Post laparoscopic hysterectomy (morcellation) of endometrial adenocarcioma

I had heard that laparoscopic surgery  because of the method can cause  spread,therefore I reasoned the method in my head , then I refused it and insisted on vaginal  complete hysterectomy.

Method; Diseased  organs are cut up into small pieces and pulled through the small openings in abdomen, My question to surgeon,  What happens to bits of cancer cells that may fall off in my abdominal cavity  enroute,  and those tiny bits thats left at   site  from the cuttings ?  will they not stick to whatever organs they fall on,?  " We hope that  doesn't happen ",was the answer   so for that and other reasons   I declined the method.

However,I had uterus,  overies  and fallopian tubes  removed  completely intact ,just the connecting  ligaments and tissues were cut not the organs themselves, none of those organs were opened inside of my body and was sent to pathology  dept to be disected.   YET  on this date 9 months later  recurrence happened in my abdomen . even with no lymph node involvement  at surgery and even to date ,no lymph node involvement.  It begs the question, How could this be ?  NO BODY ALIVE KNOWS.

Our guess is as good as the doctors , They don't know much about this cancer  neither do we.  So once your surgery is already done you can't change anything so don't import worry ,If you haven't yet had surgery then reach out to the doctors for answers then do your analysis and make decisions accordingly.

That's how my uterine cancer was found.  I had no idea I had cancer until after the procedure was done.

Double Whammy said:

This has been a newsworthy item

because it happened to a physician who went in for what she thought was a routine hysterectomy.  and even with her knowledge, she didn't "get it" and had laparoscopic surgery with everything being removed chopped up in a bag via the small incisions.  And guess what?

I was completely naive before my robotic assisted laparoscopic hysterectomy but for some reason I asked "how will you get it out"?  At that time, I was told that whenever cancer is suspected, organs are removed intact, so while I had laparoscopic surgery, my uterus, ovaries, fallopian tubes and I assume lymph nodes were all removed intact,  vaginally.  Glad I was asleep. ...

I hope the morcellation procedures will cease to exist, the bottom line is they really don't know if everything is ok, until it is out and sent to pathology.  I guess it is a known risk yet it is still happening.  So sorry that it happened to you.

Suzanne

molimoli said:

laparoscopic surgery.

I had heard that laparoscopic surgery  because of the method can cause  spread,therefore I reasoned the method in my head , then I refused it and insisted on vaginal  complete hysterectomy.

 

Method; Diseased  organs are cut up into small pieces and pulled through the small openings in abdomen, My question to surgeon,  What happens to bits of cancer cells that may fall off in my abdominal cavity  enroute,  and those tiny bits thats left at   site  from the cuttings ?  will they not stick to whatever organs they fall on,?  " We hope that  doesn't happen ",was the answer   so for that and other reasons   I declined the method.

However,I had uterus,  overies  and fallopian tubes  removed  completely intact ,just the connecting  ligaments and tissues were cut not the organs themselves, none of those organs were opened inside of my body and was sent to pathology  dept to be disected.   YET  on this date 9 months later  recurrence happened in my abdomen . even with no lymph node involvement  at surgery and even to date ,no lymph node involvement.  It begs the question, How could this be ?  NO BODY ALIVE KNOWS.

Our guess is as good as the doctors , They don't know much about this cancer  neither do we.  So once your surgery is already done you can't change anything so don't import worry ,If you haven't yet had surgery then reach out to the doctors for answers then do your analysis and make decisions accordingly.

 

 

 

This debate has also been going on in the UK.  I had no idea this procedure even existed and I am horrified that it should be performed on anyone, whether or not cancer is suspected.  Womb cancer is a sneaky beast and can be there even when it's not expected!  After atypical hyperplasia was found during a D&C, I had an "open" hysterectomy, with everything removed intact.  My surgeon wouldn't consider anything else - he wanted a good look around!  Pathology came back clear - no cancer.  Even with all that care, I had a "recurrence" in the pelvis 7 years later.  Like Molimoli, no one can explain it.  I have no lymph node or organ involvement.  At first it came back at the vaginal vault, which was treated with radiotherapy, then surgery and chemo.  Then it came back again on the pelvic sidewall.  Surgery not possible due to the location, so now on anti-hormone therapy (tamoxifen) and finished a course of Cyberknife radiotherapy last October (just had a scan and will know in a week or two if it has had any effect).  I don't believe I will ever be NED again, but I have adjusted to a new normal and I enjoy every day.  I have even started helping half a day a week at a horse rescue centre - something I never thought I would have the energy to do ever again!

Kindest wishes
Helen

molimoli said:

I WISH YOU continued energy spurts.

Wonderful Helen ,you seem to be taking things in it's stride, getting out doing something you love, thats great.   sorry about the recurrences  I wish them away 

.  but the journey comes with them, it seems , These uterine diseases are all so resistant to treatment ,with  only luck of the draw long remission, that seem to be all that we can hope for realistically .

Have you had much side effects from the treatments you have had,? Do you feel comfortable sharing?,if you don't  that's ok too. WE all understand  'not feeling up to it'.

 Happy to hear the acceptance of the new normal. Acceptance lightened my load, gave me peace of mind and steared me away from the the unclimbable mountains to little hills that I can climb one day at a time.

