Preventing sessile serrated adenomas

Posted by peacefish @peacefish, Nov 21 1:47am

Hi everyone. I just had my first screening colonoscopy. Female, age 45, thin, don’t smoke or drink, vegetarian, exercise daily, no family history of colon problems. They found 3 large sessile serrated polyps (15mm, 15mm, and 20mm), removed two with a hot snare and scheduled me 3 months out to grab the last one. Pathology says not cancer, but I am reading how hard these are to find and completely remove. And how often they grow back and become cancer… Yikes. I feel like cancer is inevitable as I have no risk factors, I already do what you’re supposed to do to avoid colon cancer, and still have these huge scary precancerous lesions. What are people supposed to do to prevent these things from coming back (besides asking your doctor to please put you on annual colonoscopy for surveillance)? I just started drinking 4 cups of green tea daily and will soon be taking daily fiber. I also just read I should stop taking my calcium supplements. Should I take aspirin regularly? I just have no idea what I should be doing. My biggest goal has suddenly become just to reach my 70’s with an intact colon.

Interested in more discussions like this? Go to the Colorectal Cancer Support Group.

I'm sorry you're going through this. You may want to have genetic screening for colon cancer. It will help guide you and your doctors in the future.

REPLY

Hello @peacefish and welcome to Mayo Connect. I can certainly understand your concerns after this diagnosis. I see that @bevjoy has already suggested genetic screening. You might want to talk with your doctor about this and see if it available in your hospital system. Often, this type of testing is done at a university medical school or another cancer center of excellence.

I did find some information on this type of colon polyp from the American Cancer Society website:
https://www.cancer.org/cancer/diagnosis-staging/tests/biopsy-and-cytology-tests/understanding-your-pathology-report/colon-pathology/colon-polyps-sessile-or-traditional-serrated-adenomas.html
I would encourage you to talk with your GI specialist about the best eating plan and/or supplements to help prevent these from recurring. Has your doctor offered any suggestions?

REPLY

Thank you for your reply. What is the benefit of genetic screening for this? It already seems apparent I am at high risk for cancer and need more active surveillance (i.e. more frequent colonoscopies). I already intend to warn my sibling to ensure they’re getting screened.

REPLY
@peacefish

Thank you for your reply. What is the benefit of genetic screening for this? It already seems apparent I am at high risk for cancer and need more active surveillance (i.e. more frequent colonoscopies). I already intend to warn my sibling to ensure they’re getting screened.

Jump to this post

That is a good question to ask your doctor, @peacefish. Here is some information about the reasons for genetic screening,
https://www.mayoclinic.org/search/search-results?q=genetic%20screening
Perhaps your doctor will not feel it necessary at this stage of your treatment.

REPLY

I felt the same way, initially and for many years had annual colonoscopies.
Why get genetic testing when it's apparent that something is causing the polyps so just get checked every year. But, knowing about my genetic predisposition gave me more information than just colon cancer risk. Some mutations carry risks beyond the colon. Mine, for example is a autosomal recessive mutation (MAP bialletic) and carries other risks such as upper gastro, thyroid, etc. In August, I had my large colon removed because after 40 years of colonoscopies, my colon became torturous and they couldn't reach parts of it for total surveillance. I believe strongly that knowing if and what type of genetic issue you may have provides you with essential info for the doctor's and your family. I hope this helps!

REPLY

I am sincerely glad those 40 yrs of colonoscopies gave you more time with your colon. I hope so much that will be an option for me, too. August is pretty recent. I hope you are adjusting to things without having the large colon. That sounds intimidating.

