Removing a Large Flat Colon Polyp by EMR without Surgery

By Jim Sease — 7/26/2010

Introduction

Jim SeaseDr. Roy Soetikno, M.D., a gastroenterologist with special skills used endoscopic mucosal resection (EMR) to remove my large flat colon polyp endoscopically without colon surgery. It was a 5 cm (2 inch) flat sessile villous adenoma colon polyp. All my other medical doctors told me I needed right hemicolectomy colon surgery to remove this polyp. They said there was no other way. But I had it removed endoscopically by EMR. Now the polyp is gone and I still have my colon.

I feel compelled to share this information about EMR because it was difficult for me to find out about EMR and to actually get it performed on me. My doctors knew about EMR but did not tell me about it. Perhaps this information will help someone else who has a large flat colon polyp and who would like to remove it without removing part of the colon. This is not something your gastroenterologist is likely to recommend to you. It's a leading edge interventional endoscopy procedure available to those motivated to pursue it.

This document describes how I found out about endoscopic mucosal resection, what it is, where to do it, and my experience of getting my polyp removed by this method. I am not a medical expert. I am just someone who researched the subject and had the procedure performed on me.

They Found a Giant Colon Polyp

Large flat villous adenoma colon polyp I had a colonoscopy in July 2007 and they found a very large 5 cm flat sessile villous adenoma colon polyp in my cecum (at the start of the colon near the junction with the small intestine). They could not remove it during the colonoscopy because it was so large and was flat like a carpet against the colon wall and draped over a haustral fold. A colon polyp this large and complicated is called a giant polyp or a difficult polyp. Fortunately the biopsy samples were benign tubulovillous adenoma.

In the photo, the polyp is the light colored bumpy looking expanse in the bottom half of the photo. It’s about 2 inches in diameter and a quarter inch thick.

A polyp of this type and size has about 100% chance of turning into colon cancer. I have a direct family history of colon cancer so I was considered at extra high risk.

I consulted with five gastroenterologists and two surgeons about this polyp and they all told me there is no way to heal it and there is no way to remove it except by a right hemicolectomy. They told me in no uncertain terms that this polyp must come out to avoid a premature death.

They said I must get a laparoscopic right hemicolectomy to remove it. That means they would remove the right side of my colon. Actually they would remove about one third (18 inches) of my colon along with the ileocecal valve between the small and large intestine and all the associated blood vessels and lymph nodes. They staple the ends of the small intestine and remaining colon together. It’s major surgery.

If you want to see a detailed video of a laparoscopic right hemicolectomy colon surgery from St. Mary's Medical Center in Duluth, MN, see the following Google video: Minimally Invasive Colon Surgery. It’s very graphic so you might want to think about this before you watch it.

My doctors made it sound like colon surgery is no big deal. But it really disturbed me. I know many people feel comfortable with this sort of operation and would just go ahead and get it done and over with. Or maybe they just don’t think about what they are about to do to the body and simply trust that the doctors know what is best for them. But I could not do that.

Seeking an Alternative to Colon Surgery

Instead of getting surgery, I embarked on a major journey to resolve it in a way that did not remove part of my colon. My doctors had me convinced that it could not be physically removed except by colon surgery so I concentrated on shrinking it or healing it naturally.

It’s a long story how I tried to heal it so I won’t go into detail here. But I changed my life style, changed my beliefs, changed my diet, moved from the high tech engineering world of Silicon Valley to a more relaxed lifestyle in Santa Cruz, and went to many alternative health practitioners. I got two more colonoscopies to monitor my progress.

The polyp healing efforts dealt with why the polyp was there in the first place, how to shrink it, and especially how to prevent colon cancer. Maybe it worked since my polyp did not increase in size and did not turn cancerous during the year and a half that I was trying to heal it. So whatever I did stabilized the polyp and also bought me time to find the right solution. It may also have prepared my body to be a better candidate for successful EMR removal of my polyp.

From the beginning I searched on the Internet for information about healing my polyp. It took me quite awhile, but eventually I discovered endoscopic mucosal resection (EMR) and the removal of large colon polyps. Three and a half months after discovering EMR, my polyp was gone without surgery and I still have my entire colon. It took considerable effort but it was worth it.

What is Endoscopic Mucosal Resection (EMR)?

