Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Please feel free to read, share your thoughts, your stories and connect with others!
Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Fri Jul 13, 2018 2:37 pm

Hi there

Hopefully I can gain some advice as to how long it took for my tumour to grow. All the experts I asked were very evasive stating its difficult to say but it could be many years.

My main reason for establishing the timeline is that in March 2011 I had a sigmoidoscopy and haemorrhoid banding. I had blood in my stools for sometime and eventually plucked up the courage to have it looked into. My consultant said it was internal haemorrhoids but that needed banding but would also carry out a sigmoidoscopy to check further.

After the procedure, my consultant visited and confirmed all was ok. He highlighted signs of diverticulitis but did not require treatment. He also mentioned a small cluster of [I'm sure he said polyps] about a cm or so in size but there was nothing to be concerned about but it would be advised to check again in 10>15 years. Being a typical man, I heard all ok, 10>15 years and hot footed it out of there!

In 2012 I had changes in bowell, soft stools and some blood occasionally. I also lost weight but as I was actively looking to do so and was eating healthily and gym/swimming/yoga everyday, taking protein shakes etc just put it down to the fitness regime, and 'the haemorrhoids must've returned!

In April 2014, I 'hit a brick wall' in terms of energy. I had such bad fatigue I could hardly get out of bed.
I had various blood tests then an Endoscopy when they discovered the tumour. I was advised it was very 'bad' one of the worst they had seen and I would be referred for advice etc. I had a meeting with the surgeon who said the tumour was inoperable and I was referred to oncology for chemo and radiotherapy treatment. The mood then changed more positively when the oncologist said that as I was so fit, it would work in my favour as I will deal with the treatment better. No guarantee but...

Thankfully after a year of treatment, I eventually had an operation and I'm still here to type this query!

The answers I would love to establish are:

1. Can a polyp grow that fast to that size in three years?
2. Is it possible that there wasn't a polyp there three years prior but in that time a polyp grew and then developed into the tumour in that time?
3. In my medical records there wasn't polyps mentioned. Is that normal?
4. In the consultation after the sigmoidoscopy, where the 10>15 year diagnosis was made, could the small cluster referred to be anything other than polyps?

I have been advised that it is best practice to remove polyps when discovered, in fact during my last colonoscopy two weeks ago, I observed them remove one. It was after that procedure, when it was evident that that polyp had taken 2 years to grow as it wasn't there in 2016, that made me question what I was told in 2011 and that had the polyp been removed in 2011 I would have avoided this nightmare.

Any expert advice I receive would be most helpful.

Kind Regards :D

Lee
Posts: 5740
Joined: Sun Apr 16, 2006 4:09 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Lee » Fri Jul 13, 2018 6:08 pm

Az1971 wrote:

After the procedure, my consultant visited and confirmed all was ok. He highlighted signs of diverticulitis but did not require treatment. He also mentioned a small cluster of [I'm sure he said polyps] about a cm or so in size but there was nothing to be concerned about but it would be advised to check again in 10>15 years. Being a typical man, I heard all ok, 10>15 years and hot footed it out of there!

In 2012 I had changes in bowell, soft stools and some blood occasionally. I also lost weight but as I was actively looking to do so and was eating healthily and gym/swimming/yoga everyday, taking protein shakes etc just put it down to the fitness regime, and 'the haemorrhoids must've returned!

In April 2014, I 'hit a brick wall' in terms of energy. I had such bad fatigue I could hardly get out of bed.
I had various blood tests then an Endoscopy when they discovered the tumour. I was advised it was very 'bad' one of the worst they had seen and I would be referred for advice etc. I had a meeting with the surgeon who said the tumour was inoperable and I was referred to oncology for chemo and radiotherapy treatment. The mood then changed more positively when the oncologist said that as I was so fit, it would work in my favour as I will deal with the treatment better. No guarantee but...

Thankfully after a year of treatment, I eventually had an operation and I'm still here to type this query!

The answers I would love to establish are:

1. Can a polyp grow that fast to that size in three years?
2. Is it possible that there wasn't a polyp there three years prior but in that time a polyp grew and then developed into the tumour in that time?
3. In my medical records there wasn't polyps mentioned. Is that normal?
4. In the consultation after the sigmoidoscopy, where the 10>15 year diagnosis was made, could the small cluster referred to be anything other than polyps?

