DEAR DR. ROACH: My husband, who is 73 and otherwise in good health, had a colonoscopy in the summer of 2012 and was told that because no polyps or any problems were found, he did not need another test for 10 years. This October, he was diagnosed with stage 4 colon cancer, which has spread to the abdomen and omentum. He also had seven polyps removed during his latest examination.
My question is, How likely is it that such a virulent cancer could grow in such a short time? I would be resigned to the diagnosis if I didn’t feel that something was missed in the initial exam. Also, I had a colonoscopy done by the same doctor this summer and also was told that I need not come back for 10 years. Should I be concerned? — H.B.
ANSWER: I am very sorry to hear about your husband. What happened is very unusual. All guidelines agree that in a person with a normal colonoscopy, a repeat in 10 years is recommended. A repeat in five years would have been recommended if a low-risk polyp had been found, earlier with high-risk or multiple polyps. I haven’t personally seen a case like your husband’s, where an advanced cancer presents less than 10 years after a normal colonoscopy. This should happen in fewer than 1 in 1,000 people.
There are several reasons why it can happen. The most important is that even a properly done colonoscopy misses polyps. Very small polyps (less than 5 mm) can be missed 26 percent of the time, but large polyps (greater than 10 mm) are missed only 2 percent of the time. Although the colonoscopy is the best screening test we have for colon cancer, it isn’t perfect. It’s also possible that he just had a very fast-growing cancer.
While I understand your concern about getting yourself an earlier repeat colonoscopy, your risk is very small, and if you trust the doctor who did the colonoscopy, you should get your repeat in 10 years.
READERS: Some 140,000 people are diagnosed with colon cancer in the U.S each year. The booklet on colon cancer provides useful information on its causes, symptoms and treatments. To order a copy, write: Dr. Roach — No. 505W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: My mother, 88 years old, recently switched her medicine for hypertension from timed release, which she has been taking for 10 years, to one that is not timed release, because the timed release was too expensive. I’m worried. Has she compromised her health by doing this? Her cardiologist gave her the go-ahead. — J.R.
ANSWER: In my opinion, timed-release versions for high blood pressure are preferable to non-timed release because the level of the medication in the blood can go up and down to a greater degree with the regular-release formulation. However, it does depend on the medication, and her cardiologist knows more than I do about her particular situation.
Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. ©2017 North America Synd.