Colon Polyps and Probability

Most colon polyps do not turn into cancer, but nearly all color cancers derive from colon polyps "gone bad".

From the Colon Cancer Foundation (which we'll assume is a reputable site for deriving statistics):

Probability 1:
"Adenomatous polyps or adenomas—These polyps can become cancerous, and they account for approximately 75% of all colon polyps."

P1 = .75

Probability 2:
"The larger a polyp grows, the more likely it is to become cancerous. Once a polyp reaches approximately one inch in size, the risk of cancer is in excess of 20%."

2.5cm = .98" (roughly one inch)

Therefore,

P2 = .2

Probability of two independent events:

P1|2 = P1 * P2 = .75 * .2

Probability that I have a adenoma that is cancerous: .15 or 15%

I'm really not liking the odds. The doctor said that he felt we'd caught it in time, but according to the sites I've read, it's not easy to visually determine if a polyp is an adenoma by visual observation; it really does require microscopic examination on the cellular level.

I have a follow up with the GI on the 22nd. I'm afraid gime is going to drag until then. I wonder if there are implications for being able to do an IVF cycle, with the exposure to high levels of estrogens and all?

Colonoscopy Day

I've had one colonoscopy before today's, and I have to say that the worst part about it has to be drinking the horrible solution that helps you evacuate your bowels. I really have a hard time drinking the stuff down and verge on vomiting with just about every sip. I was supposed to drink (shudder) 2 liters of the stuff (Moviprep this time) but I could only drink about 1.5l before I gave up. I think my body sensed it was nasty stuff and it took forever for it to pass though my stomach and into my intestines.

So the appointment was for 10:30AM, and the procedure at 11:00AM - Dr. Persian referred me to really nice GI over on 5th Avenue. As always, he was right on time. Amazingly on time. This time though, unlike my first one, they anesthetized me for the procedure. Thank god. Last time, I had my colonoscopy done at Kaiser Hospital in Santa Clara, and it was another story. It was supposed to be a sigmoidoscopy and the doctor didn't give me so much as a valium. Then she decided midway to turn it into a colonoscopy. OMFG. It was horrible. I could see the scope trying to turn the corners from ascending to transverse colon...the skin moving up and down....the pain. Egad. I had to clutch onto the table to keep from falling off of it: no bars to provide safety. I don't know what that doctor was thinking but all I can say is never get a colonscopy at the Santa Clara Kaiser. Never.

This time it was much better.

Anyways, I woke up feeling OK, but filled with air which was rather embarrassing for obvious reasons. Why they can't remove it when they are done is a mystery to me.

It turns out that it was a very good thing that I went in for this procedure. About 20cm into my colon, the doctor discovered a 2.5cm large polyp in the sigmoid colon. Anything over 1cm is considered large, so this was "very large". It filled up the entire lumen of the colon. Holy crap.

As he explained, had I left this for a few more years, I might be looking at colon cancer. There's still no 100% guarantee that what they took out of me isn't cancerous but he cut it out as low as he could and they'll examine the margin to see if the cells are all normal.

He left me with a paper that actually had photos of the area, before and after. It's shocking how large it was and how empty the area was once it was removed. The notes said that he went in all the way to where my appendix was removed, taking biopsies along the say. Nothing else was visually noted as being "abnormal". So we'll see what the biopsies show. Whether I have celiac or Chron's disease. Before leaving, he clarified that the polyp doesn't explain why I've been sick since mid July so we're still on the hunt for the cause of that. If nothing turns up in the biopsies, he'll be putting me on some super antiobiotic that's supposed to kill everything in my GI tract and then I'll have to repopulate my flora. That actually sounds quite scary to me. Gulp.

What if even that doesn't work? I wonder what's next? This is what'll be on my mind the next two weeks. If they find something, it's likely Chron's or celiac disease. If it's not, then I have to deal with this nasty antibiotic. Neither outcome seems safe to me. I read online these horror stories of people winding up with colostomies, carrying bags around for their BMs. I don't want to be that person.

So I'm taking it easy today. Trying to stay positive. Sleeping, moving a bit slowly, just trying to take care of myself and count my blessings that I went in for this procedure.

Fingers crossed for a clean pathology report in 10 days (for the polyp) and that they find some harmless cause to my GI issues.