[Fat Bear Science] You thought it was just a polyp, but it might actually be a tumor!

After receiving the medical examination report, some people are very anxious because of the small polyps in a certain part of the body shown in the report...

"For example, nasal polyps, vocal cord polyps, gallbladder polyps, gastric polyps, intestinal polyps, cervical polyps, endometrial polyps, etc."

For various types of polyps,

What people are most concerned about is why polyps grow?

Do you want treatment?

Will it turn into cancer?

In this issue, Fat Bear invited Wang Donglin, Director of the Department of Oncology at our hospital

To answer your questions

Experts of this issue

Wang Donglin

Wang Donglin: Director of the Department of Oncology, Chongqing University Cancer Hospital/Chongqing Cancer Hospital, chief physician, professor, doctor of medicine, and doctoral supervisor. He is good at chemotherapy and molecular targeted therapy of malignant tumors, especially in the diagnosis and treatment of malignant tumors such as colorectal cancer, lung cancer, gastric cancer, breast cancer, and head and neck tumors. Clinic hours: Monday all day, Thursday morning (special needs)

Polyps are extra flesh, and their occurrence is related to diet, genetics, etc.

"Polyps are extra flesh, that is, extra protruding growths on the surface of the human mucosa, which are formed by the hyperplasia of local mucosal tissue." Director Wang said that the incidence of polyps increases with age and is related to race. For example, Asian people such as China and Japan have higher incidence rates than European and American people. Some polyps occur due to inflammation of local mucosal tissue. For example, patients with long-term constipation have a large amount of dry feces in the intestines that can continuously stimulate the rectal mucosa. The mesenteric tissue is stimulated by chronic inflammatory factors for a long time, which can cause intestinal polyps.

At the same time, high estrogen levels can stimulate the proliferation of endometrial tissue and form polyps. Certain autosomal dominant genes can cause familial polyposis, such as familial adenomatous polyposis.

In addition, the occurrence of polyps is also related to dietary structure and living habits, such as consuming a large amount of high-protein, high-fat foods, long-term drinking, and frequent consumption of spicy stimulants.

80% of polyps occur in the gastrointestinal tract

"Polyps can grow in any part covered by mucous membranes, such as the nose, vocal cords, gallbladder, stomach, intestines, cervix, uterus, etc. 80% of polyps occur in the gastrointestinal tract, especially in the colorectal area." Director Wang said that polyps can include inflammatory polyps, hyperplastic polyps, and adenomatous polyps, among which adenomatous polyps are mostly benign tumors. But what exactly is the nature of polyps, whether it is inflammation, hyperplasia, tumor, or benign tumor or malignant tumor, all need to be clarified through pathological examination to provide a reliable basis for the next step of treatment.

For example, if a polyp is found under gastroscopy or colonoscopy, you can pick up a grain of rice and send it to pathology for examination to determine its nature before deciding on the next treatment. If a polyp is found under ultrasound, CT or other imaging techniques, because the nature is unknown, you can observe the location, size, shape, etc. of the polyp for 1-3 months before deciding on the next diagnosis and treatment.

"Therefore, you must never hold the mentality that 'polyps are benign and not a big deal.'" Director Wang reminded that once polyps are found, they should be treated differently under the guidance of a doctor according to the different parts of the polyps.

If nasal polyps are not cured for a long time, they may induce complications

Recently, Xiao Wang has been thinking that his nasal congestion symptoms caused by allergic rhinitis have become increasingly severe. He wanted to go to the hospital to get some medicine, but through a nasal endoscopy, the doctor found polyps in his nose and recommended surgical treatment as soon as possible.

