I am concerned about having 2 polyps – a benign at 5 mm and a 10 mm Precancerous sessile serrated adenoma polyp?



I am a 65 year old female who just had a colonoscopy 2 weeks ago,  They found 2 polyps, one of which is benign at 5 mm.
The concerning one is 10 mm Precancerous sessile serrated adenoma polyp which was removed.  I read that this type is very serious and is a precursor to colon cancer.  It seems to act differently than most polyps in that it has a different molecular structure that is malignant?
I understand that there is a higher chance of getting colon cancer even if the polyps are always removed.  Is this the case.
Also, when should I have the next colonoscopy?   Any preventative measures?
My dr. is out of town on vacation and I am extremely nervous and worried about this.
Any assistance you can give me is well appreciated…Truth always helps so I can be prepared and ready to monitor etc.
Thank you,

 

Doctor Answer:

The 10mm polyp is a premalignant lesion of the colon so its not the sign of
cancer but of malignancy, results of biopsy and evaluating the surgeon’s notes are important to understand the risks, whether there is cancer and more aggressive treatments, if any,  are needed. This type of polyp is a little more difficult to deal with, BUT If the polyp was COMPLETELY removed during the procedure and there are no additional elements, just regular follow up colonoscopies will be required 0 the first within a couple of months. Please follow the advice of your Doctor and Oncologist.

Below is a more comprehensive answer.

ADVICE AS PER ABOVEMENTIONED QUERIES:

A sessile serrated adenoma (SSA) is a premalignant flat (or sessile) lesion of the colon,
predominantly seen in the cecum and ascending colon.
SSAs are thought to lead to colorectal cancer through the (alternate) serrated pathway. This
differs from most colorectal cancer, which arises from mutations starting with inactivation of
the APC gene.

TREATMENT

Complete removal of a SSA is considered curative.
Several SSAs confer a higher risk of subsequently finding colorectal cancer and warrant more
frequent surveillance. The surveillance guidelines are the same as for other colonic
adenomas. The surveillance interval is dependent on ;
(1) the number of adenomas,
(2) the size of the adenomas, and
(3) the presence of high-grade microscopic features.
Prevention strategy
The usual approach to primary prevention of CRC or neoplastic colorectal polyps is to alter
modifiable risk factors as well as utilize effective nutritional or chemopreventive agents.
While tobacco use is associated with the presence of SSPs, there is relatively little else
known about the primary prevention of SSPs.
The focus of secondary prevention is on high quality surveillance colonoscopy, complete
eradication of SSPs is finally on improving our recognition and understanding of SPS.

 

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Doctor Answers And Comments Below:

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Dr Mahaveer
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Dr Mahaveer

hi,
The 5 mm polyp,being a benign one, need not be worried about. But the pre-cancerous 10 mm one needs to be further investigated. Staging of the polyp should be done histopathologically by doing Biopsy. Depending upon the stage,appropriate treatment- Excision along with Radiotherapy and/or Chemotherapy should be commenced at the earliest.
thanks