It all began after the birth of Amy Reed's sixth child. Reed, an anesthesiologist knew she had fibroids, but they had never bothered her until that point. One had now grown so large that it was visible when she lay on her back. She was also having trouble with increased bleeding, as well as an unusual discharge.
So Amy's husband, Hooman Noorchashm, a surgeon arranged for her to consult with a gynecological oncologist. The oncologist reassured her that it was a perfectly normal fibroid and recommended its removal. After exploring the options, Reed decided to have a laparoscopic hysterectomy.
In order to remove a uterus laparoscopically a device known as a morcellator is sometimes used. Essentially, a morcellator chops the uterus up into small pieces that are removed via the vagina. Depending on the size of the uterus or fibroids being removed, they might be too large to remove laparoscopically without morcellation. The advantage to the surgery is a quick recovery time, relative to a traditional hysterectomy.
Unfortunately, in Amy Reed's case, the surgery had a major drawback. Eight days after the surgery, she got a call from her Surgeon who told her that pathology tests on the removed tissue had found cancer, specifically leiomyosarcoma.
When Hooman Noorchashm heard the diagnosis he was horrified. As a surgeon, he knew that when sarcomas are removed surgically, they need to be removed in one piece, along with a fair bit of the surrounding tissue to ensure that no loose cells are left to spread. By morcellating Amy Reed's tumour, they had essentially sprayed her abdominal cavity with cancer cells, moving her from what was probably stage 1 cancer to Stage 4. She was the second patient at her hospital that year to have her cancer upstaged by morcellation, and since Red and Noorchashm started a crusade to have this type of surgery banned, 5 more women have come forward.
During his research, Noorchashm discovered that the risk of leiomyosarcoma in women with symptomatic fibroids is far higher than for the general population (1 in 10 000 for the general population, closer to 1 in 416 for women with systematic fibroids. Shockingly, the oncologist who told Amy Reed her fibroid was perfectly normal was one of the coauthors on the paper that established this) and leiomyosarcoma cannot be detected by MRI's or biopsies prior to surgery.
Given these facts in March, the FDA issued a warning against morcellation, and held hearings into the use of the device this past July. Johnson and Johnson, the largest manufacturer of morcellators has suspended their production and sale.
As for Amy Reed? She has opted to aggressively treat her cancer and has had a radical procedure known as the Sugarbaker operation. Her "appendix, gallbladder, omentum (the fatty covering of the intestines), and peritoneum were removed" and surgeons poured heated chemotherapy medicine into her abdominal cavity and left it there for 90 minutes. She has been told that if the surgery is successful it would give her an 80% chance of having no reoccurrence of her cancer for 10 years.
A radio documentary from the CBC radio program The Current is available here: