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Suggest Treatment For Cancerous Rectal Polyp After First Colonoscopy
Posted on
Thu, 29 May 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 30 May 2014
Answered on
Thu, 19 Jun 2014
Last reviewed on
Question : Hi - My mother had a colonsocopy in XXXXXXX 2012 - was told everything was fine- come back in 5 years - she had very litle co-morbidities. 70 years, healthy. 7 months later she developed some rectal bleedng and went back in and he did a sigmoid and found a cancerous rectal polyp - said he missed it on colonoscopy. It was 1.6 cm X 1.3 cm x .3 cm deep. It was a tubulovillous adenoma. THey said it had to come out right away but she would be fine - daignosed as T3 N1b M0. After a pet scan, 1 month later it showed 9 small liver mets. We had a horrible outcome. My Mother only had Hypertension - well-controlled> THe polyp was at the ano-rectal junction. Do you think we would have had a different outcome if he had discovered on the colonoscopy in XXXXXXX 2012? What do I need to look for to get that answer? Usually when it is that small it does not spread - I ws told under 2 cm - only 10% chance.
Brief Answer:
Cannot say
Detailed Answer:
Earlier detection would have been helpful.
Your detail states that the polyp was 1.6x1.3cm and 0.3cm deep. This was detected 7 months after the first colonoscopy. Obviously, this would have been much smaller (less than half or more of the present size) at first colonoscopy and hence could have been missed.
If you are looking for an answer as to whether the outcome would have been different, it would be very difficult to answer. The answer would be yes and no. There is NO way of finding out the exact stage of disease at that point of time locally and systemically. If there was NO spread at that point of time, the outcome would be different. If there was spread at that time itself, the outcome would NOT be different. THE UNDERLYING FACT IS THAT THERE IS NO WAY TO FIND THAT OUT. Since the proof either way is NOT feasible, the question would be redunant.
It is NOT the size but depth of invasion of the tumor that determines the ability to spread. Of course, other tumor factors also play a role. Hence, "less that 2cm size has only 10% chance of spread" is not a very correct idea.
You should also be aware of an entity called "interval cancer". These are cancers which are NOT detected at screening but manifest in between two screening procedures. This could well be one of them. These are known to be very aggressive and would generally have a poorer outcome. From your description this could well be a case of interval cancer.
Cannot say
Detailed Answer:
Earlier detection would have been helpful.
Your detail states that the polyp was 1.6x1.3cm and 0.3cm deep. This was detected 7 months after the first colonoscopy. Obviously, this would have been much smaller (less than half or more of the present size) at first colonoscopy and hence could have been missed.
If you are looking for an answer as to whether the outcome would have been different, it would be very difficult to answer. The answer would be yes and no. There is NO way of finding out the exact stage of disease at that point of time locally and systemically. If there was NO spread at that point of time, the outcome would be different. If there was spread at that time itself, the outcome would NOT be different. THE UNDERLYING FACT IS THAT THERE IS NO WAY TO FIND THAT OUT. Since the proof either way is NOT feasible, the question would be redunant.
It is NOT the size but depth of invasion of the tumor that determines the ability to spread. Of course, other tumor factors also play a role. Hence, "less that 2cm size has only 10% chance of spread" is not a very correct idea.
You should also be aware of an entity called "interval cancer". These are cancers which are NOT detected at screening but manifest in between two screening procedures. This could well be one of them. These are known to be very aggressive and would generally have a poorer outcome. From your description this could well be a case of interval cancer.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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