Zapping fibroids with heat in hunt for new options

Feb 22, 2010 By LAURAN NEERGAARD , AP Medical Writer

(AP) -- They're a bane of that decade or two before menopause, growths in the uterus called fibroids that cause bleeding, pain or other problems in nearly a third of women - and they're the No. 1 cause of hysterectomies.

The latest attempted alternative: Insert a tiny electrode through a small hole and zap, an experiment to see how well the heat of radiofrequency energy shrinks fibroids.

" still feel they need more options, justifiably so," says Dr. Erika Banks of New York's Montefiore Medical Center, which is among six health centers nationwide testing the new RF ablation method.

There's also news for women trying to decide among already-approved alternatives to hysterectomy. A separate major study aims to determine which of two options - a longtime method named uterine artery embolization or a newer one called focused ultrasound - works better for which women.

"Patients are maybe surprised there is no research that has definitive answers at this point on which procedure is best for their predominant symptom," says Dr. Estella Parrott of the National Institutes of Health, which is funding the comparison study at the Mayo Clinic and Duke University.

For something so common, fibroids bring a lot of mystery. No one knows what causes these noncancerous tumors, although the plays a role in their growth. At least 30 percent of women experience symptoms from fibroids - , heavy bleeding, bladder or bowel dysfunction, infertility or - mostly in their late 30s and 40s. Many more harbor them - two-thirds or more of all women by age 50 - without reporting problems. Black women, also for unknown reasons, are at increased risk.

Tiny fibroids usually cause no symptoms, but they can grow to cantaloupe size. Even not-so-big fibroids can cause serious bleeding if they're in the wrong spot in the uterus.

Problems can come on suddenly, as Avrille Davis, 48, of the Bronx, N.Y., discovered. Told she had fibroids since her first pregnancy more than two decades ago, she didn't develop symptoms until three years ago. But over the past year, this busy nurse started experiencing periods that lasted two weeks, so heavy that she sought the extra protection of a diaper-style undergarment. Ruling out hysterectomy, Davis decided to enroll in the radiofrequency study, lured by the promise of straight-to-the-fibroid treatment.

RF ablation, long used to treat certain cancerous tumors, uses low-energy heat to destroy targeted tissue while avoiding damage to nearby areas. For fibroids, Halt Medical Inc.'s device requires three small abdominal incisions: One for a camera, one for an ultrasound probe to more precisely aim inside the uterus, and one for a needle-like device that sticks inside a fibroid and zaps.

Davis turned out to have more than 22 fibroids, and Montefiore's Banks thinks she got most of them.

"There has been a drastic improvement," Davis said, thrilled that her periods, so far, are back to normal modest bleeding.

RF ablation "looks very promising" based on short-term shrinkage, but a key question is how long that lasts, said Dr. Howard Sharp of the University of Utah, a fibroid spokesman for the American College of Obstetricians and Gynecologists.

That experimental treatment aside, women should carefully weigh the pros and cons of multiple options before deciding what's best for them, Sharp advises:

-Surgically removing the uterus remains a key fibroid treatment because it's the only way to ensure fibroids don't return. Fibroids account for about 240,000 of the nation's 600,000 annual hysterectomies.

-Myomectomy, surgery that removes fibroids while leaving the uterus intact, is the only option yet recommended for women who still want to become pregnant. Depending on the fibroid's size and location, it sometimes can be done minimally invasively rather than through open abdominal surgery. Later pregnancies usually require c-section deliveries.

-Far less invasive is uterine artery embolization, or UAE. Doctors inject plastic pellets into certain uterine arteries to cut off the blood supply feeding the fibroids, which gradually shrink. Premature menopause is a risk.

-MRI-guided focused ultrasound requires no incision. Patients sit motionless in MRI machines as doctors use those scans to guide high-intensity sound waves to shrink the fibroids. There is debate over the best size of fibroid to treat, and long-term outcomes are still under study.

That's where the NIH-funded comparison of UAE and focused ultrasound comes in.

Another consideration is how much time women likely have before menopause, when fibroids naturally shrink, cautions Utah's Sharp. With UAE and myomectomy, between 20 percent and 30 percent of women get another procedure or hysterectomy about five years later because of fibroid recurrence, he says.

Explore further: Ebola has killed 61 in Guinea since January

More information: Fibroid study details: http://tinyurl.com/ycuha2d and http://tinyurl.com/yflyjl7

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Focused ultrasound relieves fibroid symptoms in women

May 29, 2007

A noninvasive ultrasound procedure effectively shrinks uterine fibroids and significantly relieves fibroid-related symptoms in women, according to the results of a multicenter clinical trial reported in the June issue of ...

Treatment advances for fibroids, menopause

May 03, 2008

Women with fibroids and endometriosis facing the possibility of hysterectomy may now choose less invasive treatment options to preserve fertility, according to Yale professor Aydin Arici, M.D., who will direct a scientific ...

Recommended for you

Two expats die of MERS in Saudi commercial hub

1 hour ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

1 hour ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

13 hours ago

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

US orders farms to report pig virus infections

Apr 18, 2014

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

User comments : 0

More news stories

UAE reports 12 new cases of MERS

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...