By Lindsey Caldwell
Doctors who recommend a hysterectomy procedure for their female patients have several options available for the removal of fibroid tissue. One of these involves the use of a power morcellator device. Recently, this operative procedure has come under fire from certain medical experts who claim that the risk of spreading undetected cancerous tissue throughout the abdominal area increases when fibroid tissue is cut away in this manner.
The FDA has recently issued warnings about the use of power morcellation as a means to remove fibroid tissue. In April of 2014, the administration reported that although it is difficult to detect all cancerous cells present in or near the tissue being cut and removed, the risk of spreading other cancer cells by using a power morcellator device makes this type of procedure relatively dangerous.
About Power Morcellation
Laparoscopic power morcellation is one of several techniques used during the performing of a hysterectomy or myomectomy. A traditional surgery hysterectomy involves the simple cutting and removal of the uterus, and a similar technique can be employed to cut and remove uterine fibroids.
A power morcellator is a specialized instrument that is used to slice fibroid tissue into small pieces, making for easy removal. However, this cutting procedure involves cutting of adjacent tissues that may themselves contain mutated, cancerous cells. Because it is virtually impossible to tell whether the fibroid tissues are cancerous during a normal sampling procedure, it is therefore possible that cancer cells may spread to other tissues within the uterus or adjacent linings while the morcellation technique is performed.
Dangers Of Uterine Cancer
Research including the gathering of statistical information over the past few decades has led medical researchers to declare that the average life expectancy following a diagnosis of uterine cancer is less than three years. This is why early detection is so important. A myomectomy or full hysterectomy is therefore the most commonly recommended procedure when a positive diagnosis of fibroid tissue in the uterus is made.
Uterine sarcoma is sometimes detected in tissue samples taken from women during a hysterectomy or myomectomy. According to the latest statistics available, approximately one patient in every 350 has previously undetected uterine fibroids that contain the malignant sarcoma cells. While this figure may seem quite low, it is important to remember how many women undergo a hysterectomy or similar procedure during their lives. Unlike the non-malignant uterine fibroids, uterine sarcoma is a very dangerous form of cancer, one that can easily be spread to other pelvic tissues if fibroid tissues are cut and sliced into small segments prior to removal.
The FDA Makes Recommendations
In April of 2014, the FDA issued a statement discouraging the use of laparoscopic power morcellation as a means to remove fibroid tissue from the uterus. The statement also included advisory comments directed toward physicians who perform hysterectomy or myomectomy procedures on their patients.
The FDA held further meetings in July to discuss possible changes to treatment options when fibroid tissue has been detected in the uterus and/or adjacent areas of the pelvis. A decision on whether to place restrictions on the use of power morcellation is expected soon.
Doctors are strongly encouraged to inform their patients about all treatment options as well as an educational discussion regarding the possible spreading of cancerous cells beyond the uterus. The FDA also issued later statements that were directed toward women who have been diagnosed with uterine fibroid tissue buildup. These women are encouraged to discuss alternative treatment options if the recommended surgical procedure involves the use of a power morcellation device.
Weighing The Risks
Because it is impossible to make a clear diagnosis of the presence of malignant cancer cells in fibroid tissue, women are strongly urged to consider the health risks involved with the removal of such tissue through the use of a specialized cutting device. If power morcellation is the procedure recommended by the physician, it is important to ask why this treatment option is favored over traditional surgery.
• What is a Power Morcellator? A device used in hysterectomies to cut tissue into small pieces to be removed from the body. However, uterine cancers sometimes go undetected prior to the procedure. In these cases, the morcellator dices up and spread unsuspected cancer inside the woman’s body.
• Hysterectomy is the 2nd most common surgery among women in the United States
• By age 70, one out of three American women will have had a hysterectomy
• 90% of these surgeries are done to remove Fibroids (non-cancerous tumors found in the uterus)
• The average life span following accidental morcellation of sarcoma is only 24-36 months
• Only 15% of women who have leiomyosarcoma (LMS) that has spread (stage 4) will be alive after 5 years
• Women with sarcoma who are morcellated are about 4 times more likely to die from sarcoma than if they had not been morcellated