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Fibroids

The TVClubHouse: General Discussions ARCHIVES: 2006 Jun. ~ 2006 Dec.: Health Center (ARCHIVES): Fibroids users admin

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Herckleperckle
Member

11-20-2003

Thursday, June 15, 2006 - 9:22 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported December 1, 2005


Zapping Fibroids


(Ivanhoe Newswire) -- Patients' pain from uterine fibroids can be helped without undergoing a hysterectomy, reveals a new study from researchers at Harvard University and Brigham and Women's Hospital in Boston.

The doctors performed magnetic resonance-guided, focused ultrasound surgery on 160 women with uterine fibroids. The procedure uses high-intensity ultrasound waves to non-invasively zero in on fibroids without affecting surrounding tissue.

In two-thirds of patients, the treatment time was limited to two hours. The other third could be treated for up to two-and-a-half hours. Both groups reported substantial relief one year after treatment, but those in the intensified treatment group had slightly better symptom improvement compared to the moderate group.

"This treatment immediately stops blood flow in the fibroid tissue, which results in a significant, sustained decrease in symptoms for up to 12 months," says lead study author Fiona M. Fennessy, M.D., Ph.D., instructor of radiology at Harvard Medical School and staff radiologist at Brigham and Women's Hospital.

Uterine fibroids are benign growths of the muscle in the uterus affecting between 25 percent and 50 percent of American women. They also account for one-third of the hysterectomies performed in this country. Symptoms include excessive bleeding, frequent urination, pelvic pain and infertility.

"We have shown that treating fibroids with an optimized, less restrictive protocol allows for treatment of a greater fibroid volume, which results in even greater symptomatic relief," says Dr. Fennessy.

SOURCE: Annual meeting of the Radiological Society of North America in Chicago, Nov. 26 - Dec. 2, 2005

Herckleperckle
Member

11-20-2003

Thursday, June 15, 2006 - 9:45 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported September 12, 2005


Unnecessary Hysterectomies



LOS ANGELES (Ivanhoe Broadcast News) -- Each year in the United States, 600,000 women will have a hysterectomy. American women are twice as likely to have a hysterectomy as women in England and four-times more likely than women in Sweden. So are American women right, are these invasive surgeries really necessary? Some doctors say no.

1

By age 60, one in three American women have had a hysterectomy, but Norma Jean Welter says she won't be one of them. "I still have in the back of my mind hope that I'll get pregnant. I'm only 37," she says.

Her doctors disagreed; they told her it was the only solution. She has uterine fibroids, non-cancerous growths in the uterus. "[My doctor] was very adamant. 'Sorry, Mrs. Welter, but your only option is going to be a hysterectomy.'"

UCLA's Bruce McLucas, M.D., an OB/GYN at The Fibroid Treatment Collective in Los Angeles, says women hear those words often. "I hear it all too many times that, 'I've gone to see two, three, four doctors. They've all recommended hysterectomy.'"

With hysterectomies, doctors remove the uterus and sometimes the ovaries. Twice as many younger women have them as older women, often to treat uterine fibroids.

2

"Hysterectomy is not an easy procedure to recommend, and it shouldn't be the first thing we talk about with our patients," Dr. McLucas says. One alternative for treating fibroids is embolization. In this treatment, particles are injected into uterine arteries where they block blood flow to the fibroids and cause the fibroids to shrink. Other alternatives include medications, hormones or conservative surgeries.

3
Welter had the embolization treatment done on her fibroids. They shrank 70 percent and kept her dreams for a baby very much alive.

Additionally, in America, women in the southeast have hysterectomies more often than anywhere else in the country. Dr. McLucas emphasizes there are times when hysterectomies are indeed necessary, especially when dealing with cancer.


If you would like more information, please contact:

Bruce McLucas, M.D.
The Fibroid Treatment Collective
100 UCLA Medical Plaza Ste. 310
Los Angeles, CA 90095
(866) 362-6463
inquiry@fibroids.com
http://www.fibroids.com


Herckleperckle
Member

11-20-2003

Thursday, June 15, 2006 - 9:48 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported December 16, 2004


Symptom Relief for Uterine Fibroids


(Ivanhoe Newswire) -- A new study shows MRI-guided ultrasound therapy is an effective way to treat women with uterine fibroids.

