Polyp removal not a success

Bit of a long story but thought having a bit of back story might help with any answers . I was diagnosed with stage 3 sigmoid cancer and had a higher anterior resection last March . 1 lymph node showed cancer so I had chemo although this was cut short as I caught covid . At the time of my higher anterior there was a discussion at the MDT meeting that I should have a sub total colectomy as there was also a adenoma on my ileocecal valve . It was decided that this polyp would be revisited after chemo had finished . In oct 21 with EMR this sessile adenoma with low grade dysplasia was removed by piecemeal . In Januarys blood tests my CEA was 0.6 but I had anaemia and was given iron transfusions. Last week I had a surveillance colonoscopy to check the ileocecal valve . 4 biopsies were taken as the tissue showed villous architecture. Being sedated I didn’t really ask much but the consultant said that depending on the biopsy results I will need more surgery . 
I believe that whether this shows cancer or not they won’t leave a adenoma in situ ? Does it sound like the polyp was removed but has already invaded the tissue or just not removed entirely? Could something that wasn’t cancer in October suddenly be cancer now ? 
Has anyone been in this position where surgery was the only option to remove the polyp ? Has anyone else had a unsuccessful EMR procedure . ? I’m the kind of person that loves to know all scenarios and information- good and bad lol Has anyone had the ileum removed ? 
thank you for reading 

  • Hi 

    I remember this discussion about leaving the second polyp at the time . Was there an issue of the primary making access hard or am I being inaccurate.

    Quite a long drawn out process for you . I can’t help I am afraid but given I know you like a bit more information I was wondering if you ever use pubmed search engine to look at the research articles on it . Not for everyone but I sometimes like to know a bit more . Other times I am the opposite . Just wondered if it would give you some more info .

    Take care ,

    Court 

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  • Hi @court , 

    it was left in situ purely because my bowel surgeon felt I was too young to have all the problems associated with the removal of the ileocecal valve and sub colectomy. After discussion with the EMR Joydoscopist they thought they could do a polypectomy . Hence it was left in as histology at that time was a sessile low grade dysplasia it was 4mm at that point in March 21 . In oct 21 when they went Joy to remove it had grown to 14mm . I’ve googled research papers Joy not much around just that it’s very rare to have a polyp on the valve itself . As you can imagine lots of questions are going through my head . Is it cancer ! Is it related to my sigmoid tumor? If the valve is showing villous architecture then does that mean the polyp wasn’t removed entirely? But at the end of all this I think I know that the likelihood is I’ll need surgery ! . It’s torment waiting to find out ha ha . You’d think I’d be used to this part by now . 

  • https://www.ncbi.nlm.nih.gov/books/NBK470272/

    Totally understandable. I can see why you want more answers to that .

    You have also educated me further on polyps so I have linked in an article and will bookmark the forum to use for others .

    I think I am getting it now , your polyp located on the valve was removed but signs of villous architecture remain on the valve so now waiting to see if this is within the realms of normal or requires further intervention . How totally frustrating!!! It’s such a complex process. I still long for a fast tract program at least the stress would not have time to escalate as

    much ! I read the American forums with some envy at the speed they move at but other insurance aspects right enough !

    Would you rather err on the side of caution?

    Interestingly enough my mum has only ever had one colonoscopy from reading that article it seems more might have been a good idea . She also participates in long term survival where a lot of focus is on probiotics and diet etc . Starting to see why from the article .

    I really do hope you hear soon as you clearly have a firm grasp on this and the questions need solutions .

    Take care ,

    Court 

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  • Hi @court I’m loving pubmed ! Wow ok some of the info is far to technical but you do get a jyst x Dawn

  • Joy. I thought you might like it . It’s quite interesting to see what research is coming through . Took me a while to remember to check the dates and sample sizes . I definitely can get to the end of aJoyaper and think “I have not got a clue “ what I have just read . JoyJoy. The joys of life .

    Take care ,

    Court 

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  • Hi @court , 

    I was on pubmed yesterday searching mucosal lyhmoid tissue ! My Gp phoned and read out the report  - I wouldn’t say she completely understood it . From her wordings it looked like my diagnosis would be non Hodgkins - I quickly emailed my cancer nurse and said I knew the biopsy results were back and that my GP had done her best to understand them . I got a very short message back saying - reassuring no polyp and ileocecal valve appears normal further colonoscopy booked. 
    So all looks ok thank goodness - I’ll wait the proper diagnosis letter but can go on holiday now without dreading the worst 

  • Yippee ! So pleased to hear that .

    You would be very reassured to hear all is well after that .

    Have a wonderful holiday . You have definitely earned a good break .

    Court 

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