| FAP |
| Considering Surgery to Lower Cancer Risk for People With FAP |
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By
Miriam Komaromy,
MD
Reviewed
by Peggy Conrad,
MS, CGC and Jonathan
Terdiman, MD
Last
Updated August 3, 2000
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If
you've been diagnosed with familial
adenomatous polyposis (FAP) your doctor has probably
told you that either now or in the future you will need
to have surgery to prevent cancer.
Although this can be a scary proposition, surgery is
a lifesaving option for FAP patients and needs to be
faced. Which surgical procedure you decide to undergo
depends on a number of very personal factors.
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Why
Surgery Is Necessary
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| Most
such surgeries allow the upper bowel to be reattached
to the rectum or anus so that a patient can maintain
bowel control. |
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For FAP patients, the development of colon cancer is nearly
inevitable — unless the colon has been removed. What's
more, the hundreds or even thousands of polyps
in a FAP patient's colon
make it impossible to screen effectively for the disease.
Both of these facts make colectomy — the surgical
removal of the colon — a standard recommendation.
When this type of surgery is done to prevent cancer from
occurring (rather than to treat cancer) it is called a
prophylactic colectomy and usually does not require the
patient to wear a colostomy bag. Instead, most such surgeries
allow the upper bowel to be reattached to the rectum or
anus so that a patient can maintain bowel control —
an important contrast to the way in which such surgery
was performed in the past. |
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Make An Informed Choice
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| Although
all of the surgical procedures available to FAP patients
involve removal of the colon, they differ in a number
of other ways, including whether or not the rectum is
removed. Surgery is always a permanent decision, therefore
it is important to fully understand your options and the
risks and benefits associated with each choice. |
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References
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Ambroze,
W. et al. (1995). Surgical options for familial adenomatous
polyposis. Seminars in Surgical Oncology 11:
423-427.
Rodriguez-Bigas, M. (1996). Prophylactic colectomy for
gene carriers in hereditary nonpolyposis colorectal
cancer. Cancer 78(2): 199-201.
Syngal, S. et al. (1998). Benefits of colonoscopic surveillance
and prophylactic colectomy in patients with hereditary
nonpolyposis colorectal cancer mutations. Ann Intern
Med 129(10): 787-96.
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