Colonoscopy coming up....gastroenterologist or surgeon?

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Lotus
Posts: 48
Joined: Thu Mar 29, 2018 10:03 pm

Colonoscopy coming up....gastroenterologist or surgeon?

Postby Lotus » Wed Mar 13, 2019 12:02 pm

Hi everyone,
This time last year I was diagnosed with stage 1 rectal-colon cancer....recommendation was for follow up colonoscopy one year later. Robotic LAR performed last April....oncologist suggested that my colon surgeon perform upcoming colonoscopy instead of my gastroenterologist. He said that it would be best to allow colon surgeon to do it since he performed my surgery and could observe how everything looked inside. My friend, who works in the medical field, suggested that it’s generally best to have a colonoscopy performed by gastroenterologist since that is what they do ALL day and therefore are obviously more well trained in the procedure .....that they are more experienced both using the equipment and also more well trained in noticing polyps.
Does anyone out there have an opinion on this issue? I am prepared to go with the recommendation of my oncologist but want to check here first.
Thanks in advance for your thoughts.
female age 72
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8
10/24/18CEA 0.9
4/19/19 CEA 0.8
4/23/19 colonoscopy normal
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

Ehut
Posts: 218
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby Ehut » Wed Mar 13, 2019 2:07 pm

I have had my surgeon perform my last 2 colonoscopies. I figure he's familiar with my new anatomy, and he does a lot of colonoscopies, so I feel confident he knows what he's doing. It probably doesn't matter much though.
Dx 12/11 rectal stage IV w/ 6 mets to liver, age 35
4 cycles FOLFOX 12/11 to 2/12
short course radiation 2/12
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
NED for 7+ years and counting!

zephyr
Posts: 263
Joined: Thu Aug 18, 2016 7:31 am

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby zephyr » Wed Mar 13, 2019 3:03 pm

For the first look after surgery, I would go with the surgeon. For all other colonoscopies, definitely the gastroenterologist. That's what I did.
Nov-2009 Early stage CRC found during routine colonoscopy
2010, 2011, 2014 Follow up colonoscopies, all clear
Jun-2016 CRC found during routine follow up colonoscopy, surgery, Stage 4, KRAS, MSS, inoperable lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany) on both lungs, 11 nodules (9 mets) removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr/Jul-2019 Xeloda/Avastin, SBRT
Sept-2019 Stable! Continue Xeloda/Avastin

User avatar
ANDRETEXAS
Posts: 625
Joined: Fri Feb 14, 2014 11:01 am
Location: Austin, Texas (University of Tennessee alumnus)

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby ANDRETEXAS » Wed Mar 13, 2019 3:39 pm

Since my surgery, my colorectal surgeon has done all my colonoscopies. My gastroenterologist is the one who missed my flat cancerous tumor in the beginning. If I had waited to come back in 10 years like he told me, I probably wouldn't be here. To each his own...but that's my story. I am also happy to say that my 5-year post surgery CT scan this week came back clean. One day at a time!
2014
2/10 - Colon resect
2/13 - DX- Stage IIIb
6 of 18 lymph nodes cancerous
3/7 - Port placed
3/11 - FOLFOX (12 rds w/full oxi)
8/14 - Chemo finish
8/25 - CT- Inc
9/5 - clean PET
12/10- clean CT
2015
3/2 - Clean colonoscopy & port removed
3/4- clean CT
9/21- clean CT
2016
3/23- clean CT
2017
2/22- clean CT
2018
3/21 - clean CT
4/11 - clean colonoscopy
2019
3/11 - clean CT
9/23 - Five-year release - Annual visits now !
Next colonoscopy - 2023

ONE DAY AT A TIME !

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby KathyLynn » Wed Mar 13, 2019 4:47 pm

Just had mine done by my surgeon

He was very happy with his work!!