I have been advised that it is best practice to remove polyps when discovered, in fact during my last colonoscopy two weeks ago, I observed them remove one. It was after that procedure, when it was evident that that polyp had taken 2 years to grow as it wasn't there in 2016, that made me question what I was told in 2011 and that had the polyp been removed in 2011 I would have avoided this nightmare.

Any expert advice I receive would be most helpful.

Kind Regards :D


Hi and welcome,

So do you have rectal cancer? Were you ever given a stage for this tumor? Did you have a pathology report on the tumor that was removed?

What type of doctor did you see in 2011?

What type of chemo did you receive?

Am I correct to assume you are not in USA?

Sorry butt I'm a bit confused here

Generally it takes about 10 years for a polyp to turn cancerous. Butt there is a certain medical condition (can't remember the name) when a polyp can turn cancerous in a few years.

Polyps should be removed when they are found. If it was indeed a polyp, it should have been noted on your medical records. If there was a small cluster of anything, I believe that should have been mentioned on your medical records also.

Not sure if this helps or not, butt I feel I need some more info to give you better answer.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

Soccermom2boys
Posts: 196
Joined: Tue Nov 10, 2015 10:29 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Soccermom2boys » Fri Jul 13, 2018 11:06 pm

You state that you had a sigmoidoscopy in 2011—that only goes up to the sigmoid so a large chunk of your colon went unchecked for several years until your endoscopy was performed and found the tumor. Generally an endoscopy is for the upper GI tract, I believe, so if that caught the tumor then that would most likely be why the sigmoidoscopy came out clean in 2011. There are people who grow polyps in abundance due to genetics, but generally speaking they do take many years to turn cancerous. I am absolutely not a medical professional, but based on what you explained regarding your body changes prior to the endoscopy, I am guessing your tumor was there in 2011 but too high up for a sigmoidoscopy to catch it.

I am happy to hear that you have completed treatment and are doing well all things considered.
8/3/15 Went in with a hemorrhoid, came out with a tumor
8/12/15 Biopsy from colonoscopy confirms RC (45 yrs old--zero family history!)
9/21 - 10/29/15 chemorad 28 tx (with Xeloda)
12/17/15 APR with perm colostomy
Pathology report stages me as IIIA (T2N1M0)--1/15 LN detects cancer
2/3/16 chemo port inserted
2/8-6/2/16 8 rounds of Folfox

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sat Jul 14, 2018 10:07 am

Hi Lee

Many thanks for your reply and advice.

In answer to your questions :

What type of doctor did you see in 2011? - Colorectal Surgeon (MB BS FRCS)

What type of chemo did you receive? - Oxaliplatin[ev.10 days] Capecitabine[10 days on 4 off] & Avastin[ev. 10 days] 3 cycles over 9 months

Am I correct to assume you are no - Correct. UK

I had resection surgery and the rectum mostly removed.

There was a pathology report on the tumour but I haven't seen that.

The cancer I had was Rectal and my understanding is that the sigmoidoscopy would cover the rectum and upper sigmoid colon. The polyps/cluster mentioned in 2011 is likely to be what developed into cancer.

Regards

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sat Jul 14, 2018 10:20 am

Hi there

Many thanks for your reply.

The tumour I had was 'Circumferential Tumour involving rectum with involvement of the pentoneal reflection' Stage T4. My understanding is that the the situation of the tumour was below the sigmoid colon and above the anus. This area would've been covered by the sigmoidoscopy and raises the question that although cancer was not identified in 2011, is it possible for a tumour to grow in that area when there wasn't a polyp? If it is possible, I not aware that I have a genetic make-up that grows multiple polyps, at my last colonoscopy they removed one which wasn't there 2 years prior. The more I read the more I come to the conclusion that it would be highly unlikely for there not to have been a polyp, albeit small but noticeable, in 2011 and what I was advised re all ok for 10>15 years could only be made if the polyp was removed and tested. There was no mention of polyps in my notes, there would be if removed, but looks like they were viewed as unimportant and therefore not highlighted??

