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High grade dysplasia w 35cm polyp ?

I found out today that I may need a portion of my colon removed. Why? Im not sure.
I dont know what any of the following means. Can you help me? I know you are not doctors but would love any advice.

1. I am 30, and had a 35cm polyp removed. Is this large? I was told that typically they are between 3 and 5cm What does this mean>?

2. My biopsy was sent to Harvard Med School.. which scares me... Why??

3. The conclusion was I have High Grade Dysplasia. What does that mean> How many grades are there before cancer?

4. I also have Collagenous Colitis. What is this? What does it do and what would cause it??

5. Why would he want to remove part of my colon?

6. Could this have spread to other areas??

7. where can I find more resourses? Forums.. ?

Thank you in advance for your help..
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replied January 31st, 2010
Based upon the information that you have provided, you have a premalignant polyp of the colon which, I assume, could not be completely removed by colonoscopy. Therefore, you will need to have the segment of colon containing this polyp removed.

I suspect that the "35 cm" refers to how high the polyp is located above the anal opening, rather than the actual size of the polyp.

Collagenous colitis is a chronic inflammatory condition of the colon, and is often associated with watery diarrhea. Surgery is rarely required for this condition.

Sincerely/ Robert A. Wascher, MD, FACS

A landmark, evidence-based guide to a healthy cancer-prevention lifestyle, based on cutting-edge cancer research.
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replied February 6th, 2010
Dear enchanted,

35 cm is approximately 13 inches, unusually large. Could the size be 3.5cm = 35 mm? If it's truly 13 inches, that would explain sending it to Harvard. But pathologists sometimes like to get a second opinion, which would also explain it.

If I were you, I'd get a second opinion before having a colectomy. A study conducted at the University of Texas Houston, Health Science Center, Colon and Rectal Surgery, found that "Repeat colonoscopy by an experienced surgeon leads to complete removal and avoidance of major colectomy in 58 percent of these cases. Patients with large difficult polyps referred for resection should be considered for repeat colonoscopy before surgery." Dis Colon Rectum. 2008 Mar;51(3):292-5. Epub 2008 Jan 18.

While colonoscopies are not a lot of fun, they sure beat colectomy--unless you're trying to get a lot of time off work and want your spouse to wait on you for a few months.

I also had a hard-to-remove polyp with high grade dysplasia. It took two tries, but the physicians at Mayo Clinic were able to remove it completely, using advanced techniques like endoscopic mucosal resection. These are techniques that not every endoscopist would be comfortable using.

You should be able to get a referral from your gastroenterologist or primary care physician.

Good luck,
C Swain
patient, Ph.D.
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