Polyps are small outgrowths seen on the walls of colon. Though most of them are harmless, some may bear risks of cancer in your colon. Adenoma is a type of polyp. This kind of polyp is likely to become cancer. A proper understanding of tubular adenoma is required to keep away from associated risks.
Polyps in the colon form when cells in the region multiply at a greater proportion. In general, it is normal for cells to multiply and grow. But, when the growth gets way too much, you are more likely to develop polyps in your colon. Medical studies are yet to evidence what triggers these polyps to be formed in your large intestine. However, a few studies do reveal a possible link between those who are aged 50 years or more, obesity, lifestyle habits (such as smoking, sedentary way of living, etc.), diabetes (especially type 2) left untreated, prior incidence of cancer in your colon, etc. In some instances, earlier episodes of colitis (ulcerative type) or other bowel diseases (such as inflammatory bowel disorders) are found to have an association with the formation of polyps.
Polyps are broadly categorized into two, namely – adenoma and hyperplastic polyps. Of these, adenoma has the potential to turn harmful (though, not all adenoma sport these risks). It has been observed that most of the cancers (as high as 90% and beyond) in the colon start as adenoma. It has also been inferred that adenomas of a larger size are more likely to turn into cancers. However, only 9% of adenomas are considered to be malignant, and pose the risks of cancers. On the other hand, hyperplastic polyps are not found to carry risks of becoming cancerous.
Tubular adenoma of the colon
Based on the way adenoma grows, medical studies have labelled them distinctly. Based on the patterns in which adenoma multiplies, it is labelled as serrated, sessile, villous and tubular adenoma. Of these, tubular pattern of adenoma is more common. Though most of them are considered harmless, not removing them may lead to cancers. An unremoved adenoma that has turned cancerous is termed as adenocarcinoma.
A few polyps may exhibit both villous and tubular patterns of multiplication. Doctors refer such polyps as tubulo-villous polyps or adenomas. Of these two common types, villous adenomas are larger than tubular adenomas. As larger adenomas are more likely to turn cancerous, villous carry more malignancy in them than their tubular counterparts. If the adenoma is lesser than half an inch, it is widely considered as small; most tubular adenomas are of such size.
The typical signs of tubular adenoma are bleeding from your rectum, pain in your lower abdomen, changes in bowel movements, etc. In some cases, an acute spell of anemia (significantly lower quantity of red blood cells) has been observed.
How to diagnose tubular adenoma?
It is done with the aid of a procedure called colonoscopy. This is an outpatient procedure done with an endoscope, which is a flexible cord having a camera at its end. This cord is inserted into your rectum and moved forward into the colon. This action provides a clearer view of the interiors of your colon.
You can diagnose a wide range of medical conditions using colonoscopy. The conditions commonly detected are related to causes of (1) pain in your lower abdomen, (2) unexplainable loss of body weight, (3) blood in stools, (4) changes experienced in your bowel movements, etc.
A modern development of the conventional colonoscopy is the virtual colonoscopy. It is a CT-guided procedure done on your abdomen. A 2-D output of the colon is worked upon and rendered into a 3-D image through advanced imaging technologies. Virtual colonoscopy is employed to detect size and position of adenomas. The virtual approach may pose a few difficulties in spotting extremely small sized (i.e., those sized half an inch or even less). Its virtual method makes this as a non-invasive procedure. But, if polyps with possible malignancy are detected, your doctor may advise you to go for a conventional colonoscopy.
Cancer risks
Complete elimination of tubular adenomas is done by cutting the root of these outgrowths. The remaining portion of the adenoma is then subject to tissue tests to detect cancer risks, if any. Your treating doctor will check if the root of the polyp has cancerous growth. If the root has cancerous growth, it presents likely risks of cancer. In order to detect all polyps (including small and medium sized ones), a thorough examination of the colon is performed using colonoscopy.
Cancer is labelled as first or second stages if cancer is detected within the colon. These two stages only indicate that the condition is still a localized one and has not spread beyond your colon area. In more critical terms, stage one of colon cancer is seen on the topical area of the colon’s tissues. While in next stage (stage 2), it is known to cause damages to the linings of the colon. These two stages offer more scope for a full recovery; this is because, it is possible to eliminate the infected portions of the colon by surgically removing such areas.
Cancers in the colon at an advanced level are termed as stage three and stage four. These levels indicate that the cancerous growth – originated from the adenomas – has progressed to other areas adjoining the colon. When cancerous growth has destroyed the nodes of lymph outside the colon’s walls, this medical condition is termed as stage three. On the other hand, if the growth has progressed to reach other essential organs such as liver, lungs, etc. – then it is termed as stage four of cancer.