Regards

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sat Jul 14, 2018 10:49 am

Some notes that may be of use to help better answer my question.

Malignant Neoplasm of Rectum - Malignant Tumour 10>20cm. 10>20cm From anal verge. Annular height from anal verge 75mm. Distal edge 40mm above the puborectal sling?

'Big tumour extending beyond RT field, with CRM involvement above the peritoneal reflection making it T4 CT: No other abnormality'

Not sure this helps unless you're a oncologist/surgeon??

Thanks

weisssoccermom
Posts: 5883
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby weisssoccermom » Sat Jul 14, 2018 11:35 am

It's my understanding that an endoscopy only goes as far as the very upper part (beginning) of the small bowel. There is NO way that an endoscopy could discover some tumor in the colon or rectum. You state that your tumor was rectal....rectal tumors can only be discovered (scope wise) via a flex sig or a colonoscopy.
So, something doesn't make sense about this. When the endoscopy discovered the tumor, WHERE was that particular tumor located? What type of surgery did you have back in 2014?
So, I see that you answered many of my questions in response to Lee's previous post. So I am very confused by what you have posted.

You had rectal cancer, diagnosed in 2014. That couldn't have been diagnosed by an endoscopy. Now, it could have been diagnosed by a flex sig or a colonoscopy but not an endoscopy. AS for the small cluster of whatever it was, I have a really difficult time believing that ANY reputable doctor would have left polyps in a patient. Having a flex sig/colonoscopy is a preventative measure to check for changes such as growths, polyps, etc. and to PREVENT colorectal cancer, one would remove those growths, polyps, etc. Is it possible that the doctor said that there was some scarring that he noted perhaps, in his opinion, from the diverticulitis? My suggestion would be to get a copy of that report.

Let's assume that the cluster truly was a polyp....the answer is yes, it is possible in three years for something to turn cancerous and grow. We usually hear that colorectal cancer is slow growing but one thing we do know about cancer is that ANYTHING is possible. Cancer has a mind of its own and it can and does do what it wants. Even if you have a small polyp, without doing a biopsy on it, one has no way to know it's characteristics....is it aggressive, does that polyp/growth have negative factors to it, is it an adenocarcinoma or maybe something else like a squamous cell tumor?

At this point, unless you get a copy of that original flex sig report, you will have no definitive way of knowing what the doctor saw/didn't see. At this point, however, you need to make sure that you continue to get checked on a very regular basis. Not all polyps are created the same. On another note, once you have had radiation (which it sounds like you did) you are more prone to develop polyps....not ones that will necessarily turn into cancer, so don't be shocked if you find that even every 2-3 years (assuming that's your schedule for scopes) the doc finds a polyp or two.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

User avatar
muskokamike
Posts: 210
Joined: Tue Feb 25, 2014 4:38 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby muskokamike » Sat Jul 14, 2018 9:06 pm

Az1971 wrote: He highlighted signs of diverticulitis but did not require treatment. He also mentioned a small cluster of [I'm sure he said polyps] about a cm or so in size but there was nothing to be concerned about but it would be advised to check again in 10>15 years.


Hope that dr has a great malpractice insurance. He dropped the ball big time with you.
53M Dx rc10/31/13
and a huge WTF?....then
CT scan, BONE scan
MRI/T3N0M0 1 suspicious node
5 wks chemo/rad
LAR open TME 2/26/14
temp ileo
0/24 nodes pCR - pathological
Mop up Folfox (8) Mar/28-Jul/4
Aug/14 clear CT scan
8/27/14 reversal
Feb/15 clear scope
July/15 clear CT scan
Feb/16 clear CT scan
Feb/17 clear CT scan
Feb/18 clear scope
Feb/18 clear CT scan
CEA levels 1.6 dx
1.6,1.4,1.7,2.4,2.9, 2.7 2.3 2.5 2.2 2.1 2.5
2.6 Sept 18
0-4 normal

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sun Jul 15, 2018 9:52 am

weisssoccermom wrote:It's my understanding that an endoscopy only goes as far as the very upper part (beginning) of the small bowel. There is NO way that an endoscopy could discover some tumor in the colon or rectum. You state that your tumor was rectal....rectal tumors can only be discovered (scope wise) via a flex sig or a colonoscopy.
So, something doesn't make sense about this. When the endoscopy discovered the tumor, WHERE was that particular tumor located? What type of surgery did you have back in 2014?
So, I see that you answered many of my questions in response to Lee's previous post. So I am very confused by what you have posted.

