Are Routine Fibroid Surgeries Causing Cancer?

Getting fibroids removed should mean a good thing, right? Well, for some, it’s causing more harm than good.

The U.S. Food and Drug Administration issued a warning that discouraged the use of laparoscopic power morcellation for the removal of the uterus (hysterectomy) or uterine fibroids (myomectomy) in women because, based on an analysis of currently available data, it poses a risk of spreading unsuspected cancerous tissue, notably uterine sarcomas, beyond the uterus. Also, power morcellators that break up fibroids in women are linked to a form of uterine cancer called metastatic leiomyosarcoma.

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Laparoscopic power morcellation is one of several available treatments for fibroids. It is a procedure that uses a medical device to divide the uterine tissue into smaller pieces or fragments so it can be removed through a small incision in the abdomen, such as during laparoscopy.

Uterine fibroids are non-cancerous growths that originate from the smooth muscle tissue in the wall of the uterus. According to the National Institutes of Health, most women will develop uterine fibroids at some point in their lives. While most uterine fibroids do not cause problems, they can cause symptoms, such as heavy or prolonged menstrual bleeding, pelvic pressure or pain, and frequent urination, sometimes requiring medical or surgical therapy.

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Based on an analysis of currently available data, the FDA has determined that approximately 1 in 350 women who are undergoing hysterectomy or myomectomy for fibroids have…

… an unsuspected type of uterine cancer called uterine sarcoma. If laparoscopic power morcellation is performed in these women, there is a risk that the procedure will spread the cancerous tissue within the abdomen and pelvis, significantly worsening the patient’s likelihood of long-term survival.

Now, a study out of the University of Michigan shows that post-operative complications in hysterectomies grew significantly following that FDA alert. Hospital readmissions went up by a quarter and there was a 27 percent jump in major surgical issues, excluding blood transfusions, following hysterectomies. At the same time, the number of morcellation hysterectomies decreased by 4.1 percent and vaginal and abdominal hysterectomies increased by 1.7 and 2.4 percent, respectively. (It’s interesting to note that the decrease in morcellation was among all women undergoing hysterectomies, despite the FDA advising against using the procedure specifically on patients with fibroids.)