a problem about adenocarcinoma of the colon

This is one problem about adenocarcinoma of the colon of patient and doctor response I hope it help you.

awaiting the visit oncology / gastroenterology would like an opinion from specialists.

The patient is male and 55 years of age. Following sigmoid colonoscopy rectum were detected polyps pedunculate 7 with the following distances and dimensions: 10 cm from the edge: micropolipo, 30 cm from the edge of polyp pedunculated of 1 cm in diameter, 60 cm neoformation vegetans which occupies 1/3 of the lumen, 70 cm polyp pedunculated of about 4-5cm, 70 cm polyp pedunculated of about 1 cm, 100cm polypoid formation with a large base of plant of about 2 cm, in ascending polyp pedunculated of 2 cm. The biopsies showed the presence of adenocarcinoma of the colon and the remainder was due to villous adenomas with dysplasia among low-moderate. I would like to know how to proceed in these cases: instrumental analysis and if necessary surgical resection, and if so could explain the consequences life with one small part of the residual adenocarcinoma of the colon or if they were to perform a total colectomy should do something for the replace colon? Also being cancer chemotherapy is needed? As the last question I would like to know if in these cases are appropriate do a screening instrument to detect the presence of EGF-R and whether KRAS mutated? And if there were the target therapy was performed in all hospitals?

Thank you in advance for your attention and I know that my data cannot allow you to make the diagnosis, staging and survival and whatnot, but awaiting the visit I wanted to inform me.

Kindest,

Endoscopic diagnosis of a patient definitely has to be evaluated by the surgeon.

The type of intervention, total or partial resection of adenocarcinoma of the colon is closely tied to a fair and accurate endoscopic diagnosis. In practice, the endoscopist should assess (possibly with the help of chromoendoscopy to detect flat adenomas) extending toward the blind polyp and their endoscopic resection (and here is the experience).

At what level were the major adenocarcinoma of the colon? 

That the endoscopist should also refer to the site rather than from the cm from the anus (which has no meaning apart from the rectum) but according to the anatomic location. The octopus prosimale more also must be indicated by tattoo with china in order to provide the exact position of the surgeon.

It can therefore understand the importance of the role of the endoscopist in surgical decision.

The patient with adenocarcinoma of the colon resected or excised in toto will have a period of adaptation of intestinal function (variable from subject to subject), but then live a normal life.

The decision on chemotherapy, possibly supplemented by biological treatment must be postponed to the final staging of the tumor, which is based on pre-surgical investigations (CT, etc.) and the surgical piece (neoplasm, lymph nodes, etc...).

So I shall leave because even when we do not have clear ideas on the surgical decision (established on a proper endoscopy), the type of surgery and the staging of the disease.

So, if polyps are removed endoscopically beyond that level, the surgeon may opt for a partial resection of the colon.

Would be preferable if the account created correspond to the user requesting the consultation, both for greater transparency and to ease the professional response even from the already limited means with which it interfaces with the user.
Moreover, the absence of an user's history about adenocarcinoma of the colon and some physical data make it even more difficult to give precise directions.