EMR is a method for removing a large colon polyp (such as mine) with special endoscopic tools and techniques without abdominal incisions or removing a section of the colon. It is also called endoscopic mucosectomy. All the work is done inside the colon with endoscopic tools similar to those used in a colonoscopy along with some special attachments and tools that they pass up the colonoscope tube. A saline solution (salt water) is injected into the submucosal layer under the polyp and then the polyp is removed with wires or cutters, either as one piece or in several pieces (piecemeal). The colon wall is protected from damage since the polyp is elevated by the saline solution.

The EMR process is shown briefly in the following photos (left to right).

  1. The polyp just before EMR.
  2. The polyp being raised by injecting salt water with blue dye into the submucosal layer under the polyp.
  3. The polyp being cut with a wire snare which is coming out of the end of the colonoscope tube. The blue color is the salt water injected submucosal layer which is protecting the colon wall from damage during this procedure.
  4. After the EMR polyp removal. There is still some colored dye showing. The polyp was completely removed down to the colon muscle wall.
  5. Three months later the colon is completely healed.

EMR colon polyp removal photo sequence

It's pretty amazing they can do this. it's all happening five feet up my colon through a colonoscope tube with sophisticated remote digital imaging, remote tools, sophisticated computer technology, and highly skilled operators.

EMR Videos

This section illustrates the EMR process with videos from my EMR procedure.

Note: These videos are in QuickTime format. If you prefer the Flash video format click here.

Initial View

This is the initial view of the lesion, which measures about 5 cm (2 inches) in the longest diameter. The surface pattern of the tumor looks uniform and there is no erosion or ulceration. Endoscopically the tumor is most likely to be adenomatous (i.e. not cancer).

Injection

Saline (salt water) is injected into the tissue under the tumor to expanded it and raise the tumor from the colon wall. The salt water contains indigo carmine so the solution is tinted with a slight blue color. Thus, we know that as long as there is blue area seen, we are in the correct plane and we don't need to worry about perforation. The wall of the colon is normally only 4 mm thick but is now much thicker with the cushion of salt water. Thus, there is a lot more margin of safety. Plus, the salt water absorbs the heat from the cautery so the cauterization burn does not damage the muscle layers (see the cauterizing step below).

First Cut

This is the first cut using a snare. The first piece of the tumor is removed at its edge.

More Cuts

Numerous additional tumor cuts are performed until the tumor is gone. The blue plane is the submucosa.

Cauterizing Small Blood Vessels

Small blood vessels are cauterized to minimize the chance of bleeding after going home.

Polyp Removed

This is the resected area. The tumor is completely removed.

Post EMR 3-Month Follow-up Exam

I went back three months after the EMR procedure for a follow-up colonoscopy. This is what the resected site looks like at three months. It looks completely healed.

Endoscopic Mucosal Resection (EMR) Information on the Internet

There is a lot of information about EMR on the Internet but it takes time to find the good ones to read. I list below a few EMR documents that I found useful.

To learn more about EMR and large colon polyps, do some web searches using various combinations of search terms such as the following: removing large sessile colon polyps, large flat colon polyps, endoscopic mucosal resection, EMR large colon polyps, endoscopic mucosectomy, submucosal injection polypectomy, interventional endoscopy. Combine searches with EMR doctor’s names such as Roy Soetikno, Douglas Rex, Jerome Waye, and Brian Saunders. Use advanced searching preferences to search for just PDF files so you can find complete papers and articles rather than just abstracts of papers that cost money to read.

Finding a Place to Get EMR

So I knew about EMR. But it was quite another matter to figure out where and how to have it done and whether they could actually remove my particular polyp. I live in Santa Cruz, California, so I searched for someone who could do EMR in Northern California. EMR seems mostly associated with university medical schools and hospitals. So I searched for EMR and Stanford and found Dr. Roy Soetikno. He is connected with Stanford University. He performs EMR at California Pacific Medical Center in San Francisco. He is also the head of Gastroenterology at the VA Hospital in Palo Alto. Dr. Soetikno has been in the news quite a bit raising awareness of the cancer risk of flat polyps. Here are a few links about that:

California Pacific Medical Center was the only place I found where I could get EMR in California. But that was good enough, so I stopped searching for where to go and switched to how to get it done and whether they could or would remove my polyp. This is the medical facility where Dr. Roy Soetikno removed my polyp by EMR. Below are some links to information about EMR at California Pacific Medical Center. They refer to EMR as endoscopic mucosectomy. I usually call it EMR since that seems to be the more widely used terminology.