:D

KathyLynn
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED

jep
Posts: 196
Joined: Sun Jun 11, 2017 7:45 pm

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby jep » Wed Mar 13, 2019 7:44 pm

My husband's surgeon did his first post surgery scope, and will do his 2nd post surgery scope in April...we really trust him and he is extremely thorough in all of his work, but definitely do what you feel most comfortable with. Good luck and hoping all is well!
jep
Wife of DH (47) Stage IV CC on 5/16/17
T Loc: recto-sigmoid
T type: Adenocarcinoma
T size: 7.4 cm
T grade: G3
TNM code: T3N2M1
Pos LNs: 8 out of 20
Baseline CEA value: .9
LVI: present
Perineural invasion: present
LAR margins: clear (w/in microns)
Folfox (8/17-1/18)
Scope 6/18 - CLEAR! - 2 polyps removed
PET 10/17/18: 3 pos LNs
Irinotecan + Vectobix (started in 11/18)
CEA: 1.7 (2/19)
Xeloda + radiation (5/19)
Surgery scheduled: 8/21/19 (aborted)
Phase 1 Trial (October 2019 - ?)
Bypass surgery 12/6/2019

sch
Posts: 2
Joined: Thu Mar 14, 2019 7:21 am

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby sch » Thu Mar 14, 2019 7:43 am

In the past, I've always had my colonoscopy (I have a generic condition that requires an annual colonoscopy) performed at my local endoscopy centre. When you book in, they send you out a standard sheet instructions and timings on when to take laxatives. They did a good job. They found and identified my tumour, provided me a reference to an excellent specialist surgeon who operated quickly and I am cancer free for now.

After the total colectomy, I think I'll be having my annual colonoscopy at a specialist cancer centre.
My reasoning is that after the colonsocopy, the bowel preperation times will be non standard and I'll have to be taking time to explain the history and operations that I've had each time I book in for a colonscopy.
I feel that a specialist center or surgeon will be better prepared to deal with non standard situations.
But perhaps this is a misconception on my behalf.

Hope this helps.
Sean

weisssoccermom
Posts: 5959
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby weisssoccermom » Thu Mar 14, 2019 9:50 am

I'm 12+ years out from my diagnosis and still have mine done (trying to schedule now) by my surgeon. IF something should be there, I want my surgeon to be the one that found it, knows precisely where it is, what it looks like, etc. Sometimes it is a little more difficult to schedule but heck, for me, it's all worth it.

Throughout the years on this board, I've heard numerous stories about patients being told by the GI that their tumor was say 8 cm in and it really was only 3 or vice versa. Thanks but I want to know things CORRECTLY right from the start!
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

cmrl
Posts: 174
Joined: Mon Apr 21, 2014 8:39 pm

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby cmrl » Thu Mar 14, 2019 11:14 am

I had my Surgeon do the first couple of colonoscopies, but he then wanted to wait 3 years for the next. I wasn't comfortable with that so went to a new GI, who found a massive polyp in my cecum, less than 2 years after my most recent colonoscopy.
Don't know if the surgeon had missed it, but I apparently grow them fast. Bottom line, follow your gut.
Resection of splenic flexure 7/24/13
T3N2BM0, Stage 3c,12/29 nodes
Folfox x12 9/13-3/14
CT scan 4/14, enlarged spleen, otherwise clear
CT 4/15, spleen WNL.
6/17 3 cm benign polyp at ileocecal valve, awaiting removal

User avatar
LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby LPL » Thu Mar 14, 2019 1:34 pm

At the Cancer Center (Institute, in France) where my husband is treated, he has up to now had 2 coloscopies. His oncologist has prescribed these procedures and the same GI-doctor, actually he is a professor (not hubby’s surgeon) has done it. This Cancer Institute have a special unit for coloscopies and as I understand it there are only patients with cancer in this Institute.
Reading all your comments it sounds good to have your surgeon doing the procedure. Especially if the gastro dr is not working at an only cancer patient hospital - I hope that makes it special and OK that my DH’s procedure is not done by his surgeon.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

Lotus
Posts: 48
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colonoscopy coming up....gastroenterologist or surgeon?

Postby Lotus » Thu Mar 14, 2019 4:51 pm

Thanks very much to everyone who responded....very helpful to read your experiences and perspectives. I’ve decided to go with the surgeon this time around....scheduled for April 8.
female age 72
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8
10/24/18CEA 0.9
4/19/19 CEA 0.8
4/23/19 colonoscopy normal
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy


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