27 - sessile serrated polyp

[Jac835]

Hi guys,
well I have been following the stories in these forums for a while now (much better than playing Dr Google...) and I thought maybe someone would know a bit more about Sessile Serrated Polyps so I decided to make an account. I am a 27 year old female without any other health concerns, I'm quite thin, I have never smoked, I hardly drink, I exercise, eat quite well and have regular 'normal' bowel movements. Wow that's something I didn't think I'd ever be talking about...

Anyway, my father died from Colon Cancer when he was only 45. Again, he was thin, never smoked, didn't drink excessively and was otherwise completely healthy but was diagnosed and dead within 9 months. As a result, although I didn't really have any symptoms, my GP recommended that I have a colonoscopy even though I am a lot younger than the recommended age to start screening. I finally had one a couple of weeks ago and it was just nowhere near as bad as I thought it would be. But when I woke up, the Dr came and told me they had found 6 polyps. He said they looked benign and he was fairly confident he'd removed them all anyway but he was sending them to be biopsied. I got the results the other day. Flat and sessile polyps were removed from the caecum, the hepatic flexure, the sigmoid colon and the rectum (so basically everywhere it seems). 5 were hyperplastic which he was happy about but there was one 5mm polyp in my Caecum that was found to be a Sessile Serrated Polyp. There was no dysplasia or evidence of malignancy but he's quite worried, especially considering my age and has told me I will need to have annual colonoscopies from now on.

I can't help it, I'm petrified and I just keep remembering everything that happened with Dad back when I was 15. From googling this type of polyp (which I know I shouldn't have) I've found lots of sources that seem to say my risk of developing cancer even with frequent colonoscopies is 80-100% (especially considering my family history). In addition, it also appears this type of polyp is caused by a genetic issue - the DNA repair gene being disfunctional and as a result, I would be vulnerable to all sorts of cancers.

I am really hoping that someone on these forums has had some experience with these types of polyps. I don't know what to do with myself at the moment, I don't know how to just go back to living carefree and not feeling like I only have a few years left to live and that I'm just waiting for whatever cancer I get first to be diagnosed. Probably also doesn't help that I had a friend diagnosed with breast cancer (also 27) earlier this year who just passed away 2 weekends ago.

[Ehut]

I don't know anything about that type of polyp, but I just wanted to reassure you that even IF you do develop cancer, the frequent surveillance should allow it to be caught early and most likely treated successfully. I hope you never have to go through it, but I just want you to know that getting colon cancer isn't always a death sentence, especially when detected and treated early.

[UAJessie]

I had to reply to your post as I can relate to it so closely. I am a 33 year old female, healthy, and had a colonoscopy back in October after a stomach virus lingered just a little too long. My results were internal hemmes and a single sessile serrated polyp (3mm) in my ascending colon. No history in my family of polyps or colon cancer (my father died of lung cancer at the age of 56, but had been a pack-a-day smoker for nearly 40 years), so I was (and still am) floored and freaked out. My doc didn't seem too alarmed and told me to come back in 3 years for another colonoscopy. The more I read about these polyps, the more concerned I am that 3 years is too long to wait (although it DOES seem to be what is recommended by the AMA).

I too have spent way too much time Dr. Googling this type of polyp and it seems as though there is little really known about them. In fact, it was just a few years ago that they were identified as a pre-cancerous pathway. Until then, they were typically written off as completely harmless and left in the body. But, there is a real sense of alarm around them and I too am freaked out about my future health. I have a 4 year old and a 2 year old and I cry regularly looking at them just hoping I will be around to watch them grow up.

Like you, I have a childhood friend that has been battling Stage 4 colon cancer for the past 18 months and it hits all too close to home. I am sure that feeds my fears about this polyp exponentially.

Like the original poster, I welcome any and all insight on this topic....

[Bob Bones]

I've had one of these polyps and they have a nasty habbit of growing back onced removed, so much so I've endured 6 colonoscopies to have it taken out. At one point it grew from nothing to 5cm in just 6 months with high grade dysplasia. These polyps aren't to be taken lightly and are indicative of lynch syndrome.

Have you had any genetic testing?

[UAJessie]

Thanks for the reply BobBones....that is quite terrifying. 5cm in 6 months...yikes! No, I have not had genetic testing for Lynch. I did mention it to my GI doc and I guess with just one small polyp he didn't feel it was warrented at this time. Did you have multiple polyps along the way?? Were all Sessile Serrated or did you have other types as well? Are you the first in your family to have Lynch?

[Bob Bones]

I tend to have a mixture of polyps and they always find some new ones at my annual colonoscopy which are dealt with then. This is the only one that has been so troublesome.

I'd google the Amsterdam criteria to see if you fit the profile. If they suspect lynch then it's very important to investigate this so you can receive the correct screening for the years to come.