List of EMR Doctors

EMR is highly dependent on the skill of the doctor performing it, so it is important to find a doctor who is really good at it, especially if you have a difficult polyp to remove. Keep in mind that when you look for an EMR doctor in your area, you are looking for a gastroenterologist with advanced EMR polypectomy skills, not a surgeon. A surgeon will just recommend surgery. Also it seems that gastroenterologists with normal polypectomy skills try to discourage EMR as being too difficult, risky, or impossible. So you may have to take the road less traveled if you want to keep your colon. You must take responsibility for your own health. What you do about EMR depends on how motivated you are to save your colon from unnecessary surgery. For example you could travel to one of the doctors listed on this web page if you really want to.

I list the EMR doctors that I know about below. People occasionally send me email and tell me about another EMR doctor. So this list will gradually expand. This list is sort of in the order that I find out about the EMR doctors.

Roy Soetikno, M.D. — Palo Alto, CA
Dr. Roy Soetikno is the doctor who removed my polyp by EMR at California Pacific Medical Center. Here are some contact links for Dr. Roy Soetikno: VA Hospital/Stanford, CPMC. Dr. Soetikno works primarily at the VA Hospital in Palo Alto. Dr. Soetikno is in this CBS News Video: Flat Polyps Raise Cancer Alarm.

Tonya Kaltenbach, M.D. —Palo Alto, CA
Dr. Tonya Kaltenbach has worked at California Pacific Medical Center in San Francisco but works primarily at the VA Hospital in Palo Alto. She has worked with Dr. Roy Soetikno for several years. Dr. Kaltenbach is in this CBS News Video: Flat Polyps Raise Cancer Alarm.

Kenneth Binmoeller, M.D. — San Francisco, CA
Dr. Binmoeller is the Interventional Endoscopy Program Director at California Pacific Medical Center. I talked recently to someone who had EMR from Dr. Binmoeller at CPMC who voiced the very highest praise for Dr. Binmoeller.

Jerome Waye, M.D. — New York City
Dr. Jerome Waye performs EMR in New York City and he has an excellent reputation for EMR and advanced polypectomy. He is located at 650 Park Ave, New York, NY. Phone: (212) 439-7779. A reader of this web page went to Dr. Waye and had her difficult polyp removed when several other doctors told her it would be impossible to remove except by surgery.

Gregory G. Ginsberg, M.D. — Philadelphia, PA
A reader of this web page went to Dr. Ginsberg to remove a flat polyp in the ascending colon that a previous doctor partially removed in a failed attempt. This can make it more difficult or even impossible to remove a polyp by EMR since the polyp may not lift enough due to scar tissue from the failed attempt. His other doctors recommended colon resection surgery to remove the polyp. But Dr. Ginsberg was able to remove the entire polyp using endoscopic methods without surgery. Dr. Ginsberg is located at: 3rd floor Ravdin Building 3400 Spruce Street, Philadelphia, PA 19104, Phone 215-349-8222, Fax 215-349-5915.

Douglas K. Rex, M.D. — Indiana University Hospital
Dr. Rex looks like a good possibility for EMR. His web site shows some excellent photos of removing large colon polyps by EMR. He says you can submit your endoscopic polyp photos for consideration of the feasibility of resection by colonoscopy. I don't have personal experience with Dr. Rex, but this looks good.

Shou Jiang Tang, M.D. — Texas
Dr. Shou Jiang Tang (link2) Director, Trinity Mother Frances Endoscopy Center, Trinity Clinic - Gastroenterology, 910 E. Houston, Ste. #550, Tyler, TX 75702, phone (903) 510-8718.

Brian Saunders, M.D. — UK
If you live in or near the UK it seems that Dr. Brian Saunders is the doctor to go to for EMR. He is the author of the first paper that I read about EMR “How I Do It” Removing Large or Sessile Colonic Polyps (PDF). If he had not published his paper on the Web I might not know about EMR.

