Can a Hysterectomy Help Spread Uterine Cancer?

/

The FBI is now investigating a surgical tool often used in hysterectomy procedures that was found to spread cancer in women. They're also looking Johnson & Johnson, who is the largest manufacturer and whether to now the company knew of the tool's hazard before pulling it off the market in 2014. 

The tool is called a morcellator, once believed to be a breakthrough in technology for removing an enlarged uterus due to fibroids. It enabled the surgeon to use minimally invasive techniques for removal of any size fibroid or uterus through a tiny incision.

A power morcellator is  surgical instrument that cuts the uterus and fibroids into smaller strips of tissue, when then can be easily removed through a half-inch incision. 

Role of Morcellation

The key is minimizing the risk around using this tool. New data confirms the answer may not be to eliminate the tool altogether. This device has previously been used by many hospitals around the country to perform thousands of these "minimally invasive surgeries."

In April 2014, the FDA warned that women undergoing fibroid surgery have a 1 in 350 chance of spreading existing uterine cancer, which often cannot reliably be detected before the operation. 

For many surgeries, the issue is always that while a surgeon may be working to solve one issue around a particular area in the body, other areas could be damaged during the surgery and with cancer, extra caution is essential. 

When it comes to a uterine biopsy, the procedure should never use a power morcellator. Surgeons should use a "specimen bag" to separate the uterine tissue, eliminating the risk of spread in the abdomen and pelvis. 

For women over the age of 60, morcellation of the fibroids should be avoided or performed in a bag. 

Uterine Cancer Facts

  • The uterus is a hollow organ in females located in the pelvis, commonly called the womb. The uterus functions to support fetal development until birth. The uterus is shaped like an upside down pear; the top is the fundus, the middle is the corpus, and bottom is the cervix.
  • Uterine Cancer risk factors:
    • women with endometrial overgrowth (hyperplasia)
    • obesity
    • women who have never had children
    • menses beginning before age 12
    • menopause after age 55
    • estrogen therapy
    • prescription drug, Tamoxifen
    • radiation to the pelvis
    • family history
    • Lynch syndrome 
  • Signs and symptoms:
    • abnormal vaginal bleeding or discharge
    • pain with urination and sex
    • pelvic pain