How to treat tubular adenomas?
Your doctor will advise you to remove tubular adenomas as they have the potential to become cancerous. You may want to note that colonoscopy can be used both for diagnosis as well as for the treatment of polyps. Your treating doctor may use a wire loop (which retracts) to remove tubular adenoma. This wire loop is placed onto the endoscope for ease of removal. For smaller sized tubular adenoma, your treating doctor may apply heat for getting them removed. Application of local heat is done though a special device soon after the location of polyps is identified.
However, your physician may recommend a surgery if tubular adenoma is larger in size. It may be recalled that large sized tubular adenomas are not commonly seen. But, through one way or the other – tubular adenomas need to be eliminated from your body. If a post-procedure test indicates the continued presence of polyps, it is time to explore other ways of removing them. Even after the complete removal of polyps (tubular adenomas), you may need to follow it up with periodic tests.
As a preventive measure, your treating physician may advise you to take one more session of colonoscopy if another adenoma (regardless of its size – i.e., less than half an inch or more) has taken shape in your colon.
Precautions to stay aware of
It is advised to remove tubular adenomas sooner, i.e., without any further delay upon diagnosing the presence of polyps in the colon. The residue of adenomas can lead to later multiplication of cells in the region. Hence, you may need to persist with your treatment plan (diagnosis and removal) for the effective elimination of all polyps. Your doctor may advise a surgical procedure (called segmented colectomy); this procedure is performed by accessing the colon through your abdomen.
There are no established or documented ways through which tubular adenomas can be prevented. But, it is widely believed that exposure to toxins or excessive radiations may trigger the formation of these polyps. Hence, you are advised to be cautious of such work environment or avoid accidental overexposure of radiation. Some studies however indicate that intake of fiber rich foods have the potential to reduce the risks of cancers of the colon.
Dieticians note that intake of vitamin E as well as vitamin C-rich foods (or vitamin supplements) can help reduce the risks of colon cancers; this has been observed especially among those with a family history of colorectal cancers. Vitamin E is abundantly available in peanuts, almonds, olive oil as well as canola oil. This essential vitamin is also available as a supplement either as drops or as tablets. Vitamin C is found in copious amounts in broccoli, berries, citrus fruits, potatoes, peppers, spinach, tomatoes, etc. Its supplement is available both as chewable forms as well as capsules. Deficiency of vitamin C is observed among those who suffer from gastrointestinal problems as well as cancers in colon or rectum. Clinical studies indicate that consumption of vitamin C enhances the absorption efficiency of your intestinal system; especially, your body’s ability to take-in essential nutrients gets boosted. Dieticians recommend intake of foods rich in both these vitamins instead of consuming supplements or other substitutes. However, in the absence of access to such foods, it is advised to consume needful supplements to provide for these essential vitamins.
You are advised to note that an earlier detection and successful elimination of tubular adenoma can put a stop to further risks. However, delaying the removal of polyps or leaving them untreated can lead to fatal effects; in some instances, it has even turned into a life-threatening condition.
In sum, most of the cancers (as high as 90%) in the colon are known to originate from adenomas. Common symptoms associated with an incidence of tubular adenoma include pain in your lower abdomen, changes in bowel movement, bleeding from your rectum, etc. In a few instances, patients report a significant drop in red blood cells (a medical condition called anemia). If you already had adenomas, the odds of another polyp getting formed are quite high. This may also mean that the risks of cancers in colon or rectum cannot be completely ruled out. Hence, it becomes necessary for you to talk to your physician and opt for periodic screening of your colon.
It is always recommended to eliminate tubular adenomas no sooner than they are detected. It is advised so because a delayed excision of polyps can only worsen your medical condition. Even after removal, remnants of adenomas may trigger a likely progression of cancerous cells in your colon and rectal areas. Hence, you may need to stay committed to your treatment plan (both diagnosis as well as removal) for the effective elimination of cancerous polyps. Your treating physician may recommend segmented colectomy (a surgical procedure) by which abdominal access is created to reach your colon.
Foods rich in vitamin C and vitamin E are known to reduce the risks of cancers in colon. Vitamin C is found in abundance in foods such as broccoli, berries, citrus fruits, spinach, tomatoes, etc. Vitamin E is present in olive oil, peanuts, almonds, etc. In general, inadequacy of vitamin C is known to cause gastrointestinal problems and may also trigger cancers in colon. Food and dietary experts advise consumption of foods rich in vitamin C and vitamin E over intake of their substitutes or supplements. However, if access to such foods is seasonal, you are advised to consume needful supplements to ensure your colon’s wellbeing.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
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