Laparoscopic Power Morcellation Surgery Could Spread Cancer

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It’s estimated that by age 50, as many as 80 percent of women will develop fibroids—tumors in your uterus’ wall that are almost always benign, but cause very heavy and painful periods. And now, the Food and Drug Administration (FDA) says a procedure called laparoscopic power morcellation—which removes those fibroids—could potentially spread cancerous tissue to other parts of your body. [Tweet this news!]

The prospect is alarming, but also extremely rare. Only about one in 350 to 500 patients who undergo this procedure (which is also used for hysterectomies)—in which a surgeon uses a surgical power tool to cut fibroids into smaller pieces to remove them—will have cancerous tissue. Unfortunately, there’s no way to know that the cancerous tissue is there before the procedure. “The tissue is always biopsied afterward so you’d know within a week if cancer was present,” says Linda Bradley, M.D., director of the Center for Menstrual Disorders, Fibroids & Hysteroscopic Services at the Cleveland Clinic. If you’ve already had laparoscopic power morcellation, there isn’t new cause for concern—you’d already know by now whether any of the tissue was cancerous (and odds are, it wasn’t).

But even more: Most of the time, fibroids can be treated without this technique—through medication or fibroid embolization, in which blood flow to the fibroid is cut off, causing it to shrink. “By four to six months after treatment, embolization works for 85 to 90 percent of patients,” says Bradley. (If embolization doesn’t work for you—or if your fibroids are too large for the procedure—your doctor may recommend laparoscopic power morcellation.)

If you’re being treated for fibroids or need a hysterectomy, this finding could raise a red flag, though. “Discuss with your doctor whether surgery is absolutely necessary or if there are some less invasive ways of treating your condition,” Bradley says. And if surgery is needed (and your doctor suggests laparoscopic power morcellation), ask whether the surgeon uses a bag when performing the procedure. Similar to a zip-top bag, the surgeon cuts the organs or fibroids within a bag to keep the chips of tissue contained so they’re less likely to spread. “It’s an effective barrier, but it’s not 100 percent fail-proof,” Bradley says.

There are other techniques for surgically removing fibroids, too—most simply require much larger incisions. “In the last 10 to 20 years there’s been a push for more minimally invasive surgery because it makes a big difference cosmetically and recovery is much faster,” Bradley says. Fibroid removal and hysterectomy can be performed with traditional open surgery (recovery, though, can take six weeks compared to just a few days with the laparoscopic approach).

The bottom line: “With laparoscopic power morcellation, the odds of spreading cancer are very, very rare,” Bradley says. “But when it happens to that one person then it’s a minefield.”

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