Power morcellators have been used in laparoscopic surgical procedures for several decades. In women, two of the most common laparoscopic procedures performed are hysterectomies and myomectomies, as suggested by a surgeon for the treatment of uterine fibroids.
Pre-Surgical Testing Ineffective in Diagnosing Some Uterine Cancers
When a woman undergoes pre-surgical testing, doctors are not able to determine if the uterine fibroids contain uterine cancer. Power morcellators are used to chop up benign uterine tissue intended for removal, but if the blades of the device come into contact with cancer cells, the risk of metastasis is increased because the cells are distributed throughout the abdominal cavity.
Most uterine fibroids, or growths in the uterus, are benign. However, the U.S. Food and Drug Administration (FDA) reported recently that approximately one in 350 women who undergo surgery for uterine fibroids are actually harboring undetected uterine cancer. The most dangerous of these uterine cancers are known as uterine sarcomas, of which there are several types that can be potentially spread by morcellation:
Uterine leiomyosarcoma is the most common and deadly form of uterine sarcoma. Leiomyosarcoma tumors are extremely metastatic, and if they found to be in other areas of the body when diagnosed, there is only a 14 percent chance of a five-year survival rate, according to data compiled by the American Cancer Society.
Endometrial Stromal Sarcoma
Endometrial stromal sarcoma begins in a layer of the mucous membrane called the endometrium, and is considered less aggressive than leiomyosarcoma, meaning it will not typically spread as quickly.
Undifferentiated Endometrial Sarcoma
Undifferentiated endometrial sarcoma is considered a high-grade version of endometrial stromal sarcoma, and is usually much more aggressive.
Carcinosarcoma is a very rare and aggressive form of uterine sarcoma, and has only a 35 percent five-year survival rate.
Although the FDA has issued warnings about the cancer risks associated with morcellation, the devices have not been removed from the market, although recommendations were made regarding screening out patients for whom morcellation might present accelerated risks, such as women over 50 or those considered high risk for uterine cancer.