About 25 percent of women have uterine fibroids. Many of them experience symptoms including abdominal pain, bladder irritability, and menstrual irregularities. Patients are commonly treated with surgery, but researchers from London have found an alternative.

More than 100 patients answered a quality of life questionnaire before and after having an MRI-ultrasound treatment. Researchers say, "Overall, there was a significant improvement in the quality of life scores in 80 percent of the patients," six months after the procedure. They add this procedure could be a viable alternative to a hysterectomy or myomectomy.

The procedure uses MRI (magnetic resonance imaging) to plan and guide the treatment. Focused ultrasound destroys the fibroid tissue. Researchers say the procedure is non-invasive, safe, and is associated with very few side effects. They say, "There were several instances where patients had prolonged menstrual bleeding, but this was not any different than what they had experienced before the procedure, so this was probably secondary to the underlying problem, rather than as a result of the treatment."

Researchers conclude, "[The success of the procedure] points the way forward to the utilization of this technology in other areas such as the treatment of solid organ malignancies."


SOURCE: American Journal of Roentgenology, 2004;183:1713-1719

Herckleperckle
Member

11-20-2003

Thursday, June 15, 2006 - 10:32 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported August 23, 2004


Better Care for Uterine Fibroids

Full-Length Doctor's Interview



In this full-length doctor's interview, Bruce Zwiebel, M.D., explains an improvement in uterine fibroid embolization to shrink fibroids and cure women of the painful and inconvenient symptoms.

Ivanhoe Broadcast News Transcript with Bruce Zwiebel, M.D., Interventional Radiologist, Tampa General Hospital, Tampa, Florida. TOPIC: Better Care for Uterine Fibroids



What are fibroids?

Dr. Zwiebel: Fibroids are benign tumors, which form on the lining of the uterus, the wall of the uterus, or sometimes on the outside of the uterus. They're due to a degenerative process in the uterus itself.



How common are they?

Dr. Zwiebel: They're extremely common, especially in women between ages 25 and 45. This age group is the main concentration of symptomatic fibroids. They're particularly common in black females as opposed to Caucasian females.



What are the symptoms that women can look for in having fibroids?

Dr. Zwiebel: The symptoms are bleeding, pelvic pain, and sometimes bulk symptoms such as having frequent urination because the fibroids in the uterus are pressing on the bladder and causing them to have the desire to frequently urinate. Or sometimes the fibroids on the uterus can press on the rectum and actually give symptoms of constipation and other symptoms related to bowel movements.



What are the treatment options for a fibroid that is presenting problems?

Dr. Zwiebel: Historically, hysterectomy has been the main treatment option. These are now either performed through the abdominal wall or actually through the vagina itself, which is a transvaginal technique. People also do myomectomy, which is actually taking out the fibroid itself and leaving the rest of the uterus intact. We have now developed uterine fibroid embolization as a technique for treating fibroids as well, and that has gained in popularity greatly over the last five to six years.



What makes the procedure of uterine fibroid embolization better than hysterectomy or myomectomy?

Dr. Zwiebel: Hysterectomy, no matter what people say, is major surgery. There are risks and complications associated with it, and there's a significant recovery time associated with it. The problem with myomectomy is there's a fairly high recurrence rate of the fibroid because if any tissue is left behind, it's a cause for regrowth of the fibroid. Also, it's hard to know which of the fibroids are the ones that are symptomatic. So, a myomectomy is a reasonable alternative only if you have one fibroid. If you have multiple fibroids, then a myomectomy gets to be more of an involved procedure to remove multiple pieces of fibroids from the uterus. One of the main advantages of uterine fibroid embolization is that you can treat multiple fibroids in different locations. Also, you don't burn any of the bridges that would possibly lead to hysterectomy or myomectomy for other reasons. As a matter of fact, the evolution of the procedure started in France.

