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If a woman is diagnosed with “fibroids,” it’s usually not a major concern. Affecting about 20 percent of women, fibroids are typically non-cancerous tumors that grow in the uterus. If they’re causing no symptoms, often they are just left alone. Medications may help to shrink them, or to ease symptoms. When drugs don’t work, however, surgery may be necessary to remove them.

Though there are a number of different surgery options, one of the most popular is called “open power morcellation,” in which the surgeon can remove the fibroid or even the entire uterus through a small incision, using a laparoscope. Recent reports, however, have indicated that in some cases, this procedure could lead to serious cancers.

Procedure Linked to Aggressive Cancer

The New York Times reports that when performing morcellation, surgeons use either a knife or an electrical device with a spinning blade to cut the affected tissue into small pieces that can then be pulled out through tiny incisions. Considered a minimally invasive procedure, it typically allows for faster recovery, less scarring, and a reduced risk of infection, when compared to traditional surgery.

The scientific journal JAMA, however, recently published an article expressing concern about the procedure. The problem is that though most fibroids are non-cancerous, a few rare ones are malignant. Cutting up malignant tissues into small pieces increases the risk that some of those pieces will migrate to other areas of the body, where they will seed new cancers.

That was what happened to Dr. Amy J. Reed, who developed a rare, aggressive uterine cancer after going through morcellation. She has started a campaign to stop the use of the procedure. “A review of the literature reveals that 1 in 415 women who go for fibroid surgery actually has sarcoma [cancer],” she writes. “This means that every day 2-5 women in the U.S.—and more around the world will have a deadly cancer spread because of morcellation.”

Journal Questions Safety of Procedure

A study published in JAMA on March 5, 2014, states that gynecologic surgeons have embraced laparoscopic techniques because they offer faster recovery and less postoperative pain. When laparoscopic electric morcellators were introduced in 1993, the technique achieved wide adoption.

Recently, however, the same journal notes that the process “may disperse fragments of undetected malignant tumors throughout the abdominal cavity and upstage otherwise contained cancers.” They go on to state that since it’s difficult to detect the presence of these cancerous tumors before surgery, the procedure may, in fact, “be too risky under any circumstance.”

An editorial by OBG Management Editor in Chief Dr. Robert L. Barbieri acknowledges the risks, but suggests the adoption of a similar procedure that uses a “closed environment, such as a bag” to contain the small bits of tissue so they are unable to escape. Such an adjustment may result in a larger incision, however.

Risks are Great and May Include Premature Death

All medical experts looking into the procedure state that for some women, the risks will be great. Dr. Barbieri states that “for an occasional woman, open power morcellation may be associated with the intraperitoneal spread of an occult leiomyosarcoma. This may result in the upstaging of the cancer and may cause premature death.”

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