Uterine cancer survival good but morcellation increases cancer spreading risk

Uterine cancer is the most common gynecological cancer, and the fourth most common cancer in women behind breast, lung and colon cancers. An estimated 53,000 cases of uterine cancer were diagnosed in 2014 with about 9,000 deaths. The disease has a high five-year survival rate – 81.5 percent.

With early detection and treatment, the five-year survival increases to 95 percent. The No. 1 treatment for the disease is hysterectomy, which is often performed with less invasive techniques including laparoscopy. However, women should discuss the risks associated with these procedures as some may increase the risk of cancer spread.

Uterine cancer is also known as endometrial cancer, which affects the endometrium, or the inner lining of the upper part of the uterus. In contrast, cervical cancer affects the cervix, which is the lower, narrow part of the uterus. About 95 percent of all uterine cancers are in the endometrium. The remaining 5 percent are called uterine sarcomas and grow in the muscle of the uterus.

Most women are not screened for uterine cancer, thus in most cases it is usually diagnosed after a woman sees her doctor because she is experiencing symptoms, such as unusual bleeding or discharge, usually after menopause, or a pelvic pain or mass. Various tests can detect most uterine cancers, but there is no reliable way to detect the less common uterine sarcoma until after the uterine tissue has been removed. And this is where problems can arise.

Many doctors have offered women less invasive approaches to hysterectomies and removal of uterine growths compared to traditional open surgeries, such as laparoscopic surgeries using power morcellation. A power morcellator is a surgical tool fitted with a tube-shaped blade that minces uterine growths or entire uteruses inside the body and removes the tissue through a small incision in the abdomen. This procedure also leaves less scarring and offers less recovery compared to open surgery.

However, in rare instances when a woman has undetected uterine sarcoma, there is a risk that power morcellation can send bits of cancerous tissue throughout the abdomen, seeding new growth and making the cancer more difficult to treat. This also worsens a woman’s odds of survival.

Late last year, the Food and Drug Administration (FDA) strongly discouraged power morcellation for hysterectomies and myomectomies (fibroid removal) in the majority of women. But the announcement came too late for many women. As a result, makers of power morcellators, including Johnson & Johnson, are facing lawsuits from women and their surviving family members alleging the companies were aware of the cancer spreading risks with the surgical tools but failed to warn doctors or patients.

Source: Bay State Banner