I found that acceptance In Sept  when one of  my oncologist [  head of the dept ]  said,  "Don't waste precious time worrying  about if it's coming back I can assure you it will always find it's way back, no matter what we do  it"s the when that we will try to control not the if,  until someone finds the cure I am  your UPSC manager that.s all.. " and in true  Peewe Hermon Style  I  blurted out  " I knew that"  She Shook her head  ,rolled her eyes  gave me a squeeze on the shoulder, She knew that I sensed that but needed to hear it from her,   That was my AHA !! moment. Worry will change nothing.I began to live again

                                                                             Moli. 

You describe it so well.  My "aha" moment came when the third recurrence appeared.  By then, I knew that if it had survived radiotherapy, two lots of surgery and chemo, that it wasn't going to lay down and die with any of the currently known treatments.  But neither was I, darnit!  To be honest, it was a horrendous week.  We'd just moved house the day before the news of the 3rd recurrence and my dearly loved dad died a few days later. 

 But I picked myself up, got on with what had to be done and decided that whether the time left was long or short, I was going to enjoy it, get rid of things that stress me (like work) and LIVE!  I don't have a bucket list, I just enjoy each day.  But I am a little less tolerant of spending time doing things that I don't enjoy!

As for side effects.  Well, the second surgery was hard.  It involved a colostomy which took some getting used to.  But it really has just become a part of my life now and I don't really think about it much. The chemo was tough while it lasted but I am so lucky that I have no lasting side effects from it apart from a very sllight numbness in my big toes some days!  The hormone therapy is much more manageable.  Apart from the hot flashes and night sweats I really wouldn't know that I was taking anything!

Now I wait to hear whether the Cyberknife radiotherapy that I had in October has had any effect.  In the meantime, I stay on tamoxifen to starve the little devil of what it needs to grow!  I feel well and, apart from a slight lowness of mood, caused by the awful wet, dark British winter, I am fine. 

As you say, worry will change nothing.  I don't think anyone has ever slid into their grave thinking "I wish I'd worried more"!

Kindest wishes
Helen

I was diagnosed with anal cancer (very rare) in March of this year.  I also have been diagnosed with dysplasia on my cervix and was scheduled for a LEEP.  These cancers are related.  I have been experiencing pain in my right ovary, so the doctor did a pelvic ultrasound.  Fibroids were found, so condsidering my other history, I am to discuss a hysterectomy next week with him.  My reason for posting is that the nurse explained he does the da vinci method with morcellation.  I had remembered seeing something about this spreading cancer if cancer is present from several months ago.  I have been researching this for the last several days and am horrified.  My doctor is on vacation this week, so I cannot speak with him.  I don't even really know him, as I am a new patient.  I am standing my ground and refusing this type hysterectomy.  Granted I have to give him a chance to give me other options and not make assumptions, but my question is this ... Why in the world would any doctor take a chance?  Sure, as I have read the odds are low, but again why take a chance?  The odds are low for a lot of things but since I am already one of the few that will get anal cancer this year, seems my odds went up just with that fact alone.  I am also curious as to why there is not more outrage.  This type of surgery should be banned ... period. 

ConnieSW said:

Yes

I agree!

it seems that morcellation would not be considered and that you should be referred to a gynecologic oncologist.  Maybe you are and it may be that the nurse is not aware that your doc would not do morcellation in your case.  I remember my pcp thought I would be having morcellation and I was much too stupid to even question it.  She was wrong because she's not a surgeon nor a cancer specialist.  I asked prior to my surgery how the organs would be removed because I got smarter as the days got closer.   I did have robotic surgery but my organs were removed - intact - via my vagina.   and that's what they do when cancer is suspected - the organs are removed intact, not all chopped up and put in a bag! 

There are lots of ways to do a hysterectomy.  "Given your history" and knowing what you know, I would refuse morcellation and ask for referral to someone else if you learn that this is the procedure that the SURGEON (not a nurse) says will be done.  You may be relieved when you actually have an appointment.  I hope so.

Suzanne

Double Whammy said:

'Given your history" . . .

it seems that morcellation would not be considered and that you should be referred to a gynecologic oncologist.  Maybe you are and it may be that the nurse is not aware that your doc would not do morcellation in your case.  I remember my pcp thought I would be having morcellation and I was much too stupid to even question it.  She was wrong because she's not a surgeon nor a cancer specialist.  I asked prior to my surgery how the organs would be removed because I got smarter as the days got closer.   I did have robotic surgery but my organs were removed - intact - via my vagina.   and that's what they do when cancer is suspected - the organs are removed intact, not all chopped up and put in a bag! 

There are lots of ways to do a hysterectomy.  "Given your history" and knowing what you know, I would refuse morcellation and ask for referral to someone else if you learn that this is the procedure that the SURGEON (not a nurse) says will be done.  You may be relieved when you actually have an appointment.  I hope so.

Suzanne

I am hoping you are right.  I don't usually panic about things.  In fact, with the anal cancer I was calm as can be.  I even questioned what was wrong with me not getting all worked up about it (probably numb).  However, since my last surgery for it, I seem to be really hyper-sensitive about anything else being done.  I will definitely let him do the talking and see what he has to say, but I will be ready with a response if he talks about morcellation.  I did a little checking around and saw a female group of ob/gyn doctors that prefer a vaginal hysterectomy.  Hopefully he will take everything into account like you said. 

Vaginal is still a good way to go with my history ... right? 

Michelle