Tuesday, August 3, 2010
They say that things happen in clusters. I may not be superstitious or have much faith in coincidence, but I have been amazed by the number of cases I’ve seen lately involving colon polyps and colon cancer. Unlike disc herniations or brain injuries, this is not a topic we see every day, but I have certainly seen a rise in the popularity of this topic among the attorneys who call me seeking advice for medical demonstrative evidence.
As with the litigation of almost all cancer cases, colon cancer cases primarily involve issues of failure to diagnose or failure to adequately treat. More often than not, the issues revolve around the treatment, or lack there of, of colon polyps. Therefore, I offer this brief overview.
The colon, or large intestine, is the final portion of the digestive system leading ultimately to the rectum and anus. The colon is divided into segments called the cecum, ascending colon, transverse colon, descending colon and sigmoid colon. It is like a large flexible tube and normally the inner wall of the colon is smooth. For unknown reasons, some people, later in life, develop small growths on the inner wall of the colon. These growths are called polyps.
Colon polyps are not cancer, but some polyps can become cancer over time, In fact, some references state that almost all colon cancers originally begin as polyps. For this reason, it is essential for the healthcare provider to recognize, biopsy or remove polyps before colon cancer can develop.
Diagnosis of polyps can sometimes be accomplished with a barium enema, but most often the physician will perform a colonoscopy or sigmoidoscopy. A colonoscopy involves the insertion of a flexible scope through the anus that is advanced all the way around through all aspects of the colon. A sigmoidoscopy, while not as invasive as a colonoscopy, only allows the distal portions of the colon to be viewed.
With the colonoscope, a doctor is also able to completely remove or biopsy a polyp, taking a small portion for identification under a microscope. Identification is important because there are different types of polyps. Adenomatous polyps or adenoma are the most common type of polyp, but there are various types of adenomas each with a different risk of becoming cancer. Villous adenomas, while only accounting for about 15% of all polyps, carry the highest risk of becoming cancer and when diagnosed should always be removed.
In short, if a person is over 50, has a family history of polyps or colon cancer, or has other risk factors for colon cancer, they should be examined regularly to check for the presence of polyps in the colon. If polyps are found, they should be removed or followed closely by the physician to avoid the possible development of colon cancer.