Brief Answer: Polyps correlate with cancer. Detailed Answer: Hello XXXXXXX ji, Thanks for posting your question. If polyps of the size mentioned by you (3.5cm) were found in the colon, there is a likelihood that these polyps are cancerous. Generally when we find polyps in the colon, we take a small piece of it to check if it has become a cancer, and I presume, that is what the doctors did in your father's case too. Colonic polyps are considered as a pre-cancerous condition, so I would be looking for finding if there is indeed any cancerous change if I encounter such large polyps. The staging of the condition can not be assessed with the information you have provided here. It would help me understand the condition better if you could share with me what was done to these polyps when found, were they removed? Were they then sent to lab for examining? Do you have the reports of any such test/biopsy? Do you have the colonoscopy report with you? If yes, can you upload it along with the query, so that I can see and opine accordingly. Now coming to the second part of your query, that is related to anemia. Anemia for an year may or may not be related to the colonic polyps, however I would like to stress the point that, it is highly likely that a person develops anemia if he has any type of cancer, and particularly if the cancer is originating from the intestines or stomach the anemia will be most commonly associated simply because of the chances of bleeding without ever noticing it. The suspicion of colon cancer should be high when there are very nonspecific symptoms or in case of chronic constipation in elderly people, but as you said, your father was not having any symptoms, so it is quite possible that your GP did not think of the issue. However, if the problem is only polyps which have been attached superficially to the colon, then they can be removed surgically, and based on the number of polyps and the cellular changes that are observed in the biopsied sample, a decision needs to be made about the exact course of action that needs to be taken, namely, excision of a part of colon or just removal of the polyps. I hope I have answered your question adequately, I would happy to clarify any doubts you might have. Please do write back with the requested details so that i may help you understand the problem better. Wishing you all the very best. Kindest regards.

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Brief Answer: Biopsy is a must to rule out cancer. Detailed Answer: Dear Ms XXXXXXX Thanks for writing back with the additional details. CT colonography does show if there is any cancer, and I suspect your doctors might be right in their diagnosis, however, it is best to get a colonoscopy and biopsy done to make sure that there is no cancer, and if there is cancer then colonoscopy will also help in knowing the stage of the cancer as well. CT scan of the chest and abdomen with pelvis needs to be done to rule out if there is any spread into the lung or liver, and in the initial stages of spread there will not be any symptoms. Hope I have answered your questions, please write back if you have more questions. Wishing you luck. Regards,

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Brief Answer: Yes, if the anemia was severe. Detailed Answer: Hi, Thanks for writing back, Yes, your father's GP should have suspected cancer with unexplained anemia, or at the very least he should have got some basic tests done to look for the cause for anemia, namely stool occult blood would have given some indication. That said, anemia can be caused mainly in two ways in colon cancer. 1. Anemia due to chronic blood loss which is hard to notice. 2. Anemia of chronic illness, here the body does not generate enough blood cells because of the long standing illness. The two large polyps can well be cancerous, so, if a cancer is detected, then the obvious cause for anemia would be cancer itself, and it can cause cancer as explained above. Hope this answers your concern, however if you were to need further clarification or if you have further questions, you are welcome to ask me. Warm regards,

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Brief Answer: Severe anemia, less than 7gm/dl. Detailed Answer: Hello, Thanks for writing back, We say the anemia is severe is the hemoglobin levels are less than 7gm/dl. Initially, there wouldn't be many changes in the routine blood tests, except some anemia. But, if some specific investigations are done to look particularly for cancer, like levels of TNF alpha(Tumour necrosis factor alpha), Tumor M2-PK (for colorectal and other cancers), CA19-9 (again for colorectal and pancreatic cancers), which are blood tests, they would give us an idea if there is any active cancer. The routine investigations such as, CBC, and liver function tests may not show any abnormality till very late in the disease process. Hope you will find this information useful. Warm regards.

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Brief Answer: Possibly early, but needs to be confirmed. Detailed Answer: Hi, Yes, this could mean the disease may be fairly in early stage, but we will not be sure until we get some of the tests done, such as, CT scan of the lungs, liver and a biopsy. Regards.

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Brief Answer: LFT not specific for metastases. Detailed Answer: Hello, Welcome back, Liver function tests are not specific for liver metastasis, but if the liver metastasis is significant and if these metastatic tumours grow to large size then they will compromise the liver function and that will be reflected in the liver function tests. So, small metastatic masses may not result in a significantly abnormal liver function tests. Hope this clears your doubts. Please do feel free to write back if you need further clarifications. Warm regards.

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