limbo.

Limbo - 2.
an uncertain period of awaiting a decision or resolution; an intermediate state or condition.

Yes, that's the truth. Uncertainty, not knowing, is the key problem for me.  The thing about cancer is, there is no finish line.  At some point 5 or 7 years out, you can expect the chance of a recurrence is lower than the risk of other causes of death, which is at least marginally satisfying, but in the interim, we all live a few lab tests away from the prognosis of a very bad time.  I've read quite a lot on CRC recurrence lately, and well ...it's a lot like delayed stage IV.   You've got a modest shot at LT survival if your metastasis is resectable AND you respond to chemo.  You've got a slim chance if it's not resectable.  Only 25-30% of CRC mets are resectable.

The new circulating tumor cell count tests (ctc & ctdna) *promise* to offer a lot better insight into whether cancer remains, reducing uncertainty, but so far they have their own accuracy limitations.

So, I don't understand the 'fight cancer', beat cancer', 'conquer cancer' memes.  Cancer happens when one of the ~37 trillion cells of our bodies have a special little 'whoopsie'. Surgeons may extract and extinguish the source, and if they think it's probable that cells have spread they'll use some systemic chemo, causing a lot of collateral damage.  But the ability to detect residual cancer is extremely poor and their ability to extinguish nascent mets even poorer.  Then you learn to live with the makeshift 'pipes', and maybe start improving from the chemo damage.  This sounds like "take a hard beating and hopefully survive".   I don't see 'fight' or 'win' anywhere.  These cancer cells are a normal part of each of us, just misbehaving in a rather unfortunate way. There is no one to fight but ourselves.   Some of you might be old enough to recall the 'Pogo' comic strip quip, "We have met the enemy and he is us"; it applies to cancer.  Don't fight yourself, it's a losing battle.

>> I guess we really have to have aggressive monitoring especially that we have little ones. 

I used to think that too, but now, ~22 months after surgery and becoming a lot more educated on the topic, I'm beginning to have serious doubts.  The recent "FACS trail" showed there is a LITTLE marginal improvement in the ability to detect metastases that are surgically resectable with curative intent when aggressive surveillance is performed, and there is no statistical benefit in terms of 3-year or 5-year survival. Cochrane Library (a highly respected organization for meta-reviews and analyses) shows a similar result.  More early detections and surgeries in the intensive follow-up groups, but no better outcomes.

Intensive surveillance has to be weighed against all that radiation you are getting from CTs and PET scans.  In fact, the NCCN guideline (v2, 2018) frowns on PET scans for surveillance since they state there is just a tiny chance that a PET would find anything that a  contrast-enhanced CT wouldn't have seen (get a CONTRAST CT first, then a PET only if the CT showed something).  Note the CT done together with a PET/CT are almost always non-contrast for technical reasons.  In the 22months since diagnosis, I've had 5 sets of CTs and two PET scans - mostly triggered by elevated CEAs and some naughty looking stuff on CTs that later disappeared.   What a waste. What a load of mental torture.

https://jamanetwork.com/journals/jama/fullarticle/1814213?resultClick=1

It *seems* that intensive CEA (despite it being a really crummy test) surveillance is as good as any surveillance, and has the advantage of costing $50 and not dosing you with radiation.

The "CEAwatch protocol seems like the most effective schema, BUT the overall survival is no higher than standard surveillance.

https://www.ejso.com/article/S0748-7983(15)00512-0/fulltext

https://www.ncbi.nlm.nih.gov/pubmed/28376235

 

http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD002200.pub3/abstract

"Authors' conclusions

The results of our review suggest that there is no overall survival benefit for intensifying the follow-up of patients after curative surgery for colorectal cancer. Although more participants were treated with salvage surgery with curative intent in the intensive follow-up group, this was not associated with improved survival. Harms related to intensive follow-up and salvage therapy were not well reported."

 

 

darcher's picture
darcher
Posts: 255
Joined: Jun 2017

  I have to agree the CEA is lousy at best for a lot of us.  Mine is (wait for it)... 1.3. The same as it was when I had the tumor.  For me it's not a good indicator but who knows, maybe it's good if the cancer has passed some benchmark in growth or development enough so that it releases that enzyme..  

  Same probably goes for a lot of these tests we go through.  The PET scan is still on for October.  When they pulled these two buggers out they were each cut out in 4 pieces.   Small bits and probably explains why it took a week to go to the bathroom again.  I got the official biopsy results and one in the ascending colon was nearly but not quite benign.  The other, in the transverse colon was a lot closer to being what we don't want.  Doc said he wants me back in a year.  No problem.  I'll be back in six months if it's any better.   A colonosopy is 1000 times more tolerable than the alternative.  

  I think a lot of the speculation and grey area in testing is due to the varying degrees of what constitues an aberation in cellular strucutre that becomes cancer in its true form, it grows uncontrollably.  I remember when they did the biopsy on the tumor.  It was said to be inconclusive. Maybe it didnt have enough of what ever it is that defines the absolute threshold of being cancer but to look at the picture, it sure as hell didn't belong there.   I had to sign off on them treating it as cancer. Turns out it was.

   Even though both my parents had cancer and my brother as well, I don't have any of the genetic markers for it.  Turns out, this was caused by the steal mill poluting the river we swam in as kids.  It got in the air too and may explain why my brothers wife and daughter both got cancer.  I think the environment is more at fault for it than anything else.  We're not dessigned to injest so many artifical chemicals.  There is no way to test the toxidy level without it taking decades..  

  So, for now I'm going to live as clean as possible which means reading the content lables of things bought.  If I can't pronounce it,, I probably wont buy it. 

  

    

Twinzma
Posts: 125
Joined: Jan 2018

Well I agree with you wanting to eat clean. I take issue that the grains, fruits & vegetables we consume are not as the good Lord intended them to be. Everthing is GMO,GMO GMO. The grains that were here before mankind took hold of the land no longer exist. The farmers wanted thicker crops that grew faster. We buy fruits and vegetables and they are modified the same. You can't buy a tomatoe in the store, plant the seeds and volia have your own plant growing and florishing, as that would put them out of business. 

I also have an issue with our very own human waste. The latest practice is that they are taking it treating it, mulching it and are turning "Bio-solids" into fertilizer. Yes I know it make me sound like I am a raging loon, but this is true. In my old community they wanted to put in a "bio-solids mulching facility" within a mile of my home. The engineers laughed at us when the residents argued that medicines could seep into our ground water as well as radiation from cancer patients....long story short we won our battle but not the war. VitAg opened up a facility just a bit further down the road in another county and is bagging human waste as "fertilizer". Cattle are grazing on it, the farmers are using it and the vast majority of the public is in the blind. 

So there is my rant for the day. Do we really know what the heck we are eating? 

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