Familial adenomatous polyposis

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What percent of colon cancers are due to familial adenomatous polyposis?

Approximately 1% of all colon cancers are due to familial adenomatous polyposis.

References
  • Schneider, K. (2013). . 3rd Ed.
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What is the average age that someone with familial adenomatous polyposis is diagnosed with colon cancer?

Do colon polyps in familial adenomatous polyposis always become cancerous?

When will I need to consider removing my colon if I have familial adenomatous polyposis?

What are the options for removing my colon if I have familial adenomatous polyposis?

What happens during a colectomy for patients with familial adenomatous polyposis?

If I am a patient with familial adenomatous polyposis, will I need to have a temporary or permanent stoma (ileostomy or colostomy) after the surgery?

I am a patient with familial adenomatous polyposis and need a colectomy; what is life like after a colectomy?

I am a patient with familial adenomatous polyposis, what does the upper endoscopy screening consist of?

If I have familial adenomatous polyposis, what are my options for having children?

What is the average that someone with attenuated familial adenomatous polyposis is diagnosed with colon cancer?

What is the prep work for a colonoscopy for people with familial adenomatous polyposis?

If I have familial adenomatous polyposis how long does a colonoscopy take?

What is the average age that someone with familial adenomatous polyposis is diagnosed with colon cancer?

The average age that someone with familial adenomatous polyposis is usually diagnosed with colon cancer is 39 years old.

References
  • Schneider, K. (2013). . 3rd Ed.
  • Jasperson, K. W. (2017, February 2). APC-Associated Polyposis Conditions. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK1345/.
Do colon polyps in familial adenomatous polyposis always become cancerous?

Colon polyps can become cancerous during the teenage years with familial adenomatous polyposis, however, usually they do not become cancerous until the 20-30's. Fortunately, early detection of polyps through colonoscopy can help prevent colon cancer from ever developing.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
When will I need to consider removing my colon if I have familial adenomatous polyposis?

If you have too many polyps found during a colonoscopy and they all cannot be removed during the colonoscopy, this may be when removal of the colon would be recommended. This decision will be made with your gastroenterologist and a surgical team.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
What are the options for removing my colon if I have familial adenomatous polyposis?

A colectomy is the removal of part of the colon or the entire colon. The portion of the colon removed depends on the nature and number of polyps detected. The removal of the colon can be performed in two ways: open surgery or laparoscopic surgery. For the open surgery, there would be a long incision down the center of the abdomen where the colon would be removed. For the laparoscopic surgery, the surgeon uses several very small incisions and specialized instruments to remove the colon. In general, the laparoscopic surgery has a shorter recovery period in the hospital than the open surgery. The type of surgery recommended may depend on which hospital you are at and the doctors that you are working with.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
What happens during a colectomy for patients with familial adenomatous polyposis?

During a laparoscopic colectomy, the surgeon enters the abdomen by placing a narrow-like instrument into the abdomen through a small incision. Carbon dioxide is pumped into the abdomen through the narrow-like tube to create more space within the abdomen. A tiny telescope connected to a video camera (laparoscope) is inserted to view the colon. The parts of the colon that need to be removed are then freed from the attachments to other organs and the abdominal wall. The blood vessels that provide blood to the colon are sealed to help prevent bleeding. The colon is removed through the small incisions made in the abdomen. The two remaining ends of the colon, or the rectum and the small intestine, are then reconnected.

The surgery for the open surgery is essentially the same, but the surgeon works with more traditional handheld instrument through a larger, single incision.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
If I am a patient with familial adenomatous polyposis, will I need to have a temporary or permanent stoma (ileostomy or colostomy) after the surgery?

An ileostomy or colostomy is when a portion of the small intestine or colon is brought out to the skin through a surgical opening of the abdominal wall (stoma). Instead of eliminating with a bowel movement, waste will be passed through into a specially fitted low-profile appliance, known as a pouching system or a bag. Whether or not a patient will require a stoma depends on the nature of their disease. Temporary and even permanent ileostomies are sometimes required after certain operations. If there is rectal cancer that involves or is close to the anal sphincter mechanism, a permanent colostomy could be required. Patients who may require a stoma work closely with a team of nurses to learn how to manage their stoma. Patients with stomas are able to live healthy, active lives and enjoy all of the activities they used to do before they had a stoma.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
I am a patient with familial adenomatous polyposis and need a colectomy; what is life like after a colectomy?

Usually, for the first 6 weeks after surgery it is recommended to have a low residue diet, which is low in fiber to try to reduce the frequency of stool. The long term effects depend on the amount of the colon removed. If part of the colon is removed, patients may notice little change in their bowel function. If the entire colon is removed, the patient may notice a change in the frequency of their bowels. After you have healed, your doctor will follow your progress and determine when your digestive system is ready to resume normal eating. Even in a situation when the entire colon needs to be removed, you will be able to return to your normal activities with a good quality of life despite the absence of the entire colon.

References
  • UChicago Medicine. (n.d.). Colectomy. Retrieved from http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent.
I am a patient with familial adenomatous polyposis, what does the upper endoscopy screening consist of?

A gastroenterologist will use an endoscope (a small tubing that has a tiny camera attached to the end) to go down through the esophagus into the stomach and the first part of the small intestine. This is used to look for any polyps located in the small intestine, stomach, and esophagus.

References
  • MayoClinic. (2018, September 29). Upper endoscopy. Retrieved from http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/prc-20020363.
If I have familial adenomatous polyposis, what are my options for having children?

There are options for family planning in the context of familial adenomatous polyposis. One option is to adopt or use a sperm or egg donor. Another option is to have biological children, and know that there is a 50% risk that each child could inherit this mutation. If the gene mutation causing familial adenomatous polyposis in your family is known,a final option is having preimplantation genetic diagnosis (PGD), which involves in vitro fertilization. Through the process of PGD, embryos can be checked to see if they contain the gene mutation or not, and only embryos that do not contain the mutation will be implanted in the mother.

References
  • Jasperson, KW & Burt RW. APC-Associated Polyposis Conditions. (1998) [Updated 2014]. In: Pagon RA, Adam MP., et al., editors. GeneReviews. [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2015.
What is the average that someone with attenuated familial adenomatous polyposis is diagnosed with colon cancer?

The average age that someone with attenuated familial adenomatous polyposis is usually diagnosed with colon cancer is 50-55 years old.

References
  • Schneider, K. (2013). 3rd Ed.
  • Jasperson, K. W. (2017, February 2). APC-Associated Polyposis Conditions. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK1345/.
What is the prep work for a colonoscopy for people with familial adenomatous polyposis?

You should discuss your specific prep recommendations with your doctor who will give you more specific and detailed instructions. The goal of the prep is to get your colon as clean as possible before the examination. In general, the prep consists of: drinking clear liquids only 24 hours before the exam, not eating solid foods, and drinking a large amount of a special cleansing solution and/or special oral laxatives recommended by your doctor.

References
  • Espat, A., & Cordeiro, B. (n.d.). Ensure success with colonoscopy prep. Retrieved from https://www.mdanderson.org/publications/focused-on-health/colonoscopy-preparation.h12-1589046.html.
If I have familial adenomatous polyposis how long does a colonoscopy take?

The colonoscopy procedures depends on your case and your doctor. Your doctor can give you a better idea in your exact situation. The average procedure takes approximately 30 minutes, and you will be in the recovery room afterwards for another 30 minutes.

References
  • University of Chicago. http://www.uchospitals.edu/specialties/colorectal/services/colectomy.html#primaryContent

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