You had rectal cancer, diagnosed in 2014. That couldn't have been diagnosed by an endoscopy. Now, it could have been diagnosed by a flex sig or a colonoscopy but not an endoscopy. AS for the small cluster of whatever it was, I have a really difficult time believing that ANY reputable doctor would have left polyps in a patient. Having a flex sig/colonoscopy is a preventative measure to check for changes such as growths, polyps, etc. and to PREVENT colorectal cancer, one would remove those growths, polyps, etc. Is it possible that the doctor said that there was some scarring that he noted perhaps, in his opinion, from the diverticulitis? My suggestion would be to get a copy of that report.

Let's assume that the cluster truly was a polyp....the answer is yes, it is possible in three years for something to turn cancerous and grow. We usually hear that colorectal cancer is slow growing but one thing we do know about cancer is that ANYTHING is possible. Cancer has a mind of its own and it can and does do what it wants. Even if you have a small polyp, without doing a biopsy on it, one has no way to know it's characteristics....is it aggressive, does that polyp/growth have negative factors to it, is it an adenocarcinoma or maybe something else like a squamous cell tumor?

At this point, unless you get a copy of that original flex sig report, you will have no definitive way of knowing what the doctor saw/didn't see. At this point, however, you need to make sure that you continue to get checked on a very regular basis. Not all polyps are created the same. On another note, once you have had radiation (which it sounds like you did) you are more prone to develop polyps....not ones that will necessarily turn into cancer, so don't be shocked if you find that even every 2-3 years (assuming that's your schedule for scopes) the doc finds a polyp or two.


Hi there

A colonoscopy as I understand it is the lower and upper Scan and is dependent on how much of the colon is under investigation. My Endoscopy in 2014 was oral and anal. The oral scan was clear AND the upper colon. The final part of the scan is naturally on exit, through sigmoid colon>Upper Rectum>Lower Rectum>Anus.

Sigmoidoscopy scans from the top sigmoid colon back only.

Both of these scans would find rectal cancer as both flex through to exit.

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sun Jul 15, 2018 9:59 am

weisssoccermom wrote:It's my understanding that an endoscopy only goes as far as the very upper part (beginning) of the small bowel. There is NO way that an endoscopy could discover some tumor in the colon or rectum. You state that your tumor was rectal....rectal tumors can only be discovered (scope wise) via a flex sig or a colonoscopy.
So, something doesn't make sense about this. When the endoscopy discovered the tumor, WHERE was that particular tumor located? What type of surgery did you have back in 2014?
So, I see that you answered many of my questions in response to Lee's previous post. So I am very confused by what you have posted.

You had rectal cancer, diagnosed in 2014. That couldn't have been diagnosed by an endoscopy. Now, it could have been diagnosed by a flex sig or a colonoscopy but not an endoscopy. AS for the small cluster of whatever it was, I have a really difficult time believing that ANY reputable doctor would have left polyps in a patient. Having a flex sig/colonoscopy is a preventative measure to check for changes such as growths, polyps, etc. and to PREVENT colorectal cancer, one would remove those growths, polyps, etc. Is it possible that the doctor said that there was some scarring that he noted perhaps, in his opinion, from the diverticulitis? My suggestion would be to get a copy of that report.

Let's assume that the cluster truly was a polyp....the answer is yes, it is possible in three years for something to turn cancerous and grow. We usually hear that colorectal cancer is slow growing but one thing we do know about cancer is that ANYTHING is possible. Cancer has a mind of its own and it can and does do what it wants. Even if you have a small polyp, without doing a biopsy on it, one has no way to know it's characteristics....is it aggressive, does that polyp/growth have negative factors to it, is it an adenocarcinoma or maybe something else like a squamous cell tumor?

