Princess of Wales, Catherine Middleton, Has A Potential Uterine Leiomyosarcoma (uLMS): A Delayed Diagnosis By Gynecologists At The London Clinic Will Not Be “Incidental”.
The gynecological “Assumption of Benignity” about symptomatic uterine fibroids in one in 200–400 women causes a dangerous delay in diagnosis of uterine Leiomyosarcomas. The Princess of Wales will have been placed at grave risk of harm by such a delay in the diagnosis of a putative uLMS.
It is my opinion that the Princess of Wales, Catherine Middleton, is highly likely to be battling an aggressive soft tissue cancer, known as Leiomyosarcoma. Though I sincerely hope and pray that my prognostication turns out to be false, I fear that it may not be.
I am compelled to write this analysis for the public good, because I am certain that if princess Catherine publicly announces a uLMS diagnosis, which I believe to be probable, elements within the gynecological leadership will very quickly attempt to obfuscate and deviate the public discourse away from the specialty’s systematic negligent mishandling of uterine fibroids at peril to many women— in order to defend their dangerously flawed business— as they did in the past regarding the Power Morcellator device. Afterall, it will be a cold day in hell before the Royal College of Obstetrics and Gynecology (RCOG) admits that its failure to correct a dangerous clinical practice diagnostic decision algorithm has likely harmed its patron, the Princess of Wales.
Leiomyosarcoma (LMS) is considered a rare cancer derived from smooth muscle cells. It has an incidence on the order of 1 in 10,000 in the general population — though in women struggling with symptomatic uterine fibroids, the incidence is one in 200–400.
LMS could be extremely aggressive, depending on the stage it’s diagnosed at, and the grade of the cancer itself. It can strike both men and women — and it can appear in many parts of the body where smooth muscle exists. It is extremely difficult to treat with chemotherapy, and there are no cures at present.
So the most important and effective way for physicians to save patients with LMS from death is to diagnose early and resect properly in a careful way to prevent any detectable LMS cancer cells from remaining in the patient’s body. Then, following resection, there is “adjuvant” or “preventative” chemotherapy available to prevent LMS recurrence, which this cancer is prone to. Though these chemotherapy regimens are not very effective. So the highest likelihood for curing a LMS diagnosis is early diagnosis and proper en bloc surgical resection.
But there is a VERY serious problem with Leiomyosarcomas in women. In particular, of the uterus, whose largest tissue volume consists of smooth muscle and is, thus, prone to development of benign myomas (also known as fibroids) — as well as, Leiomyosarcomas.
In fact, the dominant majority of uterine Leiomyosarcomas (uLMS) are diagnosed in women undergoing surgery for symptomatic uterine fibroids, falsely assumed to be benign tumors. These surgeries are either hysterectomies, where the entire uterus is removed, or myomectomies, where only the fibroid tumors are removed in order to preserve the uterus for childbearing — both are elective “Major Abdominal Surgeries” — as was the case for Catherine’s surgery. In fact, as a general epidemiological truth, hysterectomy is the most common major abdominal surgery in women.
But, unfortunately and tragically, ALMOST ALL uterine Leiomyosarcomas, globally, are diagnosed only AFTER hysterectomy or myomectomy operations. This pattern of uLMS diagnosis in gynecology is quite unusual in medicine, and is unlike any other cancer in the human body — a substantial proportion of which are diagnosed pre-operatively — including LMS tumors found in other organs and in men. But the terribly unusual and dangerous pattern of uLMS diagnosis AFTER surgery by gynecologists is 100% man-made!
The reason for this dangerous man-made phenomenon is that ALMOST ALL gynecologists, who specialize in the care of women with symptomatic uterine fibroids ASSUME that these tumors are benign and treat them as such. Tragically, this gynecological “Assumption of Benignity” about uterine tumors is FALSE in one in every 200–400 women who present for treatment of symptomatic uterine fibroid tumors — of whom it is my prediction and concern, Catherine is one.
