questions about an adenomatous polyp with dysplasia

[sasensas]

well, i did have my sigmo and at 35cm of the rectum a polyp of 8mm diameter was resected. today came the results of the PA lab: moderate dysplasia had been spotted in the biopsy.  i will now be scheduled for a follow-up colonoscopy.  in the meantime i have many questions that my GP can't or won't answer. here they are;

1) does 'moderate dysplasia' always mean a polyp is on the way to cancer, or can it also be temporary and reversable (like dyplasia in cervical tissue)

2) does the fact that the polyp was real small but already shows dysplasia have any significance as to my cancer risk?

3) does the fact that i am under the average risk age for colon cancer (i am 48) give me higher risk?

4) should i be prepared for more polyps (or worse) in the rest of my colon?

5) does having a colon polyp gives me a higher risk for polyps elsewhere in the body? (stomach, small intestine, other organs)

6) is there any significance in the fact that both my great-grandmother and my great aunt (her daughter) died in a relatively young age from stomach cancer?

thank you for helping me out,
kind regards,
sasensas

[Kevin Pho, MD]

To answer your questions:
1) All adenomas are dysplastic.  The severity is dependent on how much atypia there is in the cells.  Moderate would suggest a greater degree than mild.  It is usually not reversible.

2) Adenomas do incur a greater colon cancer risk in the future, no matter what the size.

3) Since the adenoma was found - regardless of age - it would put you at higher risk in the future.

4) It is possible - a colonoscopy would be suggested for a more comprehensive evaluation.

5) With some types of polyps - that is possible.  With colonic adenomatous polyps, I believe the chances of spread is less likely.

6) Yes, it certainly does put you at increased risk for those cancers.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Biskie2]

Congrats for getting the sig done and keeping us posted! I know Dr. Pho will answer your questions and I'm glad you're following through with this!

[sasensas]

i believe my GP is finally starting to believe that my symptoms are not just 'between the ears'.  my symptoms got a little better after  i started taking probiotics: i only have 1 or 2 BM a day (normal quantity)and i do not wake up at night anymore to go to the loo. however, it still looks odd (nr. 6 on the bristol scale, with undigested particles of food).  my appetite has fully returned and i still do not have any pain, apart from a little cramping around the navel from time to time, but that goes away with BM or gas-passing.  the endoscopist said that my symptoms could never have been caused by the very small polyp, so that does not make me feel really comfortable as to the outcome of the colonoscopy. well, once again: wait and see!

[Biskie2]

I too am having extreme belly button pain - took Pepcid AC and it went away in about an hour and has stayed that way for about 16 hours so far. Pain was intense for 1 week. Looking forward to what Dr. Pho says. You may have a malabsorption issue - you don't have enough acid in your digestive system to break down the particles - but having 1-2 normal BMs/day is really good! Those probiotics are wonderful!