Director Wang said that nasal polyps often appear in the maxillary sinus, ethmoid sinus, middle nasal meatus, middle turbinate, etc., and are a small benign tumor. Patients with nasal polyps often have a stuffy nose, and if the polyps continue to grow, the stuffy nose will worsen. If the polyps block the Eustachian tube, it can cause tinnitus, hearing loss, and can also cause snoring, sinusitis, chronic pharyngitis and other ENT complications, and more fatally, it can cause cancer. Therefore, once the symptoms of worsening nasal congestion appear, it is recommended to go to the hospital for a nasal endoscopy. If nasal polyps are confirmed, they should be actively treated under the guidance of a doctor.

In terms of treatment, if the patient's condition is not serious, corticosteroid nasal spray can be used and continued observation can be performed; if the polyp is large and the symptoms are severe, surgical treatment is required, and a biopsy should be performed after the operation to confirm the diagnosis.

Vocal cord polyps are easy to detect, and hoarseness may be a signal

Ms. Qin, 41, is an elementary school teacher. A few days ago, she suddenly developed hoarseness. Thinking it might be due to overuse of her voice, she did not take it seriously. However, a week later, the hoarseness did not improve. After going to the hospital for a check-up, she found a polyp on her vocal cord.

Director Wang introduced that vocal cord polyps are relatively common in clinical practice, and the cause is not very clear. It may be related to long-term improper voice, long-term adverse stimulation or chronic inflammation. The main manifestation is hoarseness, and the degree of hoarseness varies with the size and location of the polyp. In mild cases, there is only a slight change in the voice, and in severe cases, there is obvious hoarseness and even difficulty in speaking.

Vocal cord polyps can not only affect normal life and work, but also cause breathing difficulties if the polyps are large and block the laryngeal cavity. The fatal lethality of vocal cord polyps lies in the sudden canceration. However, many patients with polyps do not feel any discomfort after the canceration, and the disease develops and becomes cancerous without them noticing. Therefore, once hoarseness, foreign body sensation in the throat, dry and itchy throat and pain occur, it is recommended to go to the hospital immediately for a fiber laryngoscope to make a clear diagnosis, and if necessary, surgery can be performed under the doctor's advice to remove the polyps.

Gallbladder polyps can also become cancerous, and surgery is required if the indications are met

Recently, Ms. Chen was examined and found a polyp in her gallbladder measuring 0.4×0.6 cm with an uneven wall. She heard that gallbladder polyps can turn into cancer and was very worried.

Director Wang explained that gallbladder polyps refer to a type of lesion in which the gallbladder wall protrudes into the cavity in a polyp-like manner, including tumor polyps and non-tumor polyps. Generally, the symptoms are mild or even asymptomatic, and most of them are discovered during physical examinations and ultrasounds. The cause of gallbladder polyps is still unclear. It has been reported that people who drink alcohol for a long time, eat a high-fat diet, skip breakfast, are under great pressure, stay up late, and have an irregular lifestyle are more likely to get gallbladder polyps. Benign gallbladder polyps are more common, but cancer should also be prevented.

Therefore, once gallbladder polyps are found, regular check-ups are required. If the following surgical indications are met, surgical treatment is recommended as soon as possible.

1. Single gallbladder polyp with a diameter of more than 1 cm, thick pedicle, especially wide base, located in the neck of the gallbladder, and over 50 years old;

2. Multiple gallbladder polyps combined with gallstones, symptomatic, and over 50 years old;

3. Gallbladder polyps are accompanied by clinical symptoms;

4. If the diameter of a gallbladder polyp is less than 5 mm and it is asymptomatic, follow-up examinations should be conducted every 3 to 6 months if it is found to be rapidly enlarging or has obvious symptoms.

Intestinal polyps should be removed as soon as possible to prevent them from deteriorating into intestinal cancer.

Mr. Li, 48 years old this year, had diarrhea and constipation some time ago, so he went to the hospital for a colonoscopy. The result report showed that he had a 7 mm polyp, and the doctor recommended that it could be removed under endoscopy. This made Mr. Li very confused. Does the polyp have to be removed surgically? If it is not removed, is the chance of it turning into cancer very high?