Norman Marcon, M.D. — Toronto, Canada
Dr. Marcon works at St. Michael's Hospital in Tornonto and is a specialist in therapeutic endoscopy, which includes EMR. Here is a link (look near the bottom of the page). Phone: 416-864-6060 x 5345

Christopher Shaver, M.D. — Alabama
Dr. Christopher Shaver works at Coosa Valley Medical Center, 209 W. Spring Street, Suite 302, Sylacauga, AL 35150, 256-249-4007

Michael D. Saunders, M.D. — Seattle
Michael D. Saunders, Digestive Disease Center, University of Washington Medical Center (UWMC), Seattle, WA

Douglas O. Faigel, M.D. — Portland
Dr. Douglas O. Faigel, Oregon Health Sciences University (OHSU), Portland, OR

Eric M Goldberg, M.D. — Baltimore
Dr. Eric Goldberg (link2) at the University of Maryland Medical Center in Baltimore, Maryland

Neeraj Kaushik, M.D. — Manhasset, NY
Dr. Neeraj Kaushik (link2) (link3), North Shore Hospital, Manhasset, NY

Ram Chuttani, M.D. — Boston
Dr. Ram Chuttani, Director, Interventional Gastroenterology and Endoscopy at Beth Israel Deaconess Medical Center

John R. Saltzman, M.D. — Boston
John R. Saltzman (link2) Director of Endoscopy, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115

Making Arrangements for EMR

I sent California Pacific Medical Center my colonoscopy reports and they said they could probably remove my polyp. So I had a consultation meeting with Dr. Roy Soetikno. He said he could not be completely certain from looking at my polyp photos, which were not quite detailed enough, but there was a good chance that he could remove it if there was no cancer growing into the colon wall. It seemed that he had a pretty high confidence level that he could remove it although he did leave me with room for doubt. He told me to go talk to my Kaiser gastroenterologist and get a referral for EMR.

So I went to Kaiser Permanente, my HMO health insurance, and asked my Gastroenterologist for a referral. She said she did not recommend this course of treatment, but if I wanted to do it, I could. She knew about EMR and Dr. Roy Soetikno all along. She just never told me about it. EMR is cutting edge and controversial and Kaiser does not have that capability with their normal in-house staff. I am pretty sure that if I had not been so insistent about wanting to do EMR instead of colon surgery, she would not have requested a referral for EMR. I was determined to get EMR even if I had to pay for it myself. But Kaiser did approve the outside referral for EMR at California Pacific Medical Center.

So everything was set. I had a date to do it. Kaiser would pay for it. I had a ride with my trusted friend. All was in order.

Removing the Polyp — the EMR Procedure

The big day finally arrived. I was prepped for the procedure — no solid food for a day or so, clear liquid diet, GoLYTELY bowel prep, and all the usual stuff for a colonoscopy. The bowel prep and clear liquid diet is a difficult part of EMR and colonoscopies.

We got up early and drove to San Francisco. We got there early but it did not matter since they were running really late that day anyway. Apparently Dr. Soetikno is an in-demand expert and they kept calling on him to help with other patients. Finally I went into the hospital. They took me into the procedure room and got me setup for the colonoscopy. Eventually Dr. Soetikno arrived.

There were four people in the room working on me. Dr. Roy Soetikno was the main doctor. Another doctor did much of the hands on work of actually removing the polyp. He was driving the colonoscopy equipment. There were also two registered nurses in the room.

I had an IV in my arm for sedation. They used little or no sedation in the first part when inserting the colonoscope tube. They used light sedation during the EMR. I was pretty aware most of the time and remember quite a bit. At one point Dr. Soetikno told me to stop watching because I was talking too much and causing my body to move, making it more difficult for them to work on me. I kept looking anyway but in a much less obvious way.

It was fascinating to watch the EMR procedure on the colonoscopy computer monitors. They had several high-resolution computer monitors in the room. People were moving around but I could see at least one of the monitors most of the time. Dr. Soetikno is noted for his use of high definition imaging equipment. Apple Computer has a professional profile web page describing his advanced use of Macintosh computers and software for high-definition endoscopy at the VA Hospital in Palo Alto.

I was very impressed with how much skill it took to remove the polyp. It looked like a highly skilled person was playing a high-speed action video game in my colon. I could feel the colonoscope tube moving in and out. The doctor was holding the controller on the end of the colonoscope tube. It looked like a roundish black thing with several control buttons. He was pushing and pulling the colonoscope to position it in my colon. He pressed on the control buttons to control the instruments at the end of the colonoscope tube in my colon. The instruments included things like wire loops, liquid streams, cutting, scraping, fluid injection, and such. I could not feel anything inside my colon where they were removing the polyp. Apparently the colon does not have many nerves for the conscious mind to be aware of. It was sort of like watching a movie. It did not bother me that this was actually taking place in my colon and not just on the computer screen.

