How Common Is Leiomyosarcoma?

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This is one of the very controversial areas because there is a lot of numbers out there. Sometimes you hear something is as high as 1 out of 350, or as low as 1 out of 10,000, and the truth is probably somewhere in between. Now a number like one out of 350, let's think about that, that really defies logic because we know that fibroids are incredibly incredibly common, and in fact probably about 80% of women have fibroids, most of them don't even know it.

And typically, patient comes to see me who has fibroids, I tell her if they are not bothering you don't do anything about it. If someone has fibroid that are bothersome, you might offer a uterus sparing option such miomectomy or fibroid embolization. Well, if 1/350 of those women had Leiomyosarcoma, first of all a lot of women will be dying, we will hear about it all the time and quite frankly, no gynecologist will recommend to a patient if they hang on to their uterus.

We will tell every woman with fibroids, you must have a hysterectomy, if there's one out of 350 chance. So the reality is that numbers are much lower than that. A new study is going to be published in the Journal of medicine, which puts the number at about one out 7500, which is a lot more accurate.

Even if I talk about my personal experience, over the last 15-20 years, I've treated probably about 40, 000 women with fibroids. Between myself and my partners, we've performed more isolation about 1000 times, I have seen exactly one case of leiomyosarcoma, and there was in a patient that was diagnosed prior to surgery.

My experience is very typical. If you talk to most busy gynecologist, they will tell you, that they see one maybe two cases of leiomyosarcoma during their entire career, so it's a rare cancer, but believe me, every surgeon that takes care women with fibroids, is highly motivated, to make dissemination of this cancer even rarer.

Now a lot of people have said that the moisolation[sp?] is dangerous, and the truth is it's not the mosolator[sp?] that's dangerous, it's leiomyosarcoma that's dangerous. This is a very serious cancer and even if someone has a traditional big open incision where the uterus is removed intact, only 40% of those women are alive five years later and that's because in most cases, the cells have already been disseminated prior to surgery.

So while a lot of people are saying, it's the moisolation[sp?] that's causing the problem, number 1, moisolation[sp?] doesn't cause that cancer, it's already there and number two well, absolutely I agree that moisolation[sp?] can spread a cancer and in most cases, the cancer has already been spread.

So, we need to do the best job we can, to identify women, who might be at risk, for having a cancer and they should not have moisolation[sp?]. And then because we can't identify every woman, we need to do a better job of making it safe. And right now our best option is to perform moisolation[sp?] inside an enclosed bag so that in the event that there is undetected cancer, the chance of those cancerous cells being released in seeding other areas of the bottom body will essentially be eliminated.