The great majority of colon polyps we remove during colonoscopies are benign (harmless). However, because almost every colon and rectal cancer begins as a seemingly benign polyp, we generally remove any polyps we discover. Once removed, we send them to a laboratory and look at them under a microscope for further testing. This testing will determine if they are harmless, precancerous, or cancerous.
Removing a Suspicious Polyp
There is no way for us to know for sure how dangerous a polyp might be without first removing it. This is why we completely remove every polyp and send it for testing.
Most polyps are removed during the course of a colonoscopy and require no further treatment if benign. We do this using a special tool that we feed through the scope. The tool has a wire loop on the end. This loop will snare and remove most polyps.
When polyps are too large to remove during a colonoscopy
When polyps are too large for the wire loop tool, we may need to remove them using an advanced resection technique. These techniques may also be utilized when polyps are too flat to snare with the wire. They include:
- Endoscopic Mucosal Resection
- Endoscopic Submucosal Dissection
Your doctor will explain which will work best for your situation, depending on the location and depth of the polyp.
Understanding Your Biopsy Results
It may take a week or so for your doctor to receive the results from your biopsy. When we receive the results from the laboratory, we call the patient to schedule an appointment to review them. During this appointment, we can explain what was found and put a plan in place for your future.
In most cases, the results of these biopsies are negative. The tissue is normal, with no precancerous or cancerous cells. We may want to schedule your next colonoscopy to check for polyps sooner than we previously planned, though. If you have one polyp, you are at an increased risk for others.
If your doctor finds precancerous polyps, there is no need for any additional treatment as long as they remove the entire polyp. Removing the tissue stops the development of cancer. Since you are still at an increased risk, we will likely recommend repeating colorectal cancer screening every three to five years in the future.
Positive results mean they found cancerous cells in the laboratory, and you probably had adenomatous polyps, the most common type of polyps to turn into cancer. We will discuss your situation fully, helping you understand your diagnosis and recommending the best course of treatment based on the information we got from your colonoscopy and clinical findings.
What happens if they find cancerous polyps during a colonoscopy
If your doctor finds cancerous colon polyps during your colonoscopy, they will try to remove them completely.
However, it’s important to remember that you can’t identify cancerous polyps during a colonoscopy. The definitive diagnosis of cancer can be made only via a biopsy when a surgeon removes the polyp and sends it to the lab for microscopic analysis.
Nonetheless, surgeons aim to remove any polyps they find during a colonoscopy because you’re never sure which ones might be cancerous.
What if a polyp is cancerous?
If a polyp is cancerous, your doctor will call you to the office to discuss your diagnosis. They will also discuss your prognosis — which means how good or bad your condition can get — as well as the most appropriate treatment options for you.
It might also be a good idea to discuss your diagnosis with a friend or family, as you may need support as you undergo treatment.
Does a cancerous polyp mean colon cancer?
Yes, a cancerous polyp means colon cancer. That’s because, by definition, cancer refers to the uncontrolled growth of cells. When someone develops colon cancer, the cells lining the wall of the colon start to divide uncontrollably, leading to the formation of an outgrowth that we call a polyp.
However, it’s important to keep in mind that just because you have a cancerous polyp doesn’t mean you will die of cancer. In many cases, the polyp is too small and has not spread throughout the body. Once removed via colonoscopy, these small cancerous polyps may not even need additional treatment except a follow-up colonoscopy.
What is the next step if a colon polyp is cancerous?
The next step if a colon polyp is cancerous is cancer staging. This is when people undergo imaging tests — such as a CT scan — to determine whether the cancer cells have spread to other body parts, like the liver.
Your healthcare provider might also ask the lab to grade the polyp, which measures how abnormal the cells are. The more abnormal the cells are, the higher the grade and the worse the cancer is likely to behave.
Once your doctor has staging and grading information about your polyp, they might order additional tests — such as a complete blood count, renal function tests, and liver function tests -— to create a suitable treatment plan for you.
Understanding your treatment options
The treatment you need to treat your colon cancer depends on several factors. In many cases, routine colon screenings such as colonoscopies allow us to identify cancerous colorectal polyps early enough that only the polypectomy and/or local excision is necessary. This means if we removed the entire polyp during your colonoscopy, you might not need additional treatment.
Surgery to remove additional tissue in the area may be necessary if the cancer has grown beyond the colon wall. This is known as a partial colectomy. During this surgery, the surgeon will likely use minimally invasive surgical techniques to remove the area of the colon with the entire polyp and a section of the normal colon around it. This allows for “clean margins,” ensuring all the remaining cancer cells are removed. They will also take out some of your nearby lymph nodes to see if your cancer has spread.
If there are signs of metastasizing to other areas of the body or your cancer is at an advanced stage, your doctor may also recommend radiation therapy, chemotherapy, or other therapy.
The best thing you can do after a colon cancer diagnosis is to listen to the recommendations of your doctors. Your doctor will be able to offer the best treatment plan possible based on your condition. Often, thanks to regular colonoscopies, we are able to catch early-stage colorectal cancers early enough that they have not yet spread to other areas of the body.