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Fighting to Ban Morcellators

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Doctor Fighting to Ban Morcellators has Cancer Recurrence

The Inquirer
Marie McCullough, Inquirer Staff Writer
Posted: Thursday, March 5, 2015, 1:08 AM

Amy Reed, the doctor who has pushed for a ban on the gynecological surgery device that worsened her uterine cancer prognosis, said Wednesday that she is fighting a recurrence.

Reed, 41, had about a year in apparent remission after her 2013 diagnosis and treatment for leiomyosarcoma, a rare and ferociously aggressive uterine cancer.

Two weeks ago, she had surgery at the Hospital of the University of Pennsylvania to remove a small tumor that a scan revealed in the bony part of her spinal column. Radiation is next.

‘I had never had back surgery. They took out some bone and put in two rods. It hurts,’ she said as her six children played nearby in their Bucks County home. ‘But I’m able to go up and down steps. And we were fortunate that [the recurrence] was there and not somewhere else. They were able to remove it all.’

It’s the latest chapter in a story now known internationally. Reed, an anesthesiologist, and her husband, heart surgeon Hooman Noorchashm – both trained at Penn – had flourishing, Harvard-affiliated careers in Boston. Then, in October 2013, she had a hysterectomy for what doctors presumed were the benign growths called fibroids. But preoperative tests can’t distinguish fibroids from sarcoma.

Her surgery was done with an electric morcellator, a dissecting device that enables the tissue to be removed through small abdominal incisions rather than a big tummy incision, speeding recovery.

But the device hurled about bits of cancer that implanted throughout her abdomen and pelvis, worsening an already bad disease.

Before Reed and Noorchashm turned their tragedy into a public health campaign, doctors thought her complication was ultrarare, maybe one in 10,000 women who have a hysterectomy. The U.S. Food and Drug Administration now estimates up to one in 350 women undergoing hysterectomy with power morcellation may have a hidden cancer.

Although the FDA hasn’t banned the device, it has issued warnings that have sharply curtailed usage. Most major hospitals now eschew the device. The leading maker took its brand off the market last year. And just days ago, UnitedHealth Group Inc., the nation’s largest health insurer, began requiring doctors to obtain authorization for most types of hysterectomy.

Gynecological medical groups, however, defend using the tool in minimally invasive surgery, especially when it enables younger women to avoid a hysterectomy and preserve fertility.

For Reed, the debate seems senseless. ‘There are some days when I . . . feel, yeah, we’ve won. But most of the time, it’s completely frustrating that these devices are still out there and there are doctors – albeit not many – using them.’

‘Morcellation makes cancer worse,’ she said.

Last summer, she and her husband moved back to the Philadelphia area, where they have a large extended family. He is now working at Thomas Jefferson University Hospital. She was working part-time at Penn, and hopes to return this spring.

They have not tried to hide the reality from their children. ‘We say, ‘Everyone dies. It’s the way we’re made.”

She and her husband vow to keep their campaign going. Noorchashm has expanded it – with often combative e-mails to regulators, lawmakers, and medical groups – to warn about weaknesses in the federal approval process for medical devices.

‘Sometimes,’ he said, ‘Amy and I feel like we’re in a dark room that’s filling up with water. It’s not a kind cancer. But we are not in sob-story mode.’

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