Question about Dx

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Question about Dx

Postby Kara » Sun Aug 06, 2017 12:11 am

Hello all,

I've been reading through the forum the past few days and already feel as if I know some of you! I am sending good thoughts, prayers, and positive vibes for all of those diagnosed and caring for the diagnosed.

Let me first say that I have a colonoscopy scheduled for Tuesday. I have a family history of colon cancer (grandmother, dx age 65, but beat it and is still around at 88!) along with some long term symptoms that I've been dismissing for years (not realizing that they are symptoms) as well as some new ones that have popped up in the last couple of months. I also had a colonoscopy about 15 years ago where a couple of polyps were removed- at the time I was told that they'd been removed and I was good to go. I had no idea that polyps could be a pre-cursor to colorectal cancer. I was young and living in another city/state and have not been able to get my hands on those records, so I have no idea if anyone actually looked at them, biopsied them, etc., but I don't believe that to be the case. I also received an IBS diagnosis around the same time (hence all those symptoms I've dismissed over the years) but have suspected for many years that I actually have IBD of some kind or another. At any rate, time will tell sooner rather than later, since the colonoscopy is in a couple of days!

This brings me to my question... I've never seriously researched anything about colon cancer, but have been doing so the last week so that I can torture myself before I go in for my scope. :lol: In all my reading of others' stories, I'm confused about the diagnosis timelines. It sounds like a lot of people wake up and are told, "it's cancer", but then many others are told, "It looks like trouble, but I can't possibly say for sure until we biopsy". Is the difference here seeing a tumor versus a polyp? For those who had polyps biopsied, how long did you have to wait for the results? My assumption is that on Tuesday they will find more polyps to remove (considering I had them 15 years ago, it seems odd that I'd randomly have a couple at age 20 and then never have any more ever again) and it is my understanding (from online reading) that those will be biopsied, depending on what kind of polyp they are- or maybe regardless of what kind they are. If nothing else, I expect them to dx SOMETHING... Crohn's, Ulcerative Colitis, or possibly Diverticulosis/Diverticulitis... I just don't see this being an "all clear" type of scenario. I'd love to hear your dx timelines. Thanks in advance for your help!


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Re: Question about Dx

Postby Stewsbetty » Sun Aug 06, 2017 1:02 am

Hi Kara,
Wishing you all the best on Tuesdays scope. I hope that you leave with answers to your issues but that they aren't caused by cancer.
Regarding your question. I am guessing a bit but I believe there is often a difference in the looks of a tumour versus polyp. Unless the polyp has just turned cancerous?
My tumour was readily different in part to size. And the surgeon showed me a picture of it from the colonoscopy. It was dark coloured and a lumpy bumpy looking mess! Nothing like the polyps I have seen on YouTube colonoscopies. ;)

I know there are some really smart people in here who might know specific differences.
42yo At diagnosis. Female in BC, Canada
Dx: CC ascending
Right Hemi colectomy 06/16 clear margins
Adenocarcinoma 6cm High Grade
pT3 pN2a Stage 3
10 out of 16 lymph involved
MSI-h, Kras mut, Braf wild
Finished chemo Feb. 2017
PET scan showing active area April 2017
July 2017 CT showing LN mass and spread to other LN
Stage 4
Aug 2017 failed Fofiri
Sept 2017 keytruda scans every 3 months showing shrinkage and stability
November 2018 CT shows only 1 small tumour left
September 2019 clear CT finally NED!!!

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Re: Question about Dx

Postby veckon » Sun Aug 06, 2017 7:48 am

Kara wrote: all my reading of others' stories, I'm confused about the diagnosis timelines. It sounds like a lot of people wake up and are told, "it's cancer", but then many others are told, "It looks like trouble, but I can't possibly say for sure until we biopsy". Is the difference here seeing a tumor versus a polyp? For those who had polyps biopsied, how long did you have to wait for the results?


It depends on the staging of the tumor I think. My primary rectal tumor was large enough that it was obvious to my GI that it was cancer. So she told me immediately after waking up. She then scheduled immediate CT, MRI, and PET so I would have diagnostic information ASAP to bring to whichever oncologist I chose. During the first few days the tumor biopsy is examined and you will get your pathology report. Mine was of course positive for moderately/poorly differentiated adenocarcinoma, common in Lynch syndrome related cancers. They also gave me some nice cross-sections of the cancer to look at from the microscope.
27 yo male
Metastatic rectal cancer diagnosed 12/16
Liver metastases and peritoneal carcinomatosis
Lynch syndrome, MSI-H
Failed liver resection 3/17
FOLFOX6 12/16 - 05/17
Keytruda 5/17 - present
@Memorial Sloan Kettering

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Re: Question about Dx

Postby Tdubz » Sun Aug 06, 2017 9:29 am

My tumor was almost blocking my colon. The gi couldn't even get the camera passed it. When I woke up, he strongly hinted that it was cancer but mentioned the possibility of other things. He sent me for a Ct scan that same day where they also believed it to be cancer. I ended up having surgery 2 weeks later

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Re: Question about Dx

Postby orlar » Sun Aug 06, 2017 11:21 am

Hi Kara,

I was told upon waking that I had tumor and it was probably cancerous. The tumor was large enough that it was blocking a good portion of the colon and was showed a picture of it. I received a CT scan and blood labs within that next hour or so and the biopsy was confirmed 2 days later. I had surgery three weeks after that.

