Can laparoscopic surgery spread cancer cells?

New data shows less invasive operation causes more deaths for women with cervical cancer

In news that may appear counter-intuitive, two studies have shown a higher death rate for a less invasive version of a cancer operation in women.

According to a recent Associate Press story by Carla K. Johnson, the new evidence challenges standard practice "and the 'less is more' approach to treating cervical cancer."

The article notes that the unexpected findings already "are prompting changes at some hospitals that perform radical hysterectomies for early-stage disease."

Dr. Pedro Ramirez

Dr. Pedro Ramirez of the University of Texas MD Anderson Cancer Center in Houston, who led the more rigorous study, says that after the results became known "we immediately as a department changed our practice and changed completely to the open approach."

Findings from his study, which was conducted at more than 30 sites in a dozen countries and were published in the New England Journal of Medicine, showed "women who had the less invasive surgery were four times more likely to see their cancer return compared to women who had traditional surgery."

Dr. Jason Wright of New York-Presbyterian Hospital, a co-author of the other study, says "we're rethinking how we approach patients. There's a lot of surprise around these findings."

And Dr. Amanda Fader of Johns Hopkins Kimmel Cancer Center, explaining that the Baltimore hospital "has stopped doing less invasive hysterectomies for cervical cancer until there is more data," is quoted as saying the new research "is 'a great blow' to the [newer] technique and the findings are 'alarming.'"

Surgeons, she adds, ""should proceed cautiously."

In both studies, Johnson's story says, "researchers compared two methods for radical hysterectomy, an operation to remove the uterus, cervix and part of the vagina. The surgery cost around $9,000 to $12,000 with the minimally invasive version at the higher end."

Traditional surgery involves a cut in the lower abdomen; in the newer method, laparoscopic surgery, from which patients recover more rapidly, small incisions are made for a camera and instruments.

Some experts believe the reason for the higher death rate is because "there may be something about the tools or technique that spreads the cancer cells from the tumor to the abdominal cavity," AP's article reports.

More information on research into cancer for both men and women can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.