REPLY

Yes, it's been an interesting experience, for sure! I'm 66 yrs old and had issues very early in life, which prompted the surveillance. I had 147 polyps (all varieties) by the end of it all (15 of which were found in the areas that they couldn't surveille for 2 years because even an endoscope couldn't reach the ascending and cecum.) I had robotic laparoscopic so it was an easy recovery. (Walking a mile and driving within a week). I don't have a colectomy bag; my rectum is now attached to my small intestine. Modern medicine!
My eating has definitely changed since the surgery. I have good days and bad with BMs. I'm experimenting with what works (and doesn't). It's not always a clear correlation which is frustrating. Sometimes, I just go for it because it's unpredictable anyway!! Introducing fiber more and more, as instructed by my docs.
A note on genetics: I didn't have any relatives that had colon cancer. There are genetic disorders that run in a autosomal recessive pattern. (Both parents are carriers of the variant and then each child has 25% chance of getting both.)
I was the lucky one!!! Seriously, I do feel lucky because I sought help early in life due to digestive issues. My doctors say that had I not persisted with the colonoscopies over the years, I wouldn't have made it to a healthy 66 years old! Colonoscopies just became a part of my annual schedule. My point is that family history doesn't always tell the whole story. Stay vigilant. I continue to be with my annual upper endoscopy, thyroid ultrasounds (I've had solid polyps for years; they just don't change so no biopsy yet) and now a rectal exam instead of a colonoscopy.
Sorry about the long response… I get going on the subject!

REPLY

I had the genetic testing due to multiple polyps and I’m glad I did. It was an easy blood test. The genetic counselor talked with me after my results came in. To prevent polyps I’m guessing it’s good to have a high fiber diet, with lots of vegetables and fruits, as well as whole grains. Even though I do this, I still have a large number of polyps. But based on the posters in GI doc offices, I believe they recommend a high fiber diet. If you learn of any means of preventing adenomas, I will be happy to learn about it. Best of luck. When did the doctor say you will need your next colonoscopy?

REPLY

Thank you for your reply. I go back in February to take the third polyp out and check on the removal sites of the other two (to see if the margins were removed well enough). If I learn any latest and greatest on polyp prevention I will certainly post.

REPLY
@bevjoy

Yes, it's been an interesting experience, for sure! I'm 66 yrs old and had issues very early in life, which prompted the surveillance. I had 147 polyps (all varieties) by the end of it all (15 of which were found in the areas that they couldn't surveille for 2 years because even an endoscope couldn't reach the ascending and cecum.) I had robotic laparoscopic so it was an easy recovery. (Walking a mile and driving within a week). I don't have a colectomy bag; my rectum is now attached to my small intestine. Modern medicine!
My eating has definitely changed since the surgery. I have good days and bad with BMs. I'm experimenting with what works (and doesn't). It's not always a clear correlation which is frustrating. Sometimes, I just go for it because it's unpredictable anyway!! Introducing fiber more and more, as instructed by my docs.
A note on genetics: I didn't have any relatives that had colon cancer. There are genetic disorders that run in a autosomal recessive pattern. (Both parents are carriers of the variant and then each child has 25% chance of getting both.)
I was the lucky one!!! Seriously, I do feel lucky because I sought help early in life due to digestive issues. My doctors say that had I not persisted with the colonoscopies over the years, I wouldn't have made it to a healthy 66 years old! Colonoscopies just became a part of my annual schedule. My point is that family history doesn't always tell the whole story. Stay vigilant. I continue to be with my annual upper endoscopy, thyroid ultrasounds (I've had solid polyps for years; they just don't change so no biopsy yet) and now a rectal exam instead of a colonoscopy.
Sorry about the long response… I get going on the subject!

Jump to this post

Thank you for your response. Every word. Truly extraordinary that you don’t need a bag. Even though you’re still fine-tuning how you eat, it seems like an easier thing to be able to keep everything internal. I can’t tell you how much I appreciate how matter-of-fact you are about everything. You seem so mentally strong. I will try to be. But I think it will take a bit. Still adjusting to the fear of risks and unknowns. I’m having a hard time eating because I’m looking at all of my regular foods suspiciously – wondering which one of them did it, haha.

REPLY
Please sign in or register to post a reply.