At this point, unless you get a copy of that original flex sig report, you will have no definitive way of knowing what the doctor saw/didn't see. At this point, however, you need to make sure that you continue to get checked on a very regular basis. Not all polyps are created the same. On another note, once you have had radiation (which it sounds like you did) you are more prone to develop polyps....not ones that will necessarily turn into cancer, so don't be shocked if you find that even every 2-3 years (assuming that's your schedule for scopes) the doc finds a polyp or two.


Hi

Also, I mentioned incorrectly diverticulitis. It was DIVERTICULOSIS. so no inflammation?

Az1971
Posts: 7
Joined: Fri Jul 13, 2018 1:50 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Az1971 » Sun Jul 15, 2018 10:08 am

muskokamike wrote:
Az1971 wrote: He highlighted signs of diverticulitis but did not require treatment. He also mentioned a small cluster of [I'm sure he said polyps] about a cm or so in size but there was nothing to be concerned about but it would be advised to check again in 10>15 years.


Hope that dr has a great malpractice insurance. He dropped the ball big time with you.


Hi

Do you think so too? Am I wrong to think something was missed, overlooked or misdiagnosed?

The 10>15 year advice would not be for diverticulosis as that doesn’t make sense. It can turn to diverticulitis at any time and is not a serious condition.

Lee mentioned that he could not believe that a reputable surgeon would leave polyps but many did. Some only took biopsy if they looked odd??

weisssoccermom
Posts: 5883
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby weisssoccermom » Sun Jul 15, 2018 11:39 am

At least from what I have always been told:

A colonoscopy examines the ENTIRE lower intestine unless there is a blockage which prohibits it
A flex sig examines the area from the top right hand side down via the rectum
It was my mistake on the endoscopy....as usually, an endoscopy refers to an UPPER GI endoscopy.

You are correct that it could have included a scope rectally. My mistake was assuming it was ONLY an upper endoscopy which, no, would not have detected rectal cancer.

I would still find it very difficult to believe that any reputable doctor would have left anything that resembled a polyp in a patient. The whole idea of screening is to be PREVENTATIVE and it's long been stated that removing polyps is a preventative measure to avoid the possibility of cancer. It just doesn't make sense that IF a unscrupulous doctor did, on purpose, leave a polyp in....WHY would he inform the patient of that???
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

Lee
Posts: 5740
Joined: Sun Apr 16, 2006 4:09 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Lee » Sun Jul 15, 2018 4:00 pm

Az1971 wrote:Lee mentioned that he could not believe that a reputable surgeon would leave polyps but many did. Some only took biopsy if they looked odd??


I know of no reason why any good doctor would leave any polyp behind. You don't wait until the polyp turns cancerous to remove it.

If you can get copies of all your pathology reports and maybe get a 2nd opinion.

Good luck, so sorry this is happening to you,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

Lee
Posts: 5740
Joined: Sun Apr 16, 2006 4:09 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby Lee » Sun Jul 15, 2018 5:00 pm

This just popped into my head. Check and see if there are any medical compliant against that doctor who did the scope back in 2011.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

KimT
Posts: 614
Joined: Sat Feb 20, 2010 8:53 pm

Re: Is it possible for a rectal polyp to grow to 10cm aggressive T4 advanced tumour in 3 years?

Postby KimT » Sun Jul 15, 2018 5:12 pm

I am a nurse and from my understanding of diverticulosis, it is possible you misunderstand what the doctor was saying after your scope where you thought he said there was a cluster of polyps. Diverticulosis is the presence of small pouches or pockets in the intestinal wall. They are not harmful but they can become inflamed resulting the condition known as diverticulitis. The pockets do typically form in clusters which is not typical of polyps outside of the genetic condition where people get hundreds of polyps. It doesn’t make sense for a doctor to leave behind polyps and tell you to come back for a scope in 10-15 years. But it does make sense if what he was saying is you have a cluster of pockets or pouches and they are not anything to be concerned about.
2/10 dx colon cancer
right hemicolectomy 3/19/10
Stage 2a 0/43 nodes
Lynch syndrome
3/14/10 colon resection/ removal of metal clips
Nov 11 dx ovarian cancer


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 64 guests