Radiologists were treating fibroids pre-operatively before myomectomy, and they found that when they went to do the myomectomy, sometimes three months later, the fibroid had actually shrunk so much in size that they didn't need to do a myomectomy. Then, the thought was that this could be a stand-alone procedure. That's how we got to where we are today.



How does uterine fibroid embolization work?

Dr. Zwiebel: The embolization of the arteries is done with a variety of different products. Some of them are gelatin beads, some of them polyvinyl alcohol beads, but the concept is that the beads are quite small in size. They float out preferentially to the fibroid, which is a very vascular tumor as compared to the other parts of the uterus. So, the fibroid almost serves as a sump as it sucks up the particles. Most of the embolization is targeted at the fibroid.

This has been proven by various MRI studies that have looked at the uterus after embolization. The fibroids have clearly been embolized completely and the uterine tissue, the muscle or the lining of the uterus, remains intact and takes up contrast, meaning that there's still blood flow to the important areas continuing to keep them viable.



What is it in the beads? What do they do?

Dr. Zwiebel: Actually, they are sort of like a plug. In other words, if you had a strainer in your sink and you filled it with pieces that were big enough to fill the holes, then no longer could liquid flow down the drain. It's the same with this process. The beads go out toward the tumor, actually fill the lumen of the artery going to the tumor, and block blood flow from getting there, thereby blocking the nourishment and ingredients that allow a tumor to grow or sustain itself.



How long does it take for the fibroid to shrink?

Dr. Zwiebel: Most of the time we see shrinkage by three months. Sometimes it takes up to six months, but certainly we've seen in all patients shrinkage within a year.



How do you insert the beads into the uterus?

Dr. Zwiebel: The procedure is done is through a small, tiny incision in the ephemeral artery in the groin area. A catheter is negotiated using fluoroscopy into the uterine artery itself. Then these particles are injected, and they're flow-directed by the flow of the blood toward the fibroid.



How successful is uterine fibroid embolization vs. hysterectomy?

Dr. Zwiebel: Hysterectomy is kind of the ultimate treatment because you get rid of the uterus. Therefore, if the symptoms or the problems are related to fibroids in the uterus, there's no longer a problem. However, the success rate has actually been excellent with the embolization.

In terms of bleeding, there's between an 80-percent to 90-percent elimination of dysfunctional bleeding. In terms of pelvic pain and bulk symptoms, it's again probably in the neighborhood of an 80-percent elimination or improvement of symptoms. So, I would say the success is pretty much overwhelming.



When those beads are injected, do they know where to go if a woman has multiple fibroids?

Dr. Zwiebel: The particles, because they're flow-directed, head towards the area where most of the blood flow is. The vascularity of these tumors is such that they almost suck up the particles because the dominant amount of blood flow is going to those areas.



How long are the particles active in the uterus?

Dr. Zwiebel: Well, it's not so much that they do anything actively. They're more of a blocker for blood flow. In other words, a tumor grows and sustains itself by getting blood flow and nutrients, just like other parts of the body. When that's deprived, it starts to get smaller and kind of die in the process.



Is there a recurrence rate after embolization?

Dr. Zwiebel: The procedure hasn't been around that long, so actually long-term follow-up of 10 or 15 years hasn't been achieved. But, it seems like the need for secondary intervention is very, very small.

Usually, the recurrence is related to variant anatomy, somebody who has an anatomy that's different from the normal. We do our normal embolization, and they still have symptoms. Their fibroids are still enhancing in an MRI. We then discover that, in fact, there was a branch from the ovary or some other place that was feeding the fibroid that we didn't assess at the time and now is a factor. But, that can be treated as well.



Is pregnancy possible after this procedure?