The gynecological “Assumption of Benignity” about uterine fibroids translates into an increased catastrophic morbidity and mortality risk for the one in 200–400 women, whose tumors are in truth Leiomyosarcomas — in two ways:
- It causes a delay in uLMS diagnosis — in some women on the order of months to years of delay in diagnosis — while the gynecologists attempt to treat what they assume to be benign symptomatic fibroids with hormone therapy or other life style changes, allowing time for the deadly cancer to spread,
- It causes general gynecologists to use non-oncologically safe surgical techniques that could mechanically spread the uLMS inside the affected women’s abdominal cavities when an operation is finally performed (i.e., morcellation or tissue disruption).
Both these adverse consequences substantially increase the risk of morbidity and mortality to the one in 200–400 women, whose fibroid tumors are NOT benign, but are instead uLMS.
Based on my extremely granular knowledge and understanding of the patterns of uLMS diagnosis and treatment, I am quite encouraged by the fact that Princess Catherine was hospitalized for 12 days after her surgery. This length of hospital stay suggests that her surgeons very likely performed an open abdominal surgery, which always requires a longer recovery time. There is every reason to be hopeful that Catherine’s surgeons at The London Clinic, seeing the size of a putative uterine growth, and being aware of Dr. Amy Josephine Reed’s public health campaign, would have elected to perform the operation with a large incision in order to minimize the possibility of mechanically spreading a potential cancer — if this was, in fact, the case, then the princess has been afforded a survival advantage relative to those women with uLMS who undergo morcellation, and even vaginal hysterectomies, which often require excessive and oncologically dangerous tissue manipulation.
However, the princess has confirmed that prior to her “major abdominal surgery” her condition was thought to be “non-cancerous”. This is consistent with the experience of almost all of the one in 200–400 women with uLMS, assumed to be benign symptomatic fibroids. Unfortunately, this fact would also very likely mean that, like those women including Dr. Amy Josephine Reed, the princess of Wales was exposed to an unforgivable delay in diagnosis of her putative uLMS. A risk that will have a pivotal impact on the probabilty of her cancer metastasizing: The longer a cancer diagnosis is delayed, the higher the likelihood that it will spread.
For a frame of reference, Dr. Amy Josephine Reed was treated medically for almost one year following initiation of severe symptoms before being offered a hysterectomy by her gynecologists— and even then her very prominent gynecologists in Boston were all assuming that her uLMS was a benign fibroid and, tragically, morcellated and spread the cancer in her abdomen with a deadly consequence.
Any delay in the diagnosis of a putative uLMS in the princess of Wales Catherine, by her gynecologists at The London Clinic, will have been a totally avoidable risk she was exposed to by her gynecologists— as are thousands of women daily across the world by the gynecological “Assumption of Benignity” about uterine fibroids.
Only William, Catherine and their doctors know, as of this writing, if she has a uLMS and how long its surgical removal was delayed. But every good physician knows that the longer a cancer diagnosis is delayed, the greater the risk of metastasis and the higher the chance of cancer morbidity/mortality.
The tragic shame is that since 2013, when Ms. Jennifer Levitz of the Wall Street Journal broke the story of Dr. Amy Josephine Reed’s uLMS complication and mismanagement, gynecologists worldwide, including in the UK, have known that their “Assumption of Benignity” about fibroids, harms one in 200–400 of these women, whose “fibroids” are uLMS. Despite this knowledge, no gynecological organization, including the UK’s Royal College of Obstetrics and Gynecology (RCOG) acted to restrain this risk to women. And, now, the princess of Wales may have, and likely has, fallen to this unmitigated disaster.
If the princess’ diagnosis is, indeed, a uLMS, I hope that Prince William and Princess Catherine are able to see my public warnings and help finally eliminate this public health catastrophe from women’s health. They have the power and the voice to do so.
The truth is that the gynecologists “Assumption of Benignity” about uterine fibroids is a man-made monster that has been devouring the one in 200–400 women, whose tumors are NOT benign but are instead uLMS, for decades now. Perhaps the spirit of St. George will move William and Catherine to finally kill this monster so that no other women fall to disaster.
