Expert: Claes-Gustaf Nordquist, M.D. - 5/21/2007

Question
"I am 55 years old, caucasian, Spanish descent, 30 pounds overweight,
take aspirin, hydrochlorothiazide, nifedipine and simvastatin for high
cholesterol and blood pressure.

My father died at 55 of luekemia. My mother died at 74 of a heart
attack. My sibling (four years older)had numerous hyperplastic polyps
removed when he had a colonoscopy 4 years ago.

On Friday,May 2,2007 I had a colonoscopy. My follow up appointment with
my doctor revealed that a large (@2.00 X 1.65cm) tubulo-villous adenoma
polyp was removed.

Previously, in 2005, a sigmoidoscopy was peformed, a small hyperplastic
polyp was removed. In 2006, a second sigmoidoscopy was performed
(triggered by several positive Fecal occult exam tests); nothing was
removed but the colonoscopy was ordered.

By the way, I am a Vietnam Vet, the sigmoids were done at VA clinics;
the colonoscopy was done by a private practice surgeon because in my
state (FL)  there is a shortage of surgeons due to Iraq war.

I did my homework after my colonoscopy and before my follow up
appointment with the surgeon and became concerned because I learned that
colonic adenomas are at a higher risk for malignant transformation.

I have already made the normal corrections to diet (less fat, more
fiber.) The surgeon is recommending that I have another colonoscopy in
18 months (2009).

QUESTIONS: (1)Should I have an immediate ultrasound, MRI, etc.
to discover if any other organ, tissue abnormalities exist?

(2)Based on your experience, and if I were your patient, what would be
your immediate concerns short and long term.

I have an undergrad degree in biology and chemistry (and have been
spending lots of time researching medical journals) so please don't be
afraid to get technical on me!  

Answer
If the pathology report shows no cancer nothing more needs to be done EXCEPT regular colonoscopies (I would prefer once every year)! That is needed because it is obvious that you have a genetic tendency for this. If there is no cancer in any of the polyps and they are removed there is nothing to worry about. The cancer risk increases with polyp size. Please keep me posted. If you can keep your colon "clean" with regular colonoscopies your risk should be kept at a minimum!

Also your sibling should have such check ups once a year in my opinion! Thanks!