Dr. Zwiebel: It is possible, but it is still a source of controversy with regard to this procedure. There are numerous documented cases of women becoming pregnant following embolizations of the uterus for a variety of different entities. This is certainly true after uterine fibroid embolization, but also in women who have uterine AVMs, arterial venous malformations, which are treated with embolization, and they go on to pregnancy. There are numerous documented cases of women going on to pregnancy. The problem is we don't really know the denominator, such as how many women are trying and how many are failing. We don't have a real grasp on the number of actual failures. However, we do know that is it possible for women to achieve pregnancy after embolization.



How many hysterectomies are performed a year as a result of uterine fibroids?

Dr. Zwiebel: It's actually a fairly staggering number. The number of hysterectomies performed in the United States a year is in the neighborhood of 600,000, and 200,000 are performed for fibroids. This is actually a fairly extraordinary number.



How long has embolization been around for?

Dr. Zwiebel: Embolization has been around for a long time. It was probably developed back in the 70s. Some of the first embolizations were catheter-directed embolizations. What's new about this procedure is just its application for this type of disease entity. In other words, we've been embolizing things in the pelvis for many things such as bleeding after trauma, pelvic tumors, and tumors that erode into arteries and cause bleeding. We've been embolizing the pelvic areas for a long time, but an application specifically for fibroids is what makes it new.



What about recovery?

Dr. Zwiebel: I would say recovery is definitely one of the benefits of uterine fibroid embolization. I think any woman who's had a hysterectomy knows that the recovery period is actually quite longer than she believed it would be.

After uterine fibroid embolization, we have had women back with their exercise group three days later. There's clearly a bell curve in terms of some people who take longer to recover, but I would say the majority recover very quickly, inside of a week.

END OF INTERVIEW



If you would like more information, please contact:

Ellen Fiss
Public Relations Manager
Tampa General Hospital
P.O. Box 1289
Tampa, FL 33601
(813) 844-6397
efiss@tgh.org


Herckleperckle
Member

11-20-2003

Thursday, June 15, 2006 - 10:44 am   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Source: Ivanhoe.com
Reported March 29, 2004


How to Starve Your Fibroid Tumors


(Ivanhoe Newswire) -- Twenty percent to 40 percent of American women ages 35 and older have benign tumors in the uterus called uterine fibroids. A new study shows uterine artery embolization (UAE), or tumor shrinking, is a safer treatment for these tumors compared to surgically removing them during a myomectomy.

Researchers say this tumor-shrinking option requires shorter recovery time and results in less undesirable events post-op.

During a study presented at the 29th Annual Scientific Meeting of the Society of Interventional Radiology, UAE patients were back to work in 10 days vs. 37 days in the myomectomy group. The UAE patients returned fully to normal activities in 15 days vs. 44 days in the myomectomy group.

The UAE group also showed statistically significant better symptom relief, including improvement in sleep, less restriction to usual activities, and improved mental health.

Embolization is a minimally invasive interventional radiology treatment that cuts off blood supply to the fibroid tumors, causing them to shrink. It has been widely available in the United States for the past six years as a treatment for fibroids.

UAE is a global treatment, meaning it's effective for multiple fibroids. However, it is often not physically possible to remove all the fibroids through myomectomy because it would remove too much of the uterus. In addition, researchers say up to half of the women who have a myomectomy will have recurrence of their symptoms within five years.

Another benefit of UAE is it has negligible blood loss. In contrast, "Myomectomy surgery can entail significant blood loss, and in about 2 percent to 3 percent of the cases an emergency hysterectomy is required because of it. A woman who chooses myomectomy as a treatment because she doesn't want to lose her uterus, may wake up without one," says John Lipman, M.D., an interventional radiologist and study investigator.

In past studies, UAE has also been shown to be a safe and effective alternative to hysterectomy, still the most common cure of uterine fibroids. "Now we have trials comparing UAE to both surgical treatments, showing UAE to be a good treatment option," Dr. Lipman says. "UAE is another example of the overall trend in medicine to treat disease in the least invasive way possible. It's important for women to ask questions, obtain consults with different types of physicians, and know all of their treatment options."


