I have heard that sometimes when physicians conduct a hysterectomy where the uterus was shredded/broken down and removed through small incisions then biopsied, cancerous cells could be detected during the biopsy.  And that the presence of those cancerous cells may remain in the abdominal cavity post-procedure, which may spread and continue to develop.  Some women who this happened to ended up having to go through a intense radiation therapy treatment to remove the cancerous cells.

In April of 2014, the U.S. Food and Drug Administration (F.D.A.) published a warning between hysterectomy, myomectomies, and cancer when the Morcellation Procedure is used.  The Morcellation Procedure uses a small “power saw” called a Morcellator to slice and dice the tissue. A myomectomy is a surgery performed to remove uterine fibroids (which are noncancerous masses of growth inside the uterine wall). The procedure is similar, the tissues are broken up, possibly releasing any cancerous cells into the abdominal cavity.  The F.D.A. found that 1 in 350 women undergoing these procedures have ” anunsuspected uterine sarcoma, a type of uterine cancer that includes leiomyosarcoma.” If these tissues are ruptured and/or shredded, it may spread the cancerous cells throughout her abdominal cavity.  “For this reason, and because there is no reliable method for predicting whether a woman with fibroids may have a uterine sarcoma, the FDA discourages the use of laparoscopic power morcellation during hysterectomy or myomectomy for uterine fibroids.”

In 2015, AETNA ended coverage of most procedures using the morcellator.   In May 2015, the FBI opened an investigation of Johnson & Johnson to see if they knew of the risks of spreading cancerous cells.

A report published in 2017 found that using specific specimen bags (in this instance, the Espiner EcoSac 230) led to fewer complications or spreading of cells and no bag-breakage during procedures.

So it has been suggested:

1. If you have any history of uterine, ovarian, pelvic, or some sort of abdominal cancer in your family, avoid the “shredding” hysterectomy/myomectomy, known as the Morcellation Procedure.  Even if you don’t have a family history for any of these cancers, you may want to play it safe and avoid this procedure.
2. Don’t get a hysterectomy unless absolutely necessary.
3. If you DO need a hysterectomy or myomectomy, see if your physician can perform the vaginal hysterectomy, or conventional hysterectomy which removes the uterus as a whole, rather than breaking it down into pieces (thus avoid “freeing” the cancerous cells inside your abdominal cavity).
4. In light of new research, also talk to your doctor about the possibility of using a contained specimen bag if you opt to use a morcellator during surgery.

Is this post meant to terrify you? NO!  It’s meant to educate you, to push you to have thorough discussions with your physician, to educate you to ask these types of situations. I learned SO much today, and thank my Reader who prompted this topic.  Always, always, allllways have deep, intimate, and long talks with your physician.  It’s what we’re paying them for…

**Updated 4/6/17**

Resources:

AETNA

CBS News

Journal of the Society of Laparoendoscopic Surgeons

New York CBS News

The Telegraph

U.S. Food and Drug Administration

*Sunday is “Reader’s Choice” where my readers, friends, and family get to suggest a topic.  Today’s topic came from my friend, who shall remain anonymous, “There is a laproscopic procedure where they shred the uterus to remove it, and there are issues with cancer being spread throughout the abdomen by this if there is any cancer in the uterus.” So let the research began!  Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa