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Is It Possible Diagnose Cancer During Colonoscopy For Polyp Removal?

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Posted on Mon, 17 Aug 2015
Question: good morning. This is my story and I want you to tell me what is going on. I had a colonoscopy on May 10th 2010 it was good no polyps that was my first time. After 5 years decided to get another one. May 15 went and got the second one I was told I had a large polyp the doctor said he removed it and he mentioned he did not want to put a hole in my colon he also said it was benign he then told me to call the other doctor which is his partner in business I had an appointment for May 29. I then went to the office and the doctor told me I had some abnormal cells I asked him if I had to get treatment he then draw out the shape of a polyp and said this is how the polyp looks like a mushroom. Anyway he then said lets do another one on July the 7th then he said meanwhile I want you to go home and heal. Ok understandable. Coming to July 7th the office called me and said I had another colonoscopy with the same dr. and I said I thought the other doctor who did it the first time was going to do it, no the same doctor who did it was going to do it again. I called back that doctor office who did it the first time and his secretary said I am not schedule for one then I said why do I have to go in then. The doctor called me back and said you have a large polyp and we want to see if all is out and how you are doing ok. He also mentioned if I want to reschedule the appt. I said no I will go ahead with it. Got to the clinic that morning and after 6 weeks had the other colonoscopy when I was finished with the procedure the doctor pulled me to the back and said we found some cancer cells and you will have to have surgery, which is to take out the part where the polyp is then reattached the polyp was and he said you are young and healthy 51 you are not taking any medication for anything and I will not have to use a pouch and then he said you will be fine I feel that something went wrong not that I am in denial but it does not sound right to me if there was cancer cells why not call me before the 6 weeks and let me know you told me on the day I had the procedure. Help
doctor
Answered by Dr. Saddiq Ulabidin (59 minutes later)
Brief Answer:
suspected cancer of intestine

Detailed Answer:
Hi!
I am deeply saddened to know the kind if miseries you had been facing during the process. You seems like a real brave person to have coped with everything with courage. As it was quite shocking the way it has been put up to you. I know a lot must have been spinning through your head, which needs to be answered, as now is the time to think what needs to be done next rather then denying it as you seem like a real practical person.

Let me reassure you, that there are a lot which is still not convincing and we need to discuss all your issues in detail, and I will try to make it easy for you to bring you on the same page.

First of all, normally presence of long standing diarrhea, or bleeding in stool or black colored stools are common presenting features in such cases along with significant weight loss and low hemoglobin which is incidentally found on routine screening. You need to clear your head and think about presence of any of these. Here a very non-invasive or pain free test is detection of occult blood In stool and I would recommend you to have it.

Secondly, if polyp was found or colonoscopy, was biopsy sample taken at that time? Biopsy means taking a piece of that polyp and have it examined under microscope to know any presence of cancer cells.

Also that, if polyp was removed with colonoscopy then it can further be tested with detailed histopathology.

Also that, there are certain blood tests like looking for CAE a tumor marker, in blood for cancer of intestine.

It is only after all these evidences and having CT abdomen with contrast, to decide for surgery but for that many cross opinions should be taken.

Keep me updated about all these. And stay relax as a lot needs to be answered before coming to that conclusion.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Saddiq Ulabidin (1 hour later)
the point is what has me confused is that I take a blood test every 3 months with my gp and he never told me I had cancer cells. He always tell me I am doing good and continue to do what I am doing, never had blood in my stool or loose bowel movements. I had a ct abdomen scan in February 19th of this year and all they found was a small polyp in my gallbladder which I told the said doctor when I call the doctor office on Monday the secretary told me I was not schedule for a colonoscopy but she will talk to the doctor, what puzzles me is that he told me he wanted me to have the other colonoscopy to see if there was more polyp and to see how I was healing. when I spoke to the secretary she told me that on my chart she saw the polyp was removed on the 15th of May I am not in denial as I had uterine cancer before but I feel something is wrong here because the doctor said I can reschedule my colonoscopy and I said no. He never sent me for a scan or anything all the doctor said is that you are healthy and don't take any medication so what we will do is go in cut out that part and reattach it so I don't have to wear a pouch and then he said you''ll be fine I wonder if something went wrong when he gave me the first colonoscopy and to bring me back for another one to see how I am doing his remarks the first time is I don't want to bore a hole in your colon and he told me he removed the polyp and its benign so why all this now when I told some of my nurses friend they all say its fishy maybe he did something and to cover it up he has to say something so I can have the surgery because if I know the truth it can be a big law suit and which doctor wants to be sued.
I forgot to mention no weight loss before the colonoscopy the doctor did take a test of my stool in his office and send me off I am someone who ALWAYS check my poop when I go to the bathroom to see if blood is in it and I myself lost weight because I am on a diet and eat a lot of salad so I did not loose weight or anything like that I am still physically working out and I use a sweat suit to let me sweat while working out I have no long history of loose bowling movement or anything like that that's why I feel something happened during the first colonoscopy and he wanted me back to see how I was doing that's my only solution I have my regular visits with my gp every 3 months he takes blood test and if something was wrong he would have called me right away the only thing he told me the last time is that I have some white cells in my urine I work out hard work a lot of overtime and still go school my only feeling is feeling sleepy at times as I don't get enough sleep after the colonoscopy the doctor pulled me in the back and told me there was some cancer cells when he had already removed the polyp the first time and then wait 6 weeks when I get the other colonoscopy to tell me this when I was diagnosed the first time I was called into the office in a weeks time. Help I am not In denial but if your gut tells you something then go with it
doctor
Answered by Dr. Saddiq Ulabidin (37 minutes later)
Brief Answer:
further clarification