I'm not the first, my aunt had womb, bowel and skin cancer and my sister also had womb cancer.

[LabLover]

Actually I though sessile serrated polyps were rare in those with lynch syndrome? It was more indicative of another inherited syndrome?

[UAJessie]

Hmmm....do you happen to know what those other syndromes may be??

[LabLover]

http://www.ncbi.nlm.nih.gov/m/pubmed/17929199/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896690/

[Bob Bones]

It depends which site you Google to what information you get.

Myself, sister and aunty all had sessile polyps so obviously it's note rare at all

[twister100]

Hi all

I am a 36 yr old woman found to have several sessile serrated polyps incidentally after a colonoscopy to investigate something else. I had three procedures to remove them and have to go back in a year. I have no family history and my mum and dad have had colonoscopies since and are fine.

From what I can tell this is a very new area for doctors - as you say only a few years ago they were ignored and now they're considered precancerous. It makes me scared to think if they hadn't been found. But then another part of me wonders if they would have just sat there causing no problems....the doctor told me they're very rare in young people but then admitted that might be because young people don't usually have colonoscopies!

Its horrible always having it there in the background but at least the situation is being monitored I guess....

[UAJessie]

I agree Twister, I have the same thoughts - I HATE that this is the type of polyp that I had at 33, and the research out there on them is a little daunting. But the other side of me (my glass half full side) feels like you do that just a few years ago, they were left in and completely ignored. And now, we are monitored more closely than someone of average risk. I only had one, quite small at 3mm, that was removed on colonoscopy, and was told to come back in 3 years. I continue to obsess about it daily. Sigh....I guess this is how science evolves though...and I suppose we should be glad it does.

[Melrose48]

My dad also had colon cancer (early fifties when diagnosed) and lived until he was 80 when cancer returned to his stomach. I too was diagnosed last July (I'm 48) with colon cancer. I had 3 sessile polyps (one in transverse, one in descending, and one in Signoid) They say that once a polyp reaches 22mm (around 2 CM) that chances are 10% could be cancer then it goes higher and higher after that. Well my little sessile ones around 5-6 mm were fine but the 22mm/2CM about the size of a grape in width I suppose had 90% cancer cells in it (moderately differentiated). They said there was a clear margin underneath and the Dr. gave me the option of consulting with a surgeon who the surgeon wanted to resect my colon - take around 12-18 inches out and "check" the lymph nodes etc.

I opted for yearly scopes instead since they are typically slow growing cancers (yet) I've seen from research that it appears when it's poorly differentiated or siglet cell (pathology of tumor shows all this) that the prognosis is worse. Also I agree with what one poster said his Dr. made the comment re rarely seen in younger patients (colon cancers etc) then added but screening doesn't happen before 50. I really do not like what appears false info out there when it states that only x number percentage of under 50 have it...yet if you don't screen until 50 how do they know the percentage under 50 with it? The main reason so many have advanced cancers by the time they go in at 50. Anyway - being that I'm adopted I can't get records to my dads medical history so I only get third hand information from my biological sisters and memory of course can be a liar. I did get a CT scan that they said came out clear but my preference (my oncologist doesn't recommend though) is a PET scan since from what I've read often can detect things at a smaller level than a CT scan.

My pathology report and subsequent tumor type testing showed MSI low (1 of 5 markers positive) when checking for lynch syndrome so not highly indicative I was told but could be an "unknown" component of a hereditary link since both my father and myself was young CC patients. Keep your head up high and don't stress too much over it, just keep watch over the years since most cc take years to develop and grow unless very aggressive types. Debbie

[Jac835]

Interesting to read all of the comments, I apologise for not saying anything sooner but I had to just walk away from everything to do with bowel cancer for a while because it was seriously incapacitating me, just with reliving the memories of what happened with my father.

I am due for another colonoscopy in Nov/Dec and I think I will be opting to get one as soon as possible after hearing the stories of sessile serrated polyps growing by up to 5cm in 6 months... If they find more polyps, I'll ask about lynch syndrome. I almost don't want to know though.

I set myself the rule of not researching anything cancer related on google at night time just to try and stop myself from worrying so much. I know everyone says don't worry, they'll hopefully catch it early but I just really don't want to go down this path at all. Prevention I'm all for, but I feel as though if I have cancer in my 20's, the rest of my life isn't looking great. When I don't think about it I forget eventually and just live how I normally do, planning for the future and enjoying myself.

I am still very interested in hearing what happens to everyone else with these kinds of polyps though, here's hoping they learn more about them and quickly.

[UAJessie]

I need to set a rule for myself to walk away too. I have no family history and just the one small Sessile Serrated Polyp, but I continue to obsess as well. I am not due for another colonoscopy until October 2016, but I will be curious to hear how it goes for others on more frequent scopes. And perhaps push for one a bit sooner myself.

Cheers!