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New treatment kills tumors, saves fertility

November 23, 2009 12:00:00 AM PST
It's the most common reason for hysterectomies in the U.S. -- as many as 30-percent of women suffer from uterine fibroids. These are benign, painful tumors in the uterus. Now there's a treatment that kills the tumors, but not the option of having children.Ericka Schwappach and her husband want to start a family.

"I absolutely look forward to someone calling me mom," said Schwappach.

Schwappach has uterine fibroids, which are non-cancerous tumors that grow on the wall of the uterus. Not only does it reduce her odds of getting pregnant, it causes a lot of discomfort.

"I have severe menstrual cycles with heavy bleeding and lots of pain," said Schwappach.

Even after her fibroids were surgically removed, they came back. She thought her only option was a hysterectomy, until she heard about uterine fibroid embolization or UFE.

Interventional radiologists thread a small catheter into the arteries that supply blood to the uterus, and the fibroids.

"We actually go in and we put in permanent, very tiny spheres which block the branches of the artery that go to the fibroids," said interventional radiologist Dr. Karen Garby.

That cuts off the blood supply.

"And when their blood supply, like any tumor, is cut off they shrink and they die and they become scar and they no longer cause the symptoms," said Dr. Garby.

Studies show UFE is successful in reducing bleeding, eliminating pain and shrinking fibroids in 90-percent of cases.

"It is much better -- remarkably, noticeably better," said Schwappach.

Schwappach is hopeful motherhood is in her future, but also relieved to no longer live in pain.

"My husband would like probably four," said Schwappach. "I say let's start with one and see where we go."

This is an alternative to a hysterectomy that gave one woman more options, and changed her life.

Menopause occurs in 15-percent of women who have the procedure after age 45.

Women who get pregnant after the procedure will likely have a cesarean section during delivery rather than risk rupturing the wall of the uterus.

Web Extra Information:

BACKGROUND:

Uterine fibroids are non-cancerous growths in the uterus that can cause symptoms, depending on their size, number and location. Those symptoms include heavy bleeding, pain and reproductive problems. The condition affects 20 to 30 percent of women, according to the Center for Uterine Fibroids, and is more likely to affect minority women. More than 80 percent of African Americans and 70 percent of Caucasians develop fibroids by the time they reach menopause.

CAUSES:

Experts aren't sure what causes fibroids, but some research suggests they develop from misplaced cells that are present in the body before birth. Research also suggests the hormones estrogen and progesterone play a role in the condition. Fibroids often shrink when a woman enters menopause, and hormonal drugs that contain estrogen sometimes cause them to grow.

TREATMENT:

The American College of Obstetricians and Gynecologists says although some fibroids don't require treatment, women should seek medical intervention if they experience the following symptoms: heavy or painful menstrual periods that disrupt normal activities or cause anemia; bleeding between periods; pelvic pain; or infertility. Doctors may push for treatment if they are uncertain whether a fibroid is another type of tumor or if they see a rapid increase in growth of the fibroid.

For some women with fibroids, medications can offer relief. These medications include birth control pills; GnRH agonists, which stop the menstrual cycle and are recommended for short periods of time; and progestin-releasing intrauterine devices, which reduce heavy and painful bleeding without treating the actual fibroids.

Some women may require surgery to ease the symptoms caused by uterine fibroids. In myomectomy, surgeons remove the fibroids but leave the uterus in place. Endometrial ablation is another option, in which surgeons destroy the lining of the uterus. The procedure is only recommended for women with small fibroids. Uterine fibroids are the most common reason for hysterectomies, or removal of the uterus. They account for 200,000 of such procedures annually, with 22 percent of African American women and 7 percent of Caucasian undergoing the surgery for fibroids.

Another option for women with painful fibroids is embolization, during which the blood vessels to the uterus are blocked to stop blood flow that feeds the fibroids. The procedure, also called UFE or UAE, is usually offered to women who no longer wish to become pregnant or want to avoid a hysterectomy. Medical experts do not fully understand the procedure's effect on fertility, but there are reported cases of women who have conceived and delivered successfully following UFE.


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