DEAR DR. DONOHUE: At my urging because of a strong family history of colon cancer, my 30-year-old son had a colonoscopy. He had four tubular adenomas – a surprise to us and the doctor. The doctor suggests a repeat colonoscopy. Please explain the different types of polyps. Don’t all polyps become cancerous if not removed? – E.T.
ANSWER: A polyp is a growth that springs from the outermost lining of hollow organs. Polyps arise in the nose and sinuses, but I am going to speak only of colon polyps.
There are two major types of colon polyps. One is a hyperplastic polyp, and it is almost never a cancer threat. The other is an adenoma. More than 90 percent of adenomas do not become cancerous, but the remaining 10 percent can turn into cancer. By looking at a polyp, the doctor cannot tell if it is a dangerous one; it must be examined microscopically. Up to 40 percent of people older than 60 have at least one colon polyp.
Adenoma polyps larger than 1 cm (two-fifths of an inch) raise the suspicion of cancer and the more numerous are the polyps, the greater the cancer threat.
Adenoma polyps are further subdivided according to their appearance. Ones that look like drinking straws with a round cap on one end are tubular adenomas, the most common kind, and the least likely to become cancer. Villous adenomas resemble a tiny cauliflower and are most likely to turn into cancer. Tubovillous adenomas are a cross between these two and have an intermediate cancer threat.
If no adenoma polyps are found, then the next colonoscopy can wait for 10 years. One or two low-risk polyps should call for a repeat colonoscopy in five to 10 years. If three to 10 polyps are found, then colonoscopy should take place again in three years. More than 10 polyps require an examination sooner.
Large polyps, polyps with microscopic evidence of precancer changes and people with a family history of colon cancer have to be judged individually for the next scope examination.
Readers can obtain the booklet covering colon cancer, its detection and treatment by writing: Dr. Donohue – No. 505W, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have a touch of arthritis in my hands. It makes unscrewing jars very hard for me. Can you suggest an exercise that will build up my hand strength? – A.K.
ANSWER: You need a firm rubber ball, not one that’s rockhard but one that you can push in. Hold the ball with one hand and squeeze it hard. Hold the squeeze for four seconds. Relax and take a short rest. Then repeat nine more squeezes, with a rest between each squeeze. Switch hands and repeat the exercise.
As you get stronger, do two or three sets of 10 squeezes with each hand. If a rubber ball becomes too easy for you, use a tennis ball. Tennis balls are hard to compress.
If these exercises hurt your hands, don’t do them.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475.
©2008 North America Synd.