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Question by kevsfrannie: What is likely treatment for colon polyps (adenomatous) condition? ?
I’ve turned 50 y.o. this year, conscientiously had a physical exam (all OK) and routine referral for colonoscopy screening. I have no symptoms of illness, am pretty healthy; but what I expected to be a routine colonoscopy actually found many polyps and prompted Dr. to make a referral for labs. Dr’s report said “The large number and variety of polyps is unusual.” and that “genetic testing is indicated.” Dr. had me back twice more, each time looked around in my colon and removed many polyps. The three colonoscopy procedures during past four months have found about 50 polyps, mostly pre-cancerous “adenomas” – tubular and tubulovillous per pathology reports; but no dysplasia nor carcinoma at present). Most polyps found have been fairly small, a couple 1.0-1.5 cm. Still some small
sessile polyps remain at present. After 3rd colonoscopy Dr. counseled that consideration should be given to genetic testing, “and ultimately colectomy may be needed.” Dr. referred me for “FAPKM” genetic testing, they drew my blood and have sent it off to Mayo Clinic. This “FAPKM” testing seems pretty specialized – they are looking for a specific genetic mutation that might inhibit my colon from suppressing polyps. I have no known family history of colon polyps, no family history of colorectal cancer. Everything I’ve read seems
to indicate that a colon with 50 pre-cancerous polyps is serious,
whether the cause is genetic or “sporadic,” and leaves me with the impression the colectomy option may (eventually?) be more likely needed than not. While I await test results I wonder, can anyone here explain likely range of outcomes for someone with my current condition?
Best answer:
Answer by zrepmd
There are several familial polyposis syndromes:
Familial adenomatous polyposis (FAP), due to APC gene mutation- cancer occurs on average by 4th decade.
Attenuated FAP: similar but delayed age onset and fewer polyps
Turcots and Gardner’s syndromes: FAP plus various extraintestinal manifestations.
Peutz-Jegher’s, Juvenile polyposis syndromes, and others less common
Cancer rates can approach 100% in FAP in some series, frequently by age 45. You may have an attenuated version. Basically, if there are too many polyps to perform surveillance colonoscopy successfully, then colectomy is usually recommended.
Blessings
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