At the end of the procedure they gathered all the polyp pieces into a sort of wire mesh basket and pulled them out with the colonoscope tube. It was very satisfying to see the pieces of my polyp being gathered up and taken out in the little basket. I seem to remember them saying they got it all out.

Then I don’t remember anything until I woke up in a recovery room. The light was streaming in the windows. It was nice. I was feeling pretty good. I started becoming more aware of where I was. I thought about my friend a couple of blocks away on Fillmore Street shopping and eating at fine restaurants. I found my iPhone and called her. She arrived at the recovery room. It was really good to see her.

I got my EMR report from the Doctor. The EMR was a success. They got it all out. He gave me a prescription for three days of antibiotics. He said to have a clear liquid diet for two days and then soft food for a couple of days. Watch for bleeding for up to three weeks. Don’t take aspirin or anything that can increase bleeding risk. Come back in three months for a follow-up colonoscopy.

After the EMR Procedure

We left the hospital and drove home for a couple of hours to Santa Cruz.

I was very happy the polyp was gone, but I felt uncomfortable after the EMR procedure. My abdomen was gassy and tender and upset. Shoving all that endoscopic equipment in and out of my colon and removing a two-inch piece of flesh out of my colon was traumatic to my body even if I didn't consciously feel much.

My friend took me home and made sure I was comfortable. She is a professional colon hydrotherapist so she did some gentle abdominal massage and visceral manipulation and managed to release some trapped gas. It helped a lot. They pump gas into the colon during the EMR to inflate the colon.

I was really feeling the adverse effects of eating a liquid diet for a couple days and going most of the day of the procedure with no food or even anything to drink. So on top of the procedure itself, the lack of proper food and water was really affecting me.

For the next few days after the procedure I felt disoriented, uncomfortable, tired, and emotionally delicate. My system was upset due to all the strange diet and trauma from the procedure. I was worried that I might get internal bleeding. There was no way to tell since I was not going to the bathroom yet since I was not eating any solid food and I had been completely cleaned out by the bowel prep before the procedure. I was still on a clear liquid diet for two days after the EMR and I don’t feel very good on such a diet. After two days I ate a more normal diet and started feeling better. My digestive system appeared to be working normally. I was relieved that I did not appear to have any bleeding from the EMR procedure.

Pathology Report

I eventually got my pathology report. The polyp pieces were villous adenoma (tubulovillous adenoma or villotubular adenoma). That means it was just a polyp and there was no cancer. If there were any cancer it would say something like carcinoma or villous carcinoma. The size of the pieces was 2” square and 0.7 cm thick (about 1/4 inch thick).

This was good news. One of the reasons doctors prefer surgery over EMR is because of the chance of finding cancer in the polyp during pathology analysis. They could do EMR only to find that surgery is necessary anyway because the pathology found cancer growing through the mucosal layer into the colon wall. Surgery may be less optimum for the patient’s body but it’s more of a sure thing from the doctor’s point of view.

Three Month Follow-up Colonoscopy

I went to Dr. Roy Soetikno for the three-month follow-up colonoscopy. The purpose of the follow-up was to make sure the colon healed properly and to remove any remaining or recurrent polyp tissue. The colonoscopy was very straightforward. They used minimal sedation so I was aware of what was going on the entire time. They very carefully examined the site of the polyp with magnification (30x I think) under the following conditions:

The purpose was to compare the pattern of the polyp resection scar area with the surrounding area looking for any irregularities. In my case the pattern was very much the same under all these viewing conditions in both the resection and surrounding areas. This indicates that there is no precancerous lesion. They found a small 2mm piece of tissue that was either missed during the EMR or a regrowth. They removed it and analyzed it. They biopsied the polyp site and confirmed that there was no residual adenoma tissue. So the polyp healing process is complete. I need to get another colonoscopy in six months to check for recurrence.

Following are a video and photos of my fully healed polyp resection three months after the EMR procedure.

Post-EMR Video

Here is a QuickTime video of the post-EMR colonoscopy examination. (If you prefer a Flash version click here.)

Post-EMR Photos

Here are three photos of the polyp resection area, one in each of the viewing conditions mentioned above.

Post EMR polyp site white light

Post EMR polyp site narrow band imaging green light

Post EMR polyp site white light blue dye

Nine Month Follow-up Colonoscopy #1

This turned out to be an example of what can go wrong after EMR. It mostly involved problems dealing with the health care system, not so much with EMR itself.