SOURCE: The Society of Interventional Radiology's 29th Annual Scientific Meeting in Phoenix

Hypermom
Member

08-13-2001

Tuesday, December 12, 2006 - 7:54 pm   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
HP, thanks for posting all of this. I found out today that I most likely have one. Waiting for an ultrasound appointment now.

Mameblanche
Member

08-24-2002

Tuesday, December 12, 2006 - 8:36 pm   Edit Post Move Post Delete Post View Post Send Mameblanche a private message Print Post    
Hypermom, I had a UAE a few years ago. It has an 80% success rate. Unfortunately I was in the minority so eventually had a partial hysterectomy to remove my tennisball sized fibroid. Best thing I ever did. Wasted years in pain. But I suppose if the success rate is 80% its worth pursuing first, like I did. Let's hope you are in the majority and it works like a charm and you won't need a hysterectomy, partial or otherwise.

I just remembered something tho... and that is that even though the UAE starves existing fibroids, it might not get them all, and it doesn't prevent others from growing. (I'm fairly sure of this, but NOT positive, you definitely want to check that out.) The nice thing about a hysterectomy is that its a surefire guarantee to end the pain once and for all with no more fibroids ever. I was dancing one month to the day of my partial hysterectomy. Anyhow that's my experience, best of luck, hon! Keep us posted. :-)

Hypermom
Member

08-13-2001

Wednesday, December 13, 2006 - 8:36 am   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
Thanks Mame. My Dr. did say that another fibroid could grow back even if this one is removed. I don't know how big it is right now. I've only had problem periods the past 4 months. However, I've had anemia problems for 6 months. I was actually surprised when he told me about the fibroid. So, I just have to wait for the ultrasound appointment and go from there. My Dr. mentioned doing a low dose birth control pill for three months to help, or some other drug. I really don't want any surgery if I can help it.

Mameblanche
Member

08-24-2002

Wednesday, December 13, 2006 - 10:26 am   Edit Post Move Post Delete Post View Post Send Mameblanche a private message Print Post    
Yes, surgery should always be a last resort, but in my case, I WISH we'd done it sooner. I was in agony for at least 5 years. And with the surgery it was over and done with instantly. (Except for recovering from the surgery, which took about 3 months in total.)

Sounds like your doc is on top of things... Good luck with the ultrasound... Keep us posted! :-)

Chewpito
Member

01-04-2004

Sunday, December 17, 2006 - 9:46 pm   Edit Post Move Post Delete Post View Post Send Chewpito a private message Print Post    
It sounds like Mames had lots of pain and problems with her fibroid... But I just wanted to say that I have a fibroid about the size of a orange, Im 50 yrs and I dont experiance any pain or abnormal bleeding.. My Doc has been watching it and tells me that with menopause it most likley will shrink. If it does not or if it gets bigger or starts to cause me problems then surgery could be an option. I do not want surgery and am in no rush to even think of it at this time... I dont feel it inside of me and so for now, I will just let my doc check it every 6 months and see where it goes...but for now, Im pretending like its not even there... Thats just me though.. Like Mames said above, if its ruining your life and you know you would feel better with out it... then you should decide for your self with the advice of your doc. I hope your xrays went well...

Hypermom
Member

08-13-2001

Monday, December 18, 2006 - 3:09 pm   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
Just got home from the tests. Besides the ultrasound, she did the camera probe thing. I should know what is up in two to three days from my doctor.

Mameblanche
Member

08-24-2002

Monday, December 18, 2006 - 10:46 pm   Edit Post Move Post Delete Post View Post Send Mameblanche a private message Print Post    
Camped out here, patiently, waiting for word... :-) I must say that I'm glad they were so thorough...

