This question was answered on Sun 21, Nov 2010 09:09am by Dr.Kokil Mathur

I have been diagnosed at colonoscopy with a colon tumor at the hepatic flexure. It was biopsied and 8 samples taken. The pathology report said

    
Asked by slsama (Male; 61; UNITED STATES; see question; Relevant drugs:none ) on Sun 21, Nov 2010 07:15am
Priced at $9.00

I have been diagnosed at colonoscopy with a colon tumor at the hepatic flexure. It was biopsied and 8 samples taken. The pathology report said "fragments of villous adenoma". The colonoscopy findings were of a fungating circumferential partially obstructing mass, 3 cm in length, with oozing present. CT scans show no spread. Apparently I have none of the risk factors for this except age. I am 61, never smoked, do not drink alcohol and never used recreational drugs. I am not overweight, and do not take any medications. My father had gastric cancer. I have been told I need surgery and that it should be a right hemicolectomy. This is quite radical compared to just removing the tumor with margins. I get vague reasons about disturbed blood supply to the colon from surgery and getting a proper harvest of lymph nodes "in case" of cancer. I have consulted 3 endoscopic surgeons about having an EMR procedure to remove the tumor, but they referred me back to conventional surgery. So my question is whether or how I should pursue less aggressive surgery in order to preserve the ileocecal valve and the ascending colon where most of the fecal water is reabsorbed. This, of course, is to ensure the absolute best quality of life after surgery. The surgeons play down my concerns but I am not convinced.

Actions: | Forward |
Answer


Name 

Email 

Security code
Enter the text as shown above


E-Mail me when someone replies to this post
Answer by Dr.Kokil Mathur  on Sun 21, Nov 2010 09:09am:

Hi! I can understand your concern. Villous adenomas are basically polyps of the colon. If the size is less than 1 cm then chances of cancer are almost nil. However if the size is 1 cm or more, then there is 10% chance of developing cancer, this increases slightly if there is a family history of gut cancer, as in your case. Also if adenomas have villous extensions then the risk of cancer increases another further. Hence in your case we are talking of a higher risk of developing cancer in future than in case of simple polyps. In your case I have a feeling that you have many such growths covering a large area of hepatic flexure of colon and this may be appearing as a large tumor. This could be the reason why surgical resection of colon has been advised in your case. Also a large oozing tumor is not a good sign. Though endoscopic laser therapy has been found effective in hepatic flexure growths with or without dysplasia (http://www.ncbi.nlm.nih.gov/pubmed/10202067), you have been to several endoscopic doctors and all are advising conventional surgery and hence I feel that you should accept that as the treatment of choice in your case. Only removing the tumor may not be an option due to position, size, risk of cancer, and villous extensions. Biopsies at times miss the actual cancer portion and if doctors suspect cancer by look of the tumor then a radical surgery is panned. Hope this helps you understand your case to some extent. You can discuss these points with your surgeon. Please feel free to ask anything else you may want to know. Take care!

If you find the site useful, please consider making a donation.  Click the button to donate.   

Please rate my answer (select the stars, no need to log in.)  

Comments:

Comment by Dr Sanjivani Wanjari on Mon 22, Nov 2010 12:08am:

This question is open for comments.  Please share your opinion.

Comments


Name 

Email 

Security code
Enter the text as shown above


E-Mail me when someone replies to this post


 
What users are searching right now on Ask Medical Doctor:
symptomsforacidinflux     Search for answers     i am having pain radiating from the top on my legs to my calfs and in my hands and fingers     Search for answers     lower abdomen aching all day     petechiae     Search for answers     bibleversesonhowwesaddengod     Search for answers     percocet     complex ovarian cyst     herpes     Search for answershow to remove old thorns out of skin     canigetpregnantifitjysttouchesthelipsofmyvagins     Search for answers     dip in spine painful bruised but no trauma     Search for answers     aroundswollenspotabout     Search for answers     how to cure ulcers from acid reflux     ask questions for free     lump on lower head     Search for answers     chlordiazepoxideclidin     protein s     runners knee     Ikeepcoughingeverydaybutonlylike5or6coughsaday     Ifeellikethereissomethingblockingmythroatmakingit     Search for answers     side effects from dayquil     painmedsversus     what is hypo and hyper thyroid     mybackhurts     ihavesoreandswollenSublingualglandsand     Search for answers     

©2011 - Ask Medical Doctor  |  All Rights Reserved
The site is not a replacement for professional medical opinion, examination, diagnosis or treatment. Always seek the advice of your medical doctor or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information written by any author on this site. No health questions and information on AskMedicalDoctor is regulated or evaluated by the Food and Drug Administration and therefore the information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor. Posts made to these forums express the views and opinions of the author, and not the administrators, moderators, or editorial staff and hence AskMedicalDoctor and its principals will accept no liabilities or responsibilities for the statements made.

Home | Terms & Conditions | Contact Us | Frequently Asked Questions | Disclaimer | Privacy Policy | Advertise with us
Stats