By: Jean Johnson for Fibroids1The good news about fibroid tumors is that they are not life-threatening. There’s nothing malignant about the tumors – they are not cancerous. Consequently, women who suffer from the symptoms of fibroids have time to consider their options. First talking things over with their physician, then considering getting opinions from specialists, and finally by talking with other women, those with fibroids can gain understanding into this common problem. Understanding that empowers.
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Dealing with Fibroids
Fibroids can cause prolonged and heavy bleeding.
While fibroids can significantly reduce quality of life, the benign tumors are not life threatening.
Fibroids are present in approximately 40 percent of women over 40 and can range in size from 1 mm to 20 cm. A woman may have a single fibroid or multiple fibroids.
Women with fibroids who take time to become fully informed of their options often have long-term experiences that are superior to those who remain less knowledgeable and thus, dependent on others to make their decisions for them.
Fibroids1 archives of features contains articles on the anatomy, development, symptoms, diagnoses and treatment of fibroids. Drop by for a list of articles on topics ranging from Fibroids 101 to interviews with specialists to patient accounts of their experiences.Click here to see Fibroids1 feature archives.
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Before deciding on any one treatment, though, appreciating the pluses and minuses of various therapies is useful. That is why the Body1 Network has an entire site, Fibroids1.com, dedicated to this women’s health issue. While this particular article will highlight a recent study (a technique known as magnetic resonance MR-guided focused ultrasound surgery) further articles describing the advantages and risks of other treatment therapies can be accessed by clicking on our fibroid treatments page.Focused Ultrasound Surgery Study Results Published January 2006
Results of a study on more than 100 women who had the MR-guided ultrasound approach to treating fibroids were published in the January 2006 issue of Fertility and Sterility. In the article, lead investigator Elizabeth A. Stewart, M.D. of Brigham and Women’s Hospital in Boston and her colleagues reported that MR-guided focused ultrasound was effective in reducing symptoms associated with uterine fibroid tumors.
Women with prolonged periods and heavy bleeding significant enough to interfere with their quality of lives were recruited for the study. The team of clinicians treated the patients by using heat, or thermoablation, to cut off blood supply to the targeted fibroids.
The procedure was accomplished with minimally-invasive techniques in which doctors used real-time MR thermometry. This real-time imaging gives the team a visual picture of a woman’s uterus and fibroids. The image allows the experts to fine tune placement and make adjustments to where heat is applied, which is necessary for a successful outcome.
Results of MR-Guided Focused Ultrasound Study
Stewart’s team assessed the success of their efforts through quality of life questionnaires. It found that 79.3 percent of those treated had experienced improvement in their symptoms six months after treatment. Patients were also monitored at 12 months post surgery and their reports were promising.
Stewart’s team reported that, “This early description of MR-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.”
In other words, although they didn’t disappear completely as they would with major abdominal surgery, once cut off from their blood supply, the fibroids shrunk enough to stop causing excessive and prolonged bleeding.
“We are continuing to follow these women for at least three years and will continue to repot on this cohort,” said Stewart. “We hope to demonstrate sustained efficacy with this treatment.”
Traditional Options for Treating Fibroids
The first, most conservative approach to minimizing symptoms of fibroids is hormone therapy. Most gynecologists and women’s health physicians will try courses of hormone pills before they begin exploring more aggressive ways to shrink the bulk of the fibroids that impinge on the uterus and cause excessive bleeding.
A hysterectomy, of course, is the traditional approach to dealing with fibroids. The simple dissection into the body and removal the fibroids, uterus and all, is the method physicians recommended to women for much of the 20th century.
Another surgical approach is called a myomectomy, in which surgeons open the body to the uterus and excise only the larger fibroid masses. Thus, a myomectomy spares the uterus from being removed all together.
It is a new era, however, and many women are looking carefully at minimally-invasive options which save them from the pain and prolonged recovery time of major abdominal surgery.
Hot, Cold and Electricity
MR-guided focused ultrasound surgery, the technique previously highlighted in this article, is a minimally-invasive procedure that uses heat to sever the fibroid from its blood supply, which in turn causes the fibroid to shrink over time.
At the other temperature extreme is cold. Cryomyolysis is where physicians target fibroids with liquid nitrogen which permanently “freezes” and severs the connection between the fibroids and the circulation system.
Similarly, myolysis uses an electric current to accomplish the same goal of cutting off fibroids from their source of nourishment – the blood.
Uterine Artery Embolization
Uterine Artery Embolization (UAE) is a technique employed by a subset of medical experts on the circulation system known as interventional radiologists. Since embolization has enjoyed an impressive track record, women in the know make sure they get the full scoop on this approach to treating fibroids before they come to a conclusion regarding the type of therapy best suited to their situation. Indeed, Condoleeza Rice chose embolization to have her fibroids treated.
Like other minimally-invasive procedures, UAE also employs real time imaging. Via a screen, a radiologist can insert tiny beads into the blood vessels feeding fibroids, sealing them off from the blood which makes them grow. The procedure uses a slender catheter, about as thin as spaghetti, which is inserted in the femoral artery and guided into place at the site of the fibroid.
Patient’s Thoughts on Navigating the Complex World of Fibroid Treatment
“Knowledge is power,” said Argelis Castillo of Portland whose personal story appeared on Fibroids1 in summer 2005 under the title “Take the Red Elevator.”
“I would encourage other women who suffer from fibroids to take their time and really study the different things doctors can do these days. It’s not that complicated once you start getting familiar, but at first it seems like a whole new world of ideas and terms that only doctor could figure out.”
Another Portland woman, Deidre Schmidt, added that, “As far as I’m concerned, women can’t be too careful. Gynecologists understand the scalpel very well, but sometimes they are not so up to speed on the newer developments. So even though they might mention the techniques that don’t require major abdominal surgery, they can do it in ways that make their patients think they don’t need to pay much attention and should just stick with their doctor’s way which is usually major surgery.”
Schmidt points out that she is biased since she almost had a myomectomy before a friend took her by the hand and insisted she check out the less-invasive approaches. “It’s true that since I had embolization, I’m prejudiced.
Taking a little time to learn about all the fibroid treatment options available is a good move for any woman with fibroids. Whether you feel you need treatment now, or in case you may want treatment in the future, knowing what’s out there will make a trip to the doctor more useful and fruitful. Although fibroids are non-cancerous, women who no longer want to suffer from the symptoms of fibroids and are ready to do something about it should not shy away from visiting their doctor and discussing what methods are available to help.