Hypermom
Member

08-13-2001

Tuesday, December 19, 2006 - 7:52 am   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
Yes, the camera probe thing was surprising. lol She said most women get freaked out about it, so they don't say anything about it when setting up the appointment. I probably won't know anything until Thursday. My doctor doesn't work on Wednesdays. I'm going to call his nurse this morning and remind her that I'm not the most patient person when it comes to tests...which she and my dr. both know. lol

Chewpito
Member

01-04-2004

Tuesday, December 19, 2006 - 9:49 am   Edit Post Move Post Delete Post View Post Send Chewpito a private message Print Post    
Ya, the camera probe is kinda like a huge ("ummm, you know what".LOL).. I hope every thing goes well....I didnt catch it though, do you have pain like Mames did??.. I never even knew about mine untill I had a MRI for back problems and then was told that it might be a good idea to see my gyno... I got real scared at first, did the sonogram thing like you and was told I had a very large one and many small clusters... But like I said, I havent had any problems so im just egnoring it and hoping it will shrink naturaly. It might be differant if I was in alot of pain..but for now thank God, I just dont. I got enoph other health problems to worry about with out getting freaked about this. I just hope that you dont have to go thru surgery.. I hope your not in pain.

Hypermom
Member

08-13-2001

Tuesday, December 19, 2006 - 10:04 am   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
LOL Chew, when I saw the probe, I asked her what she was going to do with that! I don't have any pain. I'm anemic during my periods because I bleed so much. I went for my annual checkup, and my doctor said that my uterus was tilted. We're hoping it is a fibroid....he said there is a small chance that it is something else, but we won't talk about that until we know for sure. Interesting about your back pain. A year ago, I ended up going by ambulance to the ER because my back hurt so bad. No tests were done though, and I haven't had a problem since.

Mack
Member

07-23-2002

Tuesday, December 19, 2006 - 11:15 am   Edit Post Move Post Delete Post View Post Send Mack a private message Print Post    
My wife and I went through the whole fibroid business this past summer. The short story is that she had a partial hysterectomy using laparoscopic surgery at the end of July. What was amazing was the relative lack of advanced medical procedures. We live in an area with huge, diverse medical support yet found very few surgeons/radiologists practicing the more advanced procedures. UAE was not an option and the first OB/GYN wanted to do the old fashion abdominal surgery. We did seek a second opinion and at least found a doctor with more state-of-the-art skills. By the way, the first doctor was not some oldster but a young female OB/GYN, board certified, and a graduate of one of the finer schools in the country. We learned a lot about fibroids and treatments in a very short time but my wife is very pleased with the outcome and the improvement in her life.

Mameblanche
Member

08-24-2002

Tuesday, December 19, 2006 - 12:25 pm   Edit Post Move Post Delete Post View Post Send Mameblanche a private message Print Post    
Mack - your wife was so lucky to have the laparoscopic surgery! I had to have the old fashioned slice and dice type of partial hysterectomy. I have a scar from about a couple of inches below my belly button down to the top of, um, the forrest of no return. (Blush)

Mack
Member

07-23-2002

Tuesday, December 19, 2006 - 1:04 pm   Edit Post Move Post Delete Post View Post Send Mack a private message Print Post    
Funny you should use the term "slice and dice" as that's exactly what my wife said in pre-op. Once they gave her the Versed, which sometimes acts like a truth serum, she went off on the first surgeon with some comments about "if it had been up to her I'd be headed down the hall to get sliced and diced". The OR nurse got quite a smile from that.

But yes, we were very fortunate that her situation permited the less invasive procedure. Even if you can find a surgeon qualified to do laparoscopic procedures that doesn't mean that your situation is the right one for that approach.

Colordeagua
Member

10-25-2003

Tuesday, December 19, 2006 - 3:45 pm   Edit Post Move Post Delete Post View Post Send Colordeagua a private message Print Post    
I had fibroids 17 years ago. Asked my doctor about a myomectomy. She said could do that, but then new fibroids can grow. (See above generally.) I had TAH/BSO (regular surgery taking everything out). Breezed through it. No regrets. Certainly permanently solved the problems.

Hypermom
Member

08-13-2001

Thursday, December 21, 2006 - 12:39 pm   Edit Post Move Post Delete Post View Post Send Hypermom a private message Print Post    
I do have fibroids. My GP said it's no hurry, but wants me to see a Gyno in a few months, which is fine. :-)