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Fibroid Surgery Could Awake Hidden Cancer

IOWA CITY, IA (CBS2/FOX28) Uterine fibroids are the most common benign tumors in women. They effect up to 40 percent of women. In Caucasian women, that number is as high as 60 percent. They are most common in women in their later reproductive years. Yet, while they are common, most women dont have symptoms.
 If a fibroid doesnt bother the woman, then it doesnt bother the doctor,   Divya Shah, M.D, Clinical Assistant Professor of Reproductive Endocrinology and Fertility at the University of Iowa in the OBGYN Department said.
The size of a fibroid or the fibroids specific location within the uterus determines whether it causes a problem. When a woman does have symptoms, fibroids can cause heavy bleeding, fertility issues or pelvic pressure due to a large mass. Thats when women can elect to do something about their fibroids.
There are basically four approaches to dealing with fibroids. Some women tolerate the symptoms and dont treat them. For heavy bleeding, some take medications. There are a number of medications that are good at controlling bleeding. However, medications are not as good at eradicating fibroids.
 Embolization is another option. In embolization, a catheter injects small particles into the uterine arteries that supply blood to fibroids and the uterus its like cutting off a food supply keeping the fibroids from growing. Its laparoscopic and doesnt leave much of a mark. 
In some cases, with larger masses, surgery is the best option. Again, the surgery is usually laparoscopic. If the mass cannot be passed through the vagina, doctors may use a surgery technique called morecellation.  Morecellation cuts the mass into long strips so theyll fit through the small incision. But, with morecellation, comes the possibility of disturbing hidden cancer cells.
Its not about the fibroids turning into cancer, but is more about the presence of a previously undiagnosed cancer in something that we thought was just a fibroid, Shah said.
The theory is that cancer cells, by being broken apart, have been exposed to other parts of the abdomen.
An early stage cancer is typically a cancer that is confined to an organ, like confined to the uterus. But, if we remove the mass form the uterus and break it up in little pieces to remove it from the body, by definition, weve upstaged the cancer, Shah said.
Out of three studies conducted, researchers found the hidden cancer can explode  between .08 percent of the time and .49 percent of the time. That means, at most, one out of every 200 women that undergo a procedure for what they think is a fibroid, could end up with a hidden cancer called Leiomyosarcoma. Leiomyoscarcoma is very aggressive.
 What we know is that cancer is very, very rare and so and the overwhelming majority of the time if you go in thinking something is a fibroid its just a fibroid, Shah said.
There isnt a test to know for sure if a fibroid is cancerous ahead of surgery. 
If a patient is concerned, they can elect to have an incision large enough to remove the mass while its in tact.
That would keep a potential cancer from spreading during the morecellation procedure. However, that doesnt mean a hidden cancer wouldnt eventually become stage four anyway.
Keep in mind, if morcellation did lead to a cancer ballooning to stage four,  doctors say it could happen with any procedure which cuts into cancer. Cancer can simply go wild when it is disturbed, especially when it is an aggressive form of cancer like, Leiomyosarcoma.
 Also, click here to read why a Boston surgeon says morecellation worsened his wifes cancer:


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