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Washington Woman Suffers Stage IV Cancer After Morcellation

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Like most women, 67-year-old Anita Austin had two choices as to how doctors would remove her problematic uterine fibroids. One was to go through traditional surgery, which would require a large abdominal incision. The other was to go through a laparoscopic procedure that used much smaller incisions and promised a faster recovery, but involved the use of a power morcellator.

According to Fred Hutchinson Cancer Research Center (FHCRC), Austin discussed it with her doctor. It seemed to be a “no-brainer.” No one mentioned a possible risk of cancer. So in February 2011, she went through the laparoscopic procedure. After it was over, she was diagnosed with high-grade cancer.

Women with Cancerous Tissues at High Risk

It’s rare that women will have cancerous tissues in or around uterine fibroids. The FDA recently estimated that about one in 350 women going through a hysterectomy or myomectomy for fibroids will have an unsuspected cancer called “uterine sarcoma.” Early detection methods for this type of cancer are limited. Currently, doctors have no way to determine for sure prior to surgery whether cancerous tissues may be lurking underneath the skin.

Though most women make out perfectly fine with uterine fibroid removal via a power morcellator (which cuts up larger tissues for removal through small incisions), those like Anita who have preexisting cancers are at a high risk of suffering a life-threatening diagnosis. When the morcellator cuts up cancerous tissues, it is likely to spread tiny pieces around the body, where they can re-seed other cancers. The resulting diagnosis is much more serious and threatening than the original localized cancer.

“The tumor cells were Stage 1,” Austin told FHCRC. “But they blasted it all over.”

Other Women Receive Surprising Diagnoses

Like other women who have suffered a serious cancer diagnosis after morcellation surgery, Austin is now going through treatment at the Seattle Cancer Care Alliance for Stage 4 leiomyosarcoma. A mother of two, she is one of many who have come forward to warn other women of the risks.

Dr. Amy Reed, for example, who was the first patient to tell the FDA about her upstaged cancer, suffered a similar diagnosis after going through laparoscopic surgery for uterine fibroids. She thought the procedure was a routine hysterectomy, when her doctor called her to reveal the bad news.

“The surgeon had ground up, or morcellated, the uterus and sarcoma inside my pelvis…” she writes. “So, in addition to being a 40-year-old anesthesiologist, intensivist and mother of six children…I was now a stage IV sarcoma patient.” She and her husband have launched a national campaign to ban the use of morcellators in uterine fibroid surgery.

FDA Warns About Risk

In April 2014, the FDA warned healthcare professionals to stop using the morcellator in uterine surgeries because of the cancer risk. Since then, a number of hospitals have suspended the use of the tools, and at least one insurance company will stop covering the procedure in September 2014.

Johnson & Johnson has also implemented a global recall of the morcellators they manufacturer. The FDA recently convened an expert panel to obtain recommendations for further action, but so far there has been no outright ban of the procedure.

Austin, who went through chemotherapy and was later diagnosed with new tumors in her spine, told the FHCRC that the most frustrating part was the lack of information. She noted that she had thyroid cancer in the past, and that had she known about the risks, she would have elected traditional surgery.

“Given my history, honestly, I should have been advised not to do it.”