Fibroids: facts and new treatments

"This is now an accepted way to treat fibroids," says Dr. Vogelzang, one of the UFE pioneers. "Women, however, are not as aware of this uterine-sparing procedure and other less-invasive methods as they should be."

Dr. Vogelzang says his patients, many of whom are African-Americans between ages 40 to 45, find their way to his office by word of mouth and the Internet after other treatments have failed, or when they are faced with a hysterectomy.

Medical experts reason that some physicians may not want to refer a woman to a radiologist for UFE, when they themselves can perform a hysterectomy and other methods for a substantially higher fee than the cost of the UFE procedure. Some gynecologists consider UFE experimental despite the fact that UFE has a 73 percent success rate over five years and offers many benefits over conventional surgery, reports show. Clinical research, however, has not yet concluded that UFE is appropriate for women who want to become pregnant.

For other women wanting to preserve fertility, surgical options include a myomectomy, a more aggressive procedure that leaves the uterus intact. During a myomectomy, a surgeon removes medium- to large-sized tumors through a bikini-line incision just above the pubic bone. With the uterus free of fibroids, a woman may be able to conceive. The drawback is that fibroids are likely to reoccur over time.

"The perfect candidate for a myomectomy is a woman with a fibroid the size of a grapefruit," says Dr. Jackson. "A woman who has a uterus with numerous fibroids looking like a bag of cherries may not be a good candidate."

Another fibroid treatment called laparoscopic surgery uses lasers inserted into the vagina to remove small tumors without an incision.

Among other options are medications that suppress the body's supply of estrogen, thus causing temporary menopause. As the blood flow to the uterus decreases, the tumors shrink. The treatment works only while the patient is taking the medications. Side effects may include hot flashes, vaginal dryness and bone loss. Physicians usually don't prescribe the treatment for more than six months.

Birth control pills, herbs and other hormone-based drugs may help control fibroid bleeding, but their medical benefits are unclear. Consult with a physician first.

Dr. Jackson in Los Angeles says choosing the best fibroid treatment is not clear-cut and depends on the woman's age, location and number of fibroids, size of the uterus and the patient's comfort level. "I really like to listen to the patient and what her desires are," Dr. Jackson says. "I don't limit treatments to age. I look at the women's quality of life."

COPYRIGHT 2005 Johnson Publishing Co.
COPYRIGHT 2005 Gale Group