Detailed Answer:
Hi! I am doing fine and thanks for asking. It was also helpful mentioning all the details and context in which you have been asking about your illness.

Actually, it would have been even more helpful if you had scanned the reports or details of visits or your clinical summary on history section.

What I got through your end of story, it seems that they might have removed polyp on 2nd colonoscopy and sent it for histopathology, or it might have been sohmoidoscopy only and not detailed colonoscopy and they ight have waited for that to heal and afterwards meanwhile had sent the polyp for histopathology to look for cancer cells and once on your followup visit, report must have arrived after six weeks and they might have decided to do detailed colonoscopy and also might have looked for other possibilities.

The surgery, they are planning must be after concrete evidence. As I still don't know about results of those tests, I would be in better shape to explain you those if I get those reports.

I also suggest you to get a second opinion with another gastroentrologist and surgeon for reassurance and to know what they are upto.

Also when you go for the visit with your previous doctors, you ask the doctor to council you upto your satisfaction and clarify all the doubts as you are not convinced. This is your right to ask until you are satisfied with the procedure. Ask them for the reports so that you can discuss with a gastroentrologist in detail and a surgeon.

Looking forward to your progress. Keep me apprised. Take care.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Saddiq Ulabidin (35 minutes later)
I was told to do the 2nd colonoscopy 2 weeks after I did the one on May 15 the doctor just said lets do another one on the 2nd when he told me I had abnormal cells I got scared and asked him do I have to take chemo or something and he draw out to me the polyp and then he said lets take another one on the 7th july meanwhile go home and heal some more that was all
doctor
Answered by Dr. Saddiq Ulabidin (2 minutes later)
Brief Answer:
polyp details

Detailed Answer:
Hi! Then you must ask for pathologist opinion and report of the polyp if it was removed, and underwent microscopic/histopathology review about the polyp.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Saddiq Ulabidin (2 days later)
I went to another doctor for a second opinion as you suggested when I told the doctor about what happened he was surprised he said why did the doctor waited until you 2nd colonoscopy to tell you there was cancer cells he said something doesn't sound right, so he suggested that I go back get all the medical records and bring it to him along with ct abdominal scan I did in February. So Monday I will go there and get everything and take it back to hat clinic. I am going to a Chinese doctor now. Let me tell you, when you have insurance in this country the doctors tries to milk you for everything, We just had on the news a doctor who diagnose people with cancer when they didn't have any and made millions from it because of billing the insurance. Some doctors XXXXXXX for Medicaid and since Obama brought in Obamas medical law they cannot do as they used to do, so now if you have insurance they can do as they please. When asked why I had to go back for the 2nd colonoscopy I was told only to see if there was any polyp remained when the secretary told me on my chart the polyp was removed and the one done on may 15th doctor said large polyp removed its benign and he did not want to bore a hole in my colon which makes me believed he made a blunder somewhere and wants to correct by surgery. Sometimes some people think you don't have knowledge but this is the first time I have had a polyp never had any before and at the end of the other colonoscopy you called me in the back to tell me I have cancer cells. Why didn't your office called me and told me this before to come in and see you because of the findings and why wait until the 2nd colonoscopy was done to tell me this, meanwhile your partner said it was just a routine test to see if there was more polyp something is wrong somewhere. Sorry to bother you with all these questions. but thanks for your help anyway. Let me know when you see it fit to visit XXXXXXX it will be my treat. sorry you weren't practicing here either because I could have been your patient but as you say you want to practice in Pakistan but it will be a pleasure for you to just come for a visit
doctor
Answered by Dr. Saddiq Ulabidin (35 hours later)
Brief Answer:
second opinion

Detailed Answer:
Hi!

