question about my health

[momofkandj]

Hello all, this is my first post, so bear with me. I am also a RN, but my experience is in maternal and dialysis. This is more of an info-seeker thing since I know you all are likely to have some answers for me. Here's the quick rundown. Had gb surgery in 10/03, developed pancreatitis afterwards. Refused ERCP d/t personal family ongoings at the time and was fine until April of this year. Started having intense epigastric pain, n/v, diarhhea, rectal bleeding, etc. Had endo done in early May showing ulcers, started nexium 40 mg bid, symptoms worsened. Have passed out from the pain, literally. Hgb has dropped 2.5 points, am microcytic. Had colonoscopy today and he only found 2 small polyps in the rectum which were removed. MD is sending me to another GI doc at UNC-CH. here's the thing though, he is being rather evasive with my questions and the doc he is sending me to specializes in GI oncology and Hepatology. Well, my liver is fine....

I am only 28yo. My father has crohn's. My pat. grandmother and aunt both had colon cancer. does it seem plausible that if all my lab work has been somewhat normal that i May have cancer? Really the doc is not answering my questions and the appt is over a month away with the other MD.

One last thing, my doctor also feels that I may have a Grade 3 Pancreatitis, d/t to biliary crystals. My MRCP was negative and he doesn't perform ERCPs. ANy thoughts?

[caroladybelle, BSN, RN]

Lab work (blood labs) rarely show any major changes unless cancer is advanced. Therefore, normal blood labs are not indicative of being cancer free.

What will be more indicative is what the colon polyps show, as well the other biopsies that were done during the colonoscopy. Whenever a colonoscopy is done and polyps are found/or disease is suspected, there are other areas that biopsied, other than the polyps - looking for microscopic changes.

The other issue is that when someone young develops polyps, even if they are benign, it tends to be an indicator that more will occur later on, possibly not benign. Many MDs will automatically increase surveillance and/or check for certain genetic markers that indicate familial predisposition to colon cancer.

The fact that several relatives on your patrilineal line have had colon cancer, or IBD (UC has a greater increase in colon ca than Crohn's, though) is also a large factor. I suspect that a GI onco will (even if biopsies are normal) want to check the genetic markers and advise on a surveillance plan.

Also, know that some studies of colon cancer note a connection with higher rates of breast cancer.

Also, those with greater inflammatory issues affecting the GI system are more prone to developing cancers.

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The big thing right now is to not "write the script". I had a recent breast cancer scare, and had visions of dying on an MSO4 drip, with friends trying to talk me down. It is hard and scary to look at these things. But my issue resulted in, for now, the need for increased surveillance.

As the biopsies have been done and presumably reviewed, I would think that if there was a immediate issue with a positive biopsy, you would be seeing an oncologist much quicker than in a month.

If it helps, I was found to have over 20 polyps in my colon at the age of 21. I had treatment, developed UC later on. Despite this, I have been polyp free, since, though require increased surveillance.

One day, I will probably need a colectomy....but they have the J-pouch procedure now, so I may not require and ostomy. But I will worry about that when I have to.

I doubt if this makes you feel better, but maybe it will help you understand your MD's concern and some of the tests/questions that you will deal with.

Good Luck and my prayers are with you.

Carolina

[sirI, MSN, APRN, NP]

You must be very anxious and have so many unanswered questions. But, your questions/concerns are way beyond what the members of allnurses.com can help you with. Please, call your PCP again and pose these questions/concerns just as you have outlined them here. He/she is the only one who can help you at this time.

We all care and hope that everything turns out okay and that you will be on the road to recovery very soon.