I'm still new to all this, but not matter what comes our way we can and will handle it! Hoping things go well on Tuesday!
56yo male DX 5/17, Right Hemi colectomy 6/17
Stage 3c 12 of 21 LN
7/17-12/17 Folfox(no Oxi round 9-12)
12/17 liver/lung mets-Stage 4 MSS KRAS G13D
2/18 liver doubled to 8.5cm+new met, lung mets to 1.4cm, multi peri/omen
2/18-7/18 Folfiri+Avastin(no 5FU after C2)
4/18 mets shrinking
7/18 liver/lung mets growing, Folfiri stopped
10/18 In Clinical Trial
CEA 5/17-16.2, 12/17-16.1, 02/18-43.0, 3/18-16.9, 4/18-9.0, 5/18-5.5, 6/18-6.9, 7/18-7.8, 9/18-56

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Re: Question about Dx

Postby Kara » Mon Aug 07, 2017 11:21 pm

Thanks for the insight, guys! Hoping for some answers tomorrow, and CAN'T WAIT to never drink GoLytely again. *gag*

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Re: Question about Dx

Postby JJH » Mon Aug 07, 2017 11:45 pm

Kara wrote:... I'd love to hear your dx timelines. Thanks in advance for your help! ...

There are several levels of DX -- Tentative visual diagnosis based on what is seen during the examination, tentative pathology diagnosis based on what was found in the few small pieces of tissue taken in the biopsy, etc. These will be known within a day or so of examination, but they are tentative.

The final, definitive diagnosis doesn't come until much later after the entire polyp/tumor is removed by surgery and examined exhaustively by the pathologist, and after all of the various scans and x-rays have been checked for remote metastases. It may take even longer if they have to send the tumor samples out for special genetic analyses.

In my case, it took about 10 days for all of the info to be collected and properly analyzed.

Good luck on your examination today.
"The darkest hour is just before the dawn" - Thomas Fuller (1650)

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Re: Question about Dx

Postby DarknessEmbraced » Tue Aug 08, 2017 5:30 pm

I hope your colonoscopy went well and that you don't have to wait long for answers!*hugs* I wasn't told it was cancer after my colonoscopy. I was a little worried when they took blood and said I would need a chest, abdominal and pelvic ct scan. I had to wait a week or more for my appointment with my GI surgeon who told me my diagnosis.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

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Re: Question about Dx

Postby CRguy » Tue Aug 08, 2017 6:19 pm

Kara wrote:Thanks for the insight, guys! Hoping for some answers tomorrow, and CAN'T WAIT to never drink GoLytely again. *gag*

Hey Kara
hope you are doing well post scopin' and
" hope everything came out all right ! " :shock:
you'll get use to the sense of "humor" around here ..... :mrgreen:

Pico Salax ( Prepopik in the USA ) is WAAAAAAAY easier than any "-lytelys" you may encounter
so educate your doc for any follow ups !!!
I've always said IF the GI docs had to take that shit themselves ... they would NEVER prescribe it for us !!!!

Best wishes
Caregiver x 4
Stage IV A rectal cancer/lung met
13 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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Location: FL

Re: Question about Dx

Postby Maelleous » Wed Aug 09, 2017 4:36 am

Mine told me as soon as I woke up that it is "almost certainly cancer" but the biopsy will confirm. Looking at the picture, mine did not look anything like a typical polyp.

My non-blood cousin who had colon cancer just had a polyp in the exact same spot he had the cancer. The dr was slightly concerned just because of where it was, but had to wait on the biopsy. Thankfully for him it was nothing, he had just hit his 5-year mark.
M 35 yr
DX Rectal Cancer, 10/16 (symptoms Feb 2016)
Dx stage 2 - Surgery Oct 25 201 Loop ileo w/ j-pouch
Close margins within 1mm
9/38 lymph nodes involved on path / Stg IIIc,pT4, pN2 B, p.M0. MSS, K‐ras, NRAS, no mutation
Started Folfox - 3rd Treament, Dec 30th 2016 Cardiac Arrest - Lucky to be part of the 6% to survive!
S-ICD installed / Port Removed
Vaccine Clinical trial at UPMC - last shot June 2017
Reversal 8/1/17 - Praying this is it!
Still NED

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Re: Question about Dx

Postby mpbser » Wed Aug 09, 2017 6:31 am


Welcome to the board!

Whether the mass (most are "villous adenomas") is classified as a tumor versus a polyp depends entirely on the histology/pathology report.

I know this from my husband's experience of the doctors having found a mass with high grade dysplasia (physical appearance of abnormal cells by looking with the naked eye) that they all suspect is malignant because it looks like a tumor, but every biopsy has returned negative/benign results. Biopsies take cells only from the surface of the mass, so it is still possible (maybe very likely, I don't know) that the interior contains cancer. So, until the mass is removed when he has his (2nd) colon surgery and the entire thing can be tested and malignant cells are found, it is not classified as a "tumor."
Wife 4/17 Dx age 45
5/17 LAR
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles

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