First of all sorry for catching up a little late. I was away for weekend. Hope you can understand that.

Having said that, it would be an honor regarding your offer. And I'll hope that sometime in future may happen to visit US. In that case it would be lovely to have some friends there.

Regarding your case is concerned. It was very considerate of you to get a second opinion. I hope you got my point, as it is a huge diagnosis to get treated for. So it is allways best to get a second opinion in such cases.

As I mentioned earlier that there are alot of ambiguities, in the things you had shared. It is good to get all those reports, reviewed by another doctor.

It would be equally good if you can share those reports with me too. You can scan those documents and share. In that way I will be able to comment about it even further. Meanwhile keep me updated about the followup visit. Thanks again for your warm replys.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Saddiq Ulabidin (3 hours later)
just came back home, worked last night did not get any sleep because I went to Manhattan to see another doctor. We order to get my charts from medical records, and I had to take the paper back to the doctor's office so in order for them to fax over all my records They told me that they will only have May 15 results as the results for July 7th is not out yet. So I gave the doctor the paper both of my abdominal scan they talked about the polyp in my gallbladder which I have to go back for a scan in a year's time.no abnormality in the pancreas, liver is normal in size16.0 cm with the gallbladder sonographic murphy's sign is negative the spleen is normal and measuring 11.0 cm both kidneys there us no evidence of mass, calculus or hydronephrosis with respect to either kidney I went to the doctor's office and I said how do you detect cancer cells when I just got the 2nd colonoscopy what about the 1st one that I did in May didn't the pathologist report came back a week or 2 then no one from either office called me to say there was cancer there only when I do the other colonoscopy then cancer cells. That's a red flag something is wrong somewhere and the girls who worked for him was whispering to him telling him I was there for the reports and since he was doing surgery he couldn't get to the reports but she was saying that I should keep the appt. with the other doctor or talk to both of them they are partners over 30 years you think they will side with a black woman when they are both white
doctor
Answered by Dr. Saddiq Ulabidin (1 hour later)
Brief Answer:
reporting details

Detailed Answer:
Hi! The best thing in those reports you shared are that, on utrasound nothing alarming had come up, however CT abdomen , and reports of both colonoscopies will give alot of information.

Also that, try getting the copy of pathologist reports. That would be suggestive of what we are dealing with. Try to get the scanned copies of the reports, and in that way you will not need to type whole reports, as that may be little inconvenient for you. Wishing you luck with the diagnosis on second opinions. I hope everything comes out fine. Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Saddiq Ulabidin (4 hours later)
thanks going to see the doctor tomorrow.
doctor
Answered by Dr. Saddiq Ulabidin (2 hours later)
Brief Answer:
closing remarks

Detailed Answer:
Anxiously looking for to it. Chao.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Saddiq Ulabidin (43 hours later)
Hi Doc,

So I went to the doctor yesterday (I had an appointment when I got there I asked the secretary for the copies of my medical. She asked me if I wanted to see the doctor and I said yes I will still see him. I was sweating bullets because I didn't know what he was going to tell me. When I got into his office and sat down he told me to talk I begin to speak telling him that when I took the colonoscopy on the 15th May doctor tracer told me the polyp was large but benign and he did not want to bore in my colon, I lied and told him I had it taped on my other phone. It told him that the 2nd colonoscopy was shouldn't have been down since I was told the polyp was removed. He said let him talk he then told me the test it came back benign every thing came back benign and the only reason he told me to have the 2nd colonoscopy was because the polyp was large and it couldn't be moved I have to get a surgeon to do it. I know he is lying he wants to cover his friend of over 30 years. I know they either made a tear in my colon and wants to fix it. He still insists that I go for the surgery which I said I will go he told me he will get surgeon to do it for me, but I don't trust this doctor now so I would rather someone else do it After all the stress they put me through I even thought of killing myself one day and as doctors to lie to me, no I am not going to XXXXXXX them but Know in my heart its all about the money but not at the expense of someone's life but a weight has been lifted off my shoulders and he said after the surgery I can see him in another 5 years. Yes if I am alive I will go get checked out but will not go back to him
doctor
Answered by Dr. Saddiq Ulabidin (18 hours later)
Brief Answer:
surgery plan

Detailed Answer:
Hi! Thanks for sharing the details. Havibg said that, Many many congratulations on having a clean chit from cancer. I told you already, it was a very premature diagnosis and alot has to proven yet.

