IBD and Cancer: Up Close and ... Video Transcript

Webcast Transcript

So I sensed that something was different this time around from what he had seen in the past.

DAVID RUBIN, MD: Tom was awake during parts of the procedure, as patients often are, and we were discussing my findings as we were going through and there were definitely areas where I was a bit more concerned than usual.

ANNOUNCER: Tissue from the biopsies taken during the colonoscopy ended up under the microscope of Dr. Jerrold Turner. He found areas of pre-cancerous cells, also known as dysplasia.

JERROLD TURNER, MD: Several of the biopsies showed low-grade dysplasia. This biopsy also showed high-grade dysplasia.

This is an area of low-grade dysplasia. You can see the nuclei are enlarged, and they're somewhat disordered. They're no longer nice and uniformly located along the basement membrane, which is here. But some have moved upwards in the cell, downward in the microscopic image, so that they're displaced from that area.

When you look at the top, this, at the top, and here is an area of high-grade dysplasia, where the organization of the cells with relation to one another is also disordered and complex.

This is an area where glands are forming within glands, and the area is very crowded. So, again, the normal morphologic cues have been lost, and this is a feature we call cribriforming, which is a feature of high-grade dysplasia.

ANNOUNCER: Dr. Rubin was quick in getting the news to Tom, for the finding of dysplasia is a call to action: the surgical removal of the colon.

DAVID RUBIN, MD: We worked with the pathologist to get results in an expedited manner and it was only a matter of two or three days before we could call Tom with the results that, in fact, there was dysplasia in his colon.

TOM: I was not afraid of the diagnosis. And I was not afraid of what the future held for me. I actually asked him to get me in touch with a surgeon as soon as possible, because I knew nothing good could come from leaving that dysplasia condition in me.

ANNOUNCER: Within a few weeks, Tom underwent surgery, and it went well. After examining the removed colon, pathologists reported the surgery had come none too soon. There was early-stage cancer.

DAVID T. RUBIN, MD: When I heard that Tom had cancer in his colon, I was relieved that we had acted when we did and that we hadn't delayed further. But I was also astonished to see, once again, how we had had multiple colonoscopies previously that had shown no dysplasia and it had been just one year between the exam that had no dysplasia at all and the exam that not only had multiple areas of dysplasia, but now had a cancer in it.

ANNOUNCER: The relief for Tom is twofold.

TOM: It's a weight off my mind. 2004 was the first year that I haven't had a colonoscopy, and I haven't had that period of time waiting for the biopsy results to come back.

ANNOUNCER: And with no colon, Tom also has no ulcerative colitis.

TOM: After the surgery, not having the symptomatic problems of ulcerative colitis, the cramping, the passing of blood, the urgency to get to a bathroom right now, is phenomenal. My quality of life is so significantly improved. In the past, my wife and I would go on trips, and I like to joke that I'd have to map out where all the rest areas were on the road as we would take these trips, these road trips. That's no longer the case. I'm very confident and comfortable in leaving the house, and if I've got to drive 500 miles, I can drive 500 miles. There's no urgency to have to get to a rest area. It really increased the quality of my life.

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