Director Wang explained that intestinal polyps are all raised lesions on the intestinal mucosa, and not all intestinal polyps will become cancerous. Generally speaking, intestinal polyps are divided into two categories: non-neoplastic polyps and adenomatous polyps.

Non-adenomatous polyps, such as inflammatory polyps and hyperplastic polyps, have little to do with the incidence of colorectal cancer.

Adenomatous polyps are recognized as precancerous lesions. Studies have shown that more than 95% of colon cancers come from colon adenomas, which are equivalent to a "time bomb." Of course, whether adenomatous polyps become cancerous is also related to the patient's age, the number of polyps, and the size. Generally speaking, the probability of a single or two polyps becoming cancerous is not high, but the more polyps there are, the higher the chance of cancer; the larger the polyps, the higher the cancer rate. The cancer rate of polyps below 1 cm is 1-3%; the cancer rate of polyps between 1 cm and 2 cm is 20%; the cancer rate of polyps above 2 cm is 50%.

However, most patients with intestinal polyps have no clinical symptoms, and only a small number of them will have abnormalities such as blood in the stool, mucus in the stool, abdominal pain, increased bowel movements, constipation, intussusception, and even intestinal obstruction. Therefore, if the above symptoms occur, you should go to the hospital for a colonoscopy immediately. If intestinal polyps are found, they can be removed through endoscopy and then sent to the hospital for examination and treatment.

In addition, since intestinal polyps are prone to recurrence, regular check-ups are necessary. Eat more vegetables and fruits and stay away from tobacco and alcohol. For people with a family history of intestinal polyps, a colonoscopy should be performed every 2 to 3 years.

Cervical polyps can affect pregnancy, so they should be treated promptly once discovered.

Recently, Chenchen received a physical examination report from her employer, which showed that she had cervical polyps. The doctor recommended that she go to the outpatient clinic for further diagnosis and treatment. This made her very worried. How should cervical polyps be treated?

Director Wang explained that cervical polyps are the result of long-term stimulation from chronic cervicitis. Most of them are benign and have no obvious symptoms. A small number of patients will have bleeding symptoms similar to menstruation. Because cervical polyps produce inflammatory secretions, they will destroy the physiological environment of the vagina and reduce sperm motility. Polyps will also form mucus plugs, which will prevent some semen from entering the uterus and affect conception. If cervical polyps are found during pregnancy, they will slowly grow and bleed, affecting the health of pregnancy.

"Therefore, women should have regular gynecological examinations. Once cervical polyps are found, they should be treated under the guidance of a doctor." Director Wang said that generally speaking, when polyps are small, anti-inflammatory drugs can be used first. If they are larger than the size of a soybean, minimally invasive surgery can be performed to remove them. Pathological examinations should be performed after surgery to confirm the nature of the polyps and whether they have become malignant. If the pathological examination shows malignant changes, further treatment should be performed. If there are no malignant changes, cervical polyps are prone to recurrence, so regular follow-up examinations should also be performed after surgery.

Friendly reminder

If polyps are found during a physical examination, don’t panic or ignore them

Director Wang said that when faced with polyps in the above parts of the human body, people should not panic or ignore them.

1. You should maintain an objective and calm attitude, do not believe in rumors or hearsay, and go to the corresponding department of a regular hospital to see a doctor or consult whether treatment is needed.

2. Cooperate with the doctor to complete relevant examinations to further clarify the pathological type of polyps and identify and exclude other similar lesions.

3. If the pathological type is confirmed to be a tumor polyp, then you need to actively cooperate with the doctor for treatment. If it is a non-tumor polyp, the patient should also pay enough attention, follow the doctor's advice, change all kinds of bad living habits, treat related basic diseases, and follow up and reexamine regularly.

Text/ Fat Bear Picture/ Online Reviewer/ Wang Donglin

Original article, please do not reprint without authorization

Chongqing Cancer Prevention and Treatment Science Popularization Base/Member of China Medical Self-media Alliance

Chongqing Science and Technology Commission Science Popularization Funding Project