Benefits outweigh risks of colon surgery

Dear Dr. Gott: After my last colonoscopy, my internist indicated he had found a villous adenoma at the upper end of my colon. He did not remove it because the wall was too thin. The adenoma was about one inch in length. The biopsy was negative for cancer. The doctor insists that the adenoma will become cancerous within two years and wants me to have surgery at once. The National Cancer Institute says that if a villous adenoma exceeds 1 1/4 inches, it has a 40 percent chance of becoming cancerous. I am 57. Both my parents had colon cancer. I’ve had two previous surgeries. One was uneventful; the other required me to have two shots of atropine to make it out of the recovery room. Should I risk this surgery now or should I have the adenoma checked on a regular basis? I don’t like my track record with anesthesia.

Dear Reader: You should have surgery as soon as feasible. Certain benign growths, such as adenomas in the colon, can turn malignant. The larger the adenoma, the greater the risk.

You have a relatively large adenoma and, given the family history of colon cancer you mentioned in your letter, the growth should be removed. In my opinion, you are asking for serious trouble down the line if you go against your internist’s advice and adopt a wait-and-see approach.

At the time of surgery, the anesthesiologist will pay special attention to your blood pressure and pulse, because you required atropine (for a slow heart rate) during a previous operation. This is a common occurrence during general anesthesia and, I believe, should cause you no undue alarm.

Dear Dr. Gott: My sister was diagnosed with ovarian cancer 1 1/2 years ago. She underwent surgery and chemotherapy. She has between three and six drinks containing alcohol every day. What effect, if any, will her drinking have on her recovery from cancer?

Dear Reader: Your sister, who has been treated for a particularly malignant form of cancer, is probably drinking too much alcohol. I say “probably,” because I don’t know the strength of her three to six cocktails.

As a general rule, the liver cannot handle more than 4 ounces of spirits — or the equivalent in wine or beer — per day without becoming damaged. Also, the alcohol could affect your sister’s immune system, reducing her ability to destroy malignant cells that could arise in her body.

If I were your sister’s physician, I would caution her about her drinking and urge her to moderate her intake of alcohol. It seems to me that she has enough to worry about without having to cope with the potentially disastrous consequences of heavy alcohol consumption.