I went back to Kaiser Permanente, my normal health care provider, for the second follow-up colonoscopy nine months after my EMR procedure. This is the same doctor who originally found my polyp in 2007 and told me to get colon surgery, the same doctor who knew about EMR all along but never told me about it even though she knew I wanted to keep my colon, and the same doctor who advised against EMR but reluctantly gave me a referral to get it done outside of Kaiser. She was never supportive of me getting EMR. But she is my gastroenterologist at Kaiser so that’s why I went to her for the colonoscopy.

I got the colonoscopy. Afterwards she said my colon looked healthy and normal. There was no visual evidence of anything abnormal in my colon. She gave me some photos and a report. She said she took three random biopsy tissue samples from the EMR scar.

About a week later she called and said the biopsy contained some villoglandular tissue, which has a high likelihood of turning into cancer (not necessarily true for such a tiny amount of tissue) and she recommended that I get laparoscopic cecectomy surgery. That means she wants me to have colon surgery to cut out my cecum because there was microscopic evidence of polyp type tissue.

She did not consider the fact that after EMR it is common and even expected to have small instances of residual or recurrent polyp tissue that need to be removed during the initial follow-up colonoscopies, especially after removing a really large polyp such as mine. It will eventually settle down, but it may be necessary at first.

Maybe it requires special endoscopic equipment and techniques not available at Kaiser to identify and remove this type of tissue since it is so small. Or maybe she has no interest in helping me save my colon from unnecessary surgery. It’s easiest for her to just send me to surgery so she does not have to think about it anymore. I can't get colon polyps where there is no colon.

I tried to keep all this in perspective. Whatever undesirable tissue I had was really small. I previously went for years with a giant polyp hundreds of times larger before getting EMR. Getting surgery for this microscopic bit of tissue seemed inappropriate. There must be a better way.

Nine Month Follow-up Colonoscopy #2

I contacted Dr. Roy Soetikno, the doctor who removed my polyp by EMR. He looked at my Kaiser pathology slide and saw a little bit of villoglandular tissue in one of the three biopsy samples. He recommended another colonoscopy instead of surgery. He said recurrent or residual adenoma may occur after a large EMR such as mine but they are typically removed by a colonoscopy.

I got another colonoscopy from Dr. Soetikno as well as Dr. Tonya Kaltenbach, another EMR doctor. They carefully examined my colon using advanced techniques including indigo carmine dye. It took some careful examination but finally they found a very small 1 to 2 mm tubular adenoma in the EMR scar area, which they easily removed. They said based on ten years experience with EMR, my EMR scar looks normal and there is no need for surgery. They stressed that this tiny adenoma was very small and it was a good thing that I did not get the unnecessary colon surgery to remove it.

Choose Your Doctor Wisely

My follow-up colonoscopy experience points out something very important if you want to save your colon. Work with a doctor who actually wants to save your colon. It seems there are two schools of thought in gastroenterology. Mainstream gastroenterologists such as my Kaiser doctor examine the colon and remove small easily removable polyps endoscopically but use colon surgery to cut out a section of the colon for anything larger or more complicated. Interventional endoscopy doctors such as Dr. Soetikno and Dr. Kaltenbach try a lot harder to handle the more complicated issues using advanced endoscopic methods instead of surgery if possible.

It's important to get the follow-up colonoscopy from a doctor who understands about EMR and is willing to look for and remove any recurrent or residual adenoma tissue or to at least send you to someone else who will do it. You want to avoid a doctor who is trigger happy to send you to colon surgery or at least think about what they are telling you and realize there may be other options available.

Some Final Thoughts

I am pretty amazed that the polyp is gone. I spent about a year and a half trying to get rid of the polyp in various ways without damaging my body. Now it’s actually gone. And best of all I still have my colon. If there are any more issues it will be different now. No longer is there a big polyp that can turn into colon cancer. Small polyp growths could re-occur, but they can be removed by endoscopic methods. I still need to be careful with my diet and lifestyle to reduce the likelihood of growing a new polyp. But with periodic colonoscopies from the right gastroenterologists, any future polyp can be noticed before it gets so large that it is difficult to remove. It’s important to keep getting high quality colonoscopies.

By Jim Sease
jim@sease.com
http://www.sease.com/polyp/emr.html
http://www.sease.com