Familial Adenomatous Polyposis or FAP is a genetic condition wherein the patient develops hundreds and thousands of adenomatous polyps on the colon, rectum and duodenum. An adenomatous polyp is an area where the normal cells of the patient’s colon form a mass within the intestinal tract. Usually, patients suffering from this condition develop these polyps from mid-teen and by the age of 35, there will be multiple colon polyps. If this condition is not diagnosed and treated, which includes surgery, there are hundred percent chances that it will lead to colorectal cancer. Those patients who exhibit symptoms such as passing of blood in stool or obstruction have a higher chances of developing cancer.
Surgical treatment of FAP is rather complex and for that one requires not just expert technical skills but also sound judgment. Since there are 100% chances of colorectal cancer, prophylactic colorectal surgery is the best course for management of the condition. The patient factors along with the characteristics of the disease influence the surgery and associated decisions such as the time of the surgery, the reconstructions and the extent of resection. It can be rather challenging to make the right choices and doctors along with the patients have to deliberate for a long time regarding the best strategies that should be adopted.
The optimal time for having the surgery varies from person to person. Cancer occurs very rarely in 20 years of age and thus putting off surgery till late teen years is reasonable. Many people prefer to have the surgery during a time of transition in education or employment; for example, many patients choose to have the surgery after college and before starting employment. Obesity is another major reason why surgery is postponed as patients are first advised to lose weight in order to make the ideal pouch-anal formation possible. Young women who require a proctocolectomy may also delay the surgery until they have given birth. Thus, one can see that there are multiple factors which influence the surgery decision and thus it is important that there be a dialogue between the patient and the doctors before taking any major decisions.
In such times, patients also seek out for support from those who have faced similar situations or have loved ones fighting the condition. There are many online as well as offline FAP support groups that patients can enroll and benefit from. FAPVoice.com remains one of the most famous support groups in this regard as they have a strong network of patients, survivors or family of survivors along with health care professionals giving out advice and sharing anecdotes that makes it easier to deal with situation.