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Saturday, March 1, 2014

Do I have colon cancer if my doctor found a polyp during my colonoscopy?

DEAR DOCTOR K:

During a screening colonoscopy, my doctor found a polyp in my colon. Does this mean I have cancer?

DEAR READER:

Colon polyps are common, non-cancerous growths of tissue inside the
colon, or large intestine. Some of them are benign. However, other colon
polyps can progress into colon cancer. These are called adenomatous
polyps.

Overall, only a small percentage of adenomas progress to cancer, but
it’s not currently possible to accurately predict which ones will do so.
So generally they are removed.

Adenomatous polyps progress to cancer as the result of changes in
certain genes inside the cells of the polyp. Below is an illustration of
how a polyp can turn into cancer. Every human cell has certain genes
that, when turned on, can cause the cell to start multiplying
uncontrollably. Fortunately, those “oncogenes” are generally turned off.
Our cells also have certain tumor-suppressor genes that stop a cell
from multiplying uncontrollably. Also fortunately, those genes generally
are turned on.

Progression of colon polyp


How a colon polyp progresses to cancer.

A colonoscopy is designed to find growths on the colon wall before
they have a chance to turn into cancer. During this screening test, your
doctor inspects your colon with a colonoscope — a thin, lighted,
flexible tube fitted with a video camera.

A colonoscope can also grab and snip off any small polyps it
encounters. (If a polyp is larger, surgery may be required to remove
it.)

If a polyp is not removed, it will continue to grow larger and
possibly become cancerous. The larger the polyp, the greater the chance
it contains cancerous cells. However, it usually takes several years for
a polyp to change to a cancer.

People with one adenomatous polyp are at greater risk for developing
others. In fact, it is not unusual for more than one adenomatous polyp
to be discovered during a single colonoscopy. So if you had an
adenomatous polyp, you were probably advised to get another colonoscopy
in two to five years.

How soon you need to return depends largely on the size of the polyps
found in the first exam. If no adenomatous polyps are found, generally a
repeat colonoscopy is recommended in seven to 10 years.

In the meantime, certain steps may help lower your risk of colon cancer:

  • Eat less meat. Eat minimal red meat — especially processed or cured meats.
  • Follow a healthy diet. Increase your consumption of fruits, vegetables and whole grains.
  • Maintain a healthy weight. Extra fat, especially around the waist, increases your chances of developing colon cancer.
  • Don’t smoke. Smoking increases the risk of colon cancer.
You may sense a contradiction. I said that colon cancer is the result
of certain genetic changes — but I also said that it is caused by
behavior (eating red meat, smoking, becoming overweight). So which is
it?

It’s both. The behaviors affect the genes. They produce mutations in
the genes, causing them to be inappropriately turned on and off. You
should do everything you can to minimize your risk for this cancer.

Reblogged from AskDrK

DrRajHealth:
The US Preventative Services Task Force recommends beginning at age 50 and continuing until age 75.
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