Cancer Society warns against power morcellation for uterine fibroid removal

morcellator Cancer Society warns against power morcellation for uterine fibroid removalWomen who have undergone laparoscopic hysterectomy or myomectomy (surgery to remove uterine fibroids) procedures and were told that their test results were normal should continue regular visits with their doctor and promptly report any symptoms of problems, the American Cancer Society advises.

The notice is in response to a Food and Drug Administration (FDA) warning for women and doctors that laparoscopic power morcellation procedures for hysterectomies or myomectomies can cause undetected cancer to spread throughout the uterus, worsening the odds of survival.

Uterine fibroids are non-cancerous growths in the uterus. They are very common and generally do not cause symptoms. However, in some women, fibroids can cause heavy or prolonged menstrual bleeding, pressure in the pelvis or frequent urination. If the symptoms are severe enough, doctors may advise patients to have the fibroids or the entire uterus removed.

One way of removing fibroids or the entire uterus is through a large incision in the abdomen. Another, less invasive option, is using laparoscopic power morcellation, a procedure in which a morcellation device is used to shred fibroids or the entire uterus into pieces so they can be easily removed through a small incision in the abdomen. Power morcellation has been preferable because it allows for less scaring and shorter recovery.

Once the fibroids or uterus is removed, it is examined under a microscope for cancer. In some cases, it is discovered that a woman also has an uncommon type of uterine cancer known as uterine sarcoma.

The FDA reviewed studies involving power morcellation and found that about 1 in 350 women who underwent morcellation procedures for uterine fibroids or hysterectomies were later found to have uterine sarcoma. The agency warned that the devices could spread cancer throughout the abdomen, which would lessen the odds of survival.

Since there are currently no reliable methods for diagnosing uterine sarcoma prior to surgery, the FDA advised doctors to stop using power morcellation for hysterectomies and myomectomies, and if they chose to continue to use the devices they should be sure patients are fully aware of the risks in using the devices.

The American Cancer Society supports the FDA’s recommendation for women being treated for uterine fibroids to discuss with their doctors all the options available for treating the fibroids and the risks and benefits associated with each. If laparoscopic hysterectomy or myomectomy are recommended, the doctor should be asked if power morcellation will be used and if so, why he/she believes it is the best option.

Source: American Cancer Society