Chhavi Mittal, a breast cancer survivor, recently underwent surgery to remove a uterine fibroid. Taking to Instagram, the Family Vacation actor revealed that the fibroid had grown quickly due to the Tamoxifen medication she was taking. Expressing her frustration with the constant ups and downs of her health, further elaborated: “I hate this. This constant going back to square one and finding myself “recover” then “restrengthen” only to spiral back when I feel it’s all behind me. I’m not afraid, just irritated.”

Dr Jeyhan Dhabhar, Consultant Medical Oncology and Immunotherapy Expert at Jaslok Hospital and Research Centre, Mumbai, says fibroids are extremely common. They are non-cancerous growths arising from the muscle of the uterus, and in many women they may not cause any symptoms at all. Simply having a fibroid does not mean that a woman needs surgery, but at the same time, one should not take them lightly.

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Dr Dhabhar explains that doctors generally consider surgery when fibroids start affecting a woman’s quality of life — for example, “very heavy or prolonged menstrual bleeding, anaemia, significant pelvic pain or pressure, urinary symptoms, rapidly increasing abdominal distension, fertility-related problems”, or when there is uncertainty about the diagnosis.

 

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According to him, the type of surgery depends on the woman’s age, symptoms, size and location of the fibroids, and whether she wishes to preserve fertility. “In some cases only the fibroids are removed, which is called a myomectomy, while in selected women a hysterectomy, or removal of the uterus, may be advised,” he tells indianexpress.com.

Does a history of cancer increase risk?

For a cancer survivor, Dr Dhabhar says that previous history of cancer does not automatically make fibroid surgery dangerous. “The risk depends much more on the type of cancer they had, the treatment they received, how long ago the treatment was completed, and their present health,” he informs.

For example, he says that previous chemotherapy or radiotherapy may sometimes have an impact on blood counts, immunity, wound healing or organ function. If the patient is currently receiving cancer treatment, the timing of surgery also becomes important, he adds.

Another consideration is women who have had hormone-sensitive cancers such as certain breast cancers, like Mittal. In such patients, Dr Dhabbar informs that the gynaecologist and oncologist should review any ongoing hormonal treatment and the proposed management together.

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So, rather than labelling fibroid surgery as inherently high-risk for cancer survivors, he believes it needs to be individualised. “If the cancer is under control, the patient has recovered adequately from treatment and her pre-operative assessment is satisfactory, many cancer survivors can undergo fibroid surgery safely,” he shares.