Went to 1st ever colonoscopy 3 wks ago due simply to age (50) without family history or other predispositions. Was held back by "doctor wants to speak to you" at the end of procedure and was shocked to find a despondence doctor stating "A large mass was found. Could be cancerous. Surface biopsies done. Need to follow up wit CT and Surgeon". Colonoscopy note included "Likely Malignant...Malignant appearing tumor" (turned out it referenced only ONE polypoid that was "about 10cm". CT scan confirmed "suspicious carcinoma at least 6cm".
Biopsy states "high grade dysplasia...MAY represent underlying invasive carcinoma". Unable to speak to Out of Office doctor other than was told "Colon Cancer. Need to follow up with surgeon" by "on-duty Dr" in the office. When asked "if High Grade Dysplasia equals colon cancer should I also schedule Oncologist?" Was then told "Don't know yet"
Sources of confusion:
Cutting to the chase, the first source of confusion here is the despondence of the doctor. Not all doctors have their shit strapped down
and you totally need one who is emotionally competent and able to remain coherent and doesn't fall down the rabbit hole. Some just fail
when it comes to being the bearer of bad news and a drama becomes manufactured that is not helpful.
For over 10 years I worked in histopathology laboratories as admin support, typing up these colonic biopsy reports until my eyes crossed.
(never thinking I'd be on the business end of one either). Worked in small regional labs so on slow days the histopathology lab scientist
and pathologist would teach me stuff; so thems my creds and why I've swung by your thread.
High-grade dysplasia is a histological finding in a pathology report. The surface biopsies didn't go deep enough into the mass. These biopsies
are actually quite small, no bigger than a match-head. There is a specific sampling protocol that is followed. It is not unusual for samples to
be too small, for the sample to disintegrate in the Tissue-Tek machine. Every GI has their own technique and some 'snip' too small.
The samples that were biopsied aren't conclusive enough for the wording "malignant carcinoma-in-situ". High-grade dysplasia is on the border. It's
not just semantics : the pathologist is going by the book and from what was seen under the microscope
. Likely that your tissue samples were
studied by other pathologists if the service is in a hospital where there are several histo-pathologists on staff.
Still confused with the wording being used - "colon cancer", "malignant neoplasm", while a complete histology and pathology of the actual tumor is yet to occur.
When the complete histopathology has been signed off on (get a copy of that and start up a file), and the FACTS are to hand, everything will become
much much clearer. For your sake, I hope it is 'just a polyp' and some are more nastier than others. In any case, the mass and part of your sigmoid
is going to be sitting in a tub of formalin and stored in a dark room for the next few years. Whatever it turns out to be; it will no longer be in your
When is your surgery scheduled?
The partial colectomy (laparocopic sigmoid resection) is the biggest, and only, surgery I've ever had (never even been in a hospital).
What are the expected side effects and precautionary tales of the operation?
Never been in hospital before, eh? The food is often much better than the mythology would have you believe, however you'll be on a special
diet following major abdominal surgery and there'll be a fascination with your bowel movements just like when you where a small child and
What you want the histopathology report to say, following that resection, is "clear margins" and nothing in the lymph nodes. Once the surgeon has
the pathology report in hand then everyone will be on the same page and there'll be less confusion. YOUR job will be to take care of yourself and
befriend your new body and get familiar with how everything works with that piece missing. It's a whole new ballgame.
Let us know where you are in the world so that anyone who is local can offer you specific information with medical resources.