FDA Warns of Cancer Risk in a Type of Uterine Fibroid Surgery
Article date: April 22, 2014
By Stacy Simon
The US Food and Drug Administration (FDA) is warning women and doctors about the risks of a certain technique used in surgery for uterine fibroids. The procedure, called laparoscopic power morcellation, uses a medical device to break uterine fibroids into small pieces, so they can be removed through a small incision in the abdomen. According to the FDA, if the woman also has uterine cancer, this procedure can risk spreading the cancer within the abdomen and pelvis, making it harder to treat.
Uterine fibroids are non-cancerous growths in the uterus. They are very common and often do not cause symptoms. However, fibroids sometimes do cause problems such as heavy or prolonged menstrual bleeding, pelvic pressure or pain, and frequent urination. If these symptoms are severe enough, the fibroids may need to be treated.
One option has been surgery to remove the uterus (hysterectomy). One way to do this is through a large incision in the lower abdomen. Another option is to remove the uterus (or the fibroid) using laparoscopy, which only requires a few small incisions. The smaller incisions mean a much shorter recovery time for the patient. It may not be possible, though, to remove the uterus (or fibroid) through a small incision without first breaking it up into small pieces. In rare cases, a doctor may discover after the procedure that the woman doesn’t just have fibroids – she also has uterine sarcoma, a type of cancer. There is currently no reliable method for predicting whether a woman with fibroids may have uterine sarcoma.
The FDA looked at studies about the use of power morcellation to find out how often problems occur. They found that about 1 in every 350 women treated for fibroids by having their uterus or fibroids removed was later found to have uterine sarcoma. Diagnosis was made when the tissue removed at surgery was examined under a microscope.
The FDA plans to hold a public meeting of its obstetrics and gynecological medical devices panel to discuss power morcellation and possibly consider requiring a warning of the risks. For now, the FDA is discouraging the use of this procedure to treat fibroids and urging women to discuss the risks and benefits with their doctor when choosing how to treat fibroids:
- Discuss with your doctor all the options available to treat the condition, including the risks and benefits of each option. A number of other treatment options are available for fibroids, including abdominal and vaginal hysterectomy, and non-surgical options.
- If laparoscopic hysterectomy (surgery to remove the uterus) or myomectomy (surgery to remove the fibroids) is recommended, ask your doctor if power morcellation will be used, and why it is the best option for you.
- If you have already had a hysterectomy or myomectomy for fibroids, you were already tested for cancer at that time. If you were informed the test was normal and you have no symptoms, continue with your regular doctor visits. If you do have symptoms, report them to your doctor.
Reviewed by: Members of the ACS Medical Content Staff
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