No more scopes!

quote:

I don't have any of the cells left that can get cancer.

I have not heard of cancer-proof intestinal cells. Can you have some tissue samples preserved so I can get some?

Pretty amazing. Especially since I have read reports of colonic mucosa growing back even after mucosectomy! Maybe you don't need them every year, but I would think some sort of occasional looky loo would be appropriate, particularly since it has been so long since your first diagnosis, and since your surgery.

Granted, chronic pouchitis, PSC, prior dysplasia, or other factors would absolutely increase your risk, but still...

P.S. I found this fairly recent article from the Cleveland Clinic about surveillance endoscopy for IBD patients with IPPA. It may well be that in the future, follow up is not necessary, but for now, they are still recommending it:
http://www.eventscribe.com/201...sinfo.asp?title=7579

Jan

I read this article that Jan posted with interest as my surgeon indicated almost everyone has some type of inflammation in their pouch if they are scoped even though they often present with no symptoms. Also, he recently told me that muscosa does NOT grow back after a mucosectomy when I asked this question and I have found that statement to be untrue based upon my own research (I believe reported by Cleveland Clinic that there have been reports of mucosa cells growing back after a mucosectomy). I am not sure if that is your case or if you had other treatment for rectal/colon cancer.

Honestly, I would be a bit skeptical of any surgeon who told me that I NEVER need follow up after having jpouch surgery.

Jeane, I imagine what your surgeon is saying is that mucosa does not grow back if mucosectomy is done right!! And of course, a perfect surgeon NEVER leaves a stray cell behind. Of course, we all know that cells are microscopic, so even in a perfect world with a perfect surgeon, a stray cell can be left...

And yes, it is true that every pouch shows some level of inflammation, so that is normal. That is why I tell people not to get too worried about their biopsies showing inflammation. It is a matter of degree after all, and symptoms. Some people have terrible symptoms with hardly any inflammation, others have no symptoms with terrible inflammation. So, you have to take both the clinical and objective information together. I am sure that the 50% abnormal findings in the article link I posted do not include the "normal" expected mild inflammation, but that which is considered some form of pouchitis.

These things are only coming to light after decades of follow up.

Jan

P.S. After a bit of looking, I found the Cleveland Clinic article that described the mucosa regrowing:
"Patients with hand-sewn IPAA with mucosectomy are not immune to dysplasia, since islands of the rectal columnar mucosa can regrow or may have been preserved due to incomplete mucosectomy."

Here is the article
http://www.google.com/url?sa=t...uFHn-URneFElS5V3MvFA

Thanks for the article Jan. I have been devouring any information I can get my hands on regarding pouch advancement surgery and mucosectomy and getting rid of the nasty remaining diseased mucosa.

I was skeptical too about this. That's why I posted. I was especially hoping to hear Jan's opinion. Thanks Jan.

I think I'll get a younger colon-rectal surgeon at Lahey. I'm not super confident about the docs at Dartmouth.

Theresa

I had annual scopes for ten years post takedown. Then my surgeon said I don't need another scope for three years. I think every doctor has his own preference for surveillance schedules.

Hi Theresa,

My opinion? Get another opinion! As was already said, there is no such thing as cancer proof cells, I can't believe a medical profession could be so nieve. I had two pea sized tumours found on the outside of my colon after it ruptured way back in 1990, and even though I was cancer free, and had only some chemo (no radiation necessary) as they were convinced it was totally contained within the tumours (they took many biopsies), I still get myself checked every year. Although my rectum, colon and 4 feet of small bowel are gone, I know cancer can come back any time in any part of my body. I don't mean to scare you, but generally, those of us who've had it once, are more prone to getting it again. I beg you, revisit the decision not to get tested yearly. I know it's not fun, but it can save your life, good luck, hope you stay cancer free forever!

Cheers,
Eric