Non-surgical fibroid treatment: Uterine fibroid embolization
If you are suffering from fibroids, a hysterectomy isn't the only solution. Board-certified obstetrician and gynecologist Dr. Bruce McLucas, founder of the Los Angeles Fibroid Treatment Center, says a hysterectomy should be the last option for women, even though many doctors recommend it as a primary fibroid treatment. We talked with Dr. McLucas, who has been featured on The Doctors, about fibroids and his use of uterine fibroid embolization, an effective non-invasive procedure to treat fibroid tumors.
What are fibroids?
Fibroid tumors, which affect one out of four women over 45 years old in the United States, are benign growths that grow from the wall of the uterus, ranging in size from microscopic tumors to large masses that fill the entire abdominal cavity. While many fibroids are small and need no treatment, others can grow and spread aggressively. They can be asymptomatic or cause heavy painful periods, frequent urination, backache, stomach ache, painful sex, pregnancy problems, infertility and even miscarriage. Needless to say, women who are experiencing symptoms can't ignore them.
What causes fibroids?
According to Dr. McLucas, the specific cause of uterine fibroids is uncertain but that research and clinical experience indicate it is hormonal. "Fibroids contain more estrogen and progesterone receptors than do normal uterine muscle cells," he explains. "Estrogen promotes the growth of fibroids."
Who is at risk of developing fibroids?
"There are few known risk factors for uterine fibroids, other than being a woman of reproductive age," says Dr. McLucas. "Other characteristics that can have an impact on fibroid development include pregnancy, race and age."
Pregnancy and childbirth: Pregnancy and childbirth seem to have a protective effect and may decrease your risk of developing uterine fibroids. But a pregnant woman with fibroids can experience growth of these fibroids due to increased estrogen levels.
Race: Black women are more likely to have fibroids than are women of other racial groups. Fibroids affect close to 50 percent of black women over the age of 40 and they also tend to have fibroids at younger ages, and are likely to have larger and more fibroids.
Age: Fibroids affect more than 40 percent of women over the age of 40. Women in the age group immediately prior to the menopause (ages 45-50) have more unopposed estrogen, and are likely to experience rapid growth of their fibroids.
What is uterine fibroid embolization?
Women with fibroids are often told by their doctors that the best treatment is a hysterectomy. However, Dr. McLucas says a hysterectomy should be the last option and that uterine fibroid embolization is an effective and far less debilitating option than removing a woman's uterus. "Uterine fibroid embolization is a non-invasive, non-surgical outpatient procedure," the medical expert explains. "This procedure blocks the blood supply of the arteries that supply fibroids causing them to atrophy. Embolization uses angiographic [imaging] techniques to place a catheter into the uterine arteries so that particles the size of grains of sand can be injected through catheter and into the blood supply of the fibroids."
Dr. McLucas is one of the only gynecologists in America with the skills necessary to perform uterine fibroid embolization.
Why aren't more doctors recommending uterine fibroid embolization?
Dr. McