Expert: Claes-Gustaf Nordquist, M.D. - 11/8/2007

Question
Hi,
I have recently asked you questions regarding my condition and this is more information or a follow up question. Your help has been excellent. I understand that a Villous Adenoma dysplasia colon tumor of greater than 4 cm appears to have a 40% chance of being cancerous statistically. My colon tumor is approximately 5 cm and 2 sets of multiple biopsies have been negative for malignancy or pre-cancerous. Does the fact the there have been negative biopsies improve the statistical chances of the tumor being benign? I understand that a tumor can have cancerous areas or parts, and a biopsy can miss these areas and give a false negative result. How common is that? My doctor is very hesitant to speculate or deal with statistical percentages. He is cautious and wants to wait and see based on what we actually know for sure. I respect that, but he does not have to live with the anxiety of not knowing. Again, your comments are much appreciated.

Answer
I can understand him. Statistics deals with vast numbers of cases, it is of much less use in a single case like this! On the other hand I can understand you too! You have to worry all the time, he does not need to! The statistics you mention is correct. Yes that means that according to size the risk with your tumor is somewhat higher. BUT 2 negative biopsies of it have been done. THAT does improve your chances. Yes they both may have missed cancerous areas but when you consider the risk of that and all other random chances involved your situation HAS improved somewhat. But you are right that there are no guarantees involved here either way! The ONLY way to know for sure is to have this tumor removed totally and checked completely by a pathologist! GET that done soonest!