It was so considerate of you to get second opinion and virtue of which you got some reassurances and rethinking from your primary doctors.

I would still prescribe you, if they are planning for a major surgery, get opinion of another surgeon too if possible. As solitary polyp if benign, can be left out for monitoring. But if surgical options are advised by two surgeons, then proceed with the plan.

And last but not the least, it's nice to share the details regarding contact and for a warm welcoming offer. May be sometime in future, it's possible for me to visit and it would be my pleasure. My social media details are ob this id: YYYY@YYYY
Regards, and stay in touch regarding your health issues via HCM.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Saddiq Ulabidin (2 days later)
Good morning Dr. Ulabidin,

As I write you this letter there are tears in my eyes because I don't know what to think about these doctors here. I remember telling you I went to Dr. Bigajer's office on Tuesday which he proceed to tell me every thing was normal, the polyp was benign and all I have to do is go and get it removed and come back and see him in 5 years. I got a call from my medical doctor on Thursday saying it is important to come into his office. I didn't know what it was about but he said he got a letter from Dr. Tracer saying that you for referring Ms. XXXXXXX to me, (my doctor NEVER referred me ) then he proceed to tell my doctor that he did a colonoscopy on me found I had a flat polyp and cut pieces out and send it to the lab and it came back a high dysplasia intromusca adenocarcinoma, which there are cancer cells, (one doctor says one thing the other says something else different) then he told my doctor that he couldn't remove the polyp by colonoscopy and it has to be done by surgery, meanwhile he dated the letter XXXXXXX 2nd Dr. Ulabidin, I have NEVER heard from their office telling me to come in for any kind of test, they took a stool test it came back negative, they took some thing for my abdomen it came back benign now my medical doctor has now referred me to a doctor for surgery and sending me to an oncologist to see if I have to get chemo I really don't know what to think. If it's for money or did the doctor injured my colon and wants me to go fast and get the surgery to cover up they are both saying a large polyp has to be removed so what about the doctor telling me part of my colon has to be removed the doctor says the polyp has the cancer cells, how come he never told me any of this when I had to test done In May I remember him saying he removed a large polyp and didn't want to make a hole in my colon Tomorrow I go and see another doctor and explain everything to him, it makes me not want to trust doctors now.





doctor
Answered by Dr. Saddiq Ulabidin (31 hours later)
Brief Answer:
surgical plans or chemo?

Detailed Answer:
Dear Ms. XXXXX! Hey why are you weaping and losing hope. I wasn't expecting this from a brave person like you. Look we had been discussing all these issue for quote sometime now, and I have found you to be a very practical person who is allways interested to know how to proceed next rather than mourning over the past.

Look there are alot which can be done and needs to be done.

Please evaluate few details as per your previous record.

There had been a polyp, on one colonoscopy and according to that doctor he removed it. The histopathology is showing few cells and they want you to remove it surgically.

Now you are taking second opinions and planning whether to have surgery or not.

That is a sensible thing to do.

Next appropriate thing would be to get your medical record rechecked by another skilled gastroentrologist and discuss all the issues in detail. Discuss and share your reports. Another possibiltiy would be to have another colonoscopy before proceeding surgery from another gastroentrologist elsewhere to get an independent opinion not influenced by your previous doctors. That would significantly explain about disease status and any surgical intervention needed, whether emergent or not?

For all of that to happen, You need to stay relax. That way you ll be able to figure out all the things which can be done at best depending upon all the best possible resources around you. Please keep me posted. I ll be waiting for all the fresh updates.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Saddiq Ulabidin (2 hours later)
I decided to just go and do the surgery, tomorrow I will go to Downstate Hospital and meet with a doctor to make arrangements for surgery, better just get it out and done at least if something went wrong during the colonoscopy the doctor who doing the surgery will know and he will be able to tell me. I am glad the cancer cells is just in the polyp and not surrounding area so moving part of your colon is not bad and the doctor says 95% of people don't take chemo. I had a 2nd opinion today and the doctor just look at the reports I got from my medical doctor and just say I understand what your doctor was saying he said he marked the spot where the polyp is so when the doctor goes in he will see where the polyp is located. another thing because I had uterine cancer 3 years ago they say I am high risk for colon cancer. Lord just 3 years ago I had surgery now I have to go back again, I hope after this I don't go back again after this. Thanks for all your help
doctor
Answered by Dr. Saddiq Ulabidin (6 hours later)
Brief Answer:
good luck for surgery

Detailed Answer:
Hi! The details put in this answer reflects the real you. The more determined, and ready to be dealing with the problem. I am glad that you have taken this decision courageously. So let's proceed with the surgery, as less doubts are left now regarding what to be done next. It will also help to get some samples from sorrounding colon for biopsy and histopathology, and will also eliminate the problem earlier.

