Dr Oz: Could a Hysterectomy Spread Cancer?
Hysterectomy is at the center of a civil war in medicine. Dr Oz said he used to think it was one of the safest surgeries out there. But a colleague reached out to share the story of his wife, who “was diagnosed with widespread cancer after undergoing a minimally invasive hysterectomy for Fibroids.”
Since that patient’s operation, the device used in the procedure was taken off the market by its manufacturer, because it could “spread hidden, undiagnosed cancer.” The Morcellation technique was believed to be safer than a standard Hysterectomy, because it was minimally invasive.
Dr Oz: Morcellation Cancer Risk
Now, patients and doctors are questioning whether this procedure spreads cancer. While OB/GYNs disagree with this opinion, manufacturer Johnson & Johnson has removed the Morcellator from the marketplace. The FDA has also issued an advisory to discourage this procedure.
One in three women will have to decide on a Hysterectomy procedure at some point in life. Doctor Oz wanted to share the facts: 10% of women use Morcellation for a Hysterectomy. One study concluded that one in 368 women who had this procedure received a cancer diagnosis.
Despite concerns and an FDA advisory, the American College of Obstetricians and Gynecologists believe the cases can be considered “rare” in terms of spreading cancer due to Morcellation.
Dr Oz: Temple University Bans Morcellation
Fibroids are the biggest reason women undergo Hysterectomies, and Morcellation was attractive because it was minimally invasive and resulted in a shorter recovery time. Dr Lauren Streicher illustrated how the procedure would work, which looked very involved.
The question was whether small bits of cancer could be spread if a doctor did not know they were there. Dr Larry Kaiser, dean at Temple University School of Medicine and CEO of Temple University Health, was the first to ban Morcellation at his facility in January 2014.
Dr Kaiser said that it seemed like the right thing to do, since the unintended consequences could potentially be fatal. From the same institution, OB/GYN Dr Enrique Hernandez said that doctors need to make sure they are not exposing patients to a greater cancer risk.
Dr Oz: Surgery Spreading Cancer
Sarah, a patient who had Fibroids on her Uterus, underwent a Morcellation procedure and was later diagnosed with Cancer. No one knew ahead of time that Sarah had this cancer. But the procedure spread her Cancer throughout the body, whereas it would have otherwise been removed before it could travel through the body.
“I’m going to prematurely die of this cancer,” Sarah told Dr Oz. Dr Oz used an animation to show how Cancer cells could be spread when a Fibroid is being removed laparoscopically, perhaps getting into the bloodstream.
Dr Oz: ACOG Statement
The American College of Obstetricians and Gynecologists shared a statement with Dr Oz:
“If an occult cancer is present and morcellation is used during surgery, there is a risk that the cancer may spread and worsen the patient’s outcome.”
Dr Oz: Safer Method of Morcellation?
Dr Streicher, a professor and OB/GYN at Northwestern University, has performed Fibroid operations using Morcellation, and she said every surgeon wants to reduce the prospect of complications.
However, she believes that taking Morcellation off the table will increase a patient’s risk for complications from other operating methods, as well as a longer recovery time. She advocated for making the procedure safer.
She said that she and others are now doing Morcellation in an unbreakable bag, to prevent fragments or stray cells from escaping and traveling elsewhere in the body. “The Morcellator is not causing the cancer, and we need to make sure that women have the option to make a procedure as safe as possible,” she said.
Dr Oz: Is Morcellation Dangerous?
Doctor Oz said that he is concerned about the increased risk, and that patients may not be fully aware of the risks. Dr Streicher agreed, but noted that she thinks presenting the facts and letting patients make a decision is the right move.
Dr Kaiser shared his perspective, calling the continued use of this procedure “a real violation of surgical principles.”
Dr Oz: Johnson & Johnson Morcellation Statement
Johnson & Johnson, one of five companies who produced Morcellation devices, shared a statement with Dr Oz about their decision to take their product off the market.
“Due to this continued uncertainty…a market withdrawal…is the appropriate course of action at this time until further medical guidelines are established and/or new technologies are developed to mitigate the risk.”
Dr Oz: Morcellation Conversation
Cancer patient Sarah said that the company is doing too little, too late. Dr Oz offered his thoughts, seeming to lean toward the recommendations of the FDA, Dr Kaiser, and others who are against Morcellation.
Doctor Oz urged women to have a conversation about this topic if they need to have any work done on the Uterus.