The doctor who gave his final opinion appears to be quite helpful. He has been to the point and have not created as much confusions as you had to face earlier. The person who has had done colonoscopy would have been on a better position to make spot on decisions rather leaving things grey, which apprently happened.

I am sincerely hoping for you to recover soon after surgery and may this decision proves to be helpful for you in longer run. I hope when I listen to you next time, you are improving after a suucccefful surgery and things getting better as planned. Regards.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Saddiq Ulabidin (29 hours later)
Hi, My surgery is going to be on July 31st at Downstate Medical center. I took a stress test yesterday and it was good and I also did a physical. Today I am going to do a ct scan of my abdomen, then I go to the hospital on Friday to take pre opt test. I hope all goes well and I don't have to use a pouch. How many hours does this kind of surgery last and how many weeks to recover
doctor
Answered by Dr. Saddiq Ulabidin (26 hours later)
Brief Answer:
surgery plans

Detailed Answer:
Hi! Glad to know that everything is going well on schedule.

Well it depends upon the kind of surgery. If it is open surgery it may last for few hours and recovery period is a bit longer but likelihood is of laproscopic surgery in which three small holes in skin are made, for light, laproscopic and surgical apparatus after sufficient analgesia and anestgesia, and it may last little longer than the open one, but recovery period is very quick and in matter of days you can be back in life, with few precautions like lifting heavy weights etc. Otherwise you ll be good to go.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Saddiq Ulabidin (8 hours later)
tomorrow I am going to take a pt scan for my abdomen and the doctor is from XXXXXXX (a lot of XXXXXXX doctors here set up clinics) and he told me to come back after the surgery. Anyway I changed medical doctors I now have an XXXXXXX doctor as my primary care physician; why? the other doctor never told me anything about what is going on in my body all he did is refer me to a surgeon said to me I am going to send you to an oncologist and you may have to have chemo etc. The XXXXXXX doctor and the surgeon said no chemo what the doctor said they will remove part of my colon and reattach it so I can go to the bathroom as normal if for some reason anything goes wrong I will have to wear a bag temporary. The surgery is on the 31st so the doctor who did the surgery for uterine cancer refer me to a Japanese doctor who will do the surgery (my other doctor is Chinese) he also said because I had surgery and had a big cut he may have to give me an incision instead of laproscopic so he told me he will see what he can do to clean it up
doctor
Answered by Dr. Saddiq Ulabidin (3 days later)
Brief Answer:
recent progress

Detailed Answer:
Hi! Hopefully by now you have been through CT scan and must be undergoing rest of work up before surgery. This was good decision on your behalf to take multiple opinions. I am surprised and saddened as you deserved to be counselled and told well before when all of it was happening rather using vague terms like we don't want to put hole in your colon etc.

Anyways I am anxiously waiting to hear for your well being, and hopefully you will be on recovery path sooner or later.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Dr. Saddiq Ulabidin

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Is It Possible Diagnose Cancer During Colonoscopy For Polyp Removal?

Brief Answer: suspected cancer of intestine Detailed Answer: Hi! I am deeply saddened to know the kind if miseries you had been facing during the process. You seems like a real brave person to have coped with everything with courage. As it was quite shocking the way it has been put up to you. I know a lot must have been spinning through your head, which needs to be answered, as now is the time to think what needs to be done next rather then denying it as you seem like a real practical person. Let me reassure you, that there are a lot which is still not convincing and we need to discuss all your issues in detail, and I will try to make it easy for you to bring you on the same page. First of all, normally presence of long standing diarrhea, or bleeding in stool or black colored stools are common presenting features in such cases along with significant weight loss and low hemoglobin which is incidentally found on routine screening. You need to clear your head and think about presence of any of these. Here a very non-invasive or pain free test is detection of occult blood In stool and I would recommend you to have it. Secondly, if polyp was found or colonoscopy, was biopsy sample taken at that time? Biopsy means taking a piece of that polyp and have it examined under microscope to know any presence of cancer cells. Also that, if polyp was removed with colonoscopy then it can further be tested with detailed histopathology. Also that, there are certain blood tests like looking for CAE a tumor marker, in blood for cancer of intestine. It is only after all these evidences and having CT abdomen with contrast, to decide for surgery but for that many cross opinions should be taken. Keep me updated about all these. And stay relax as a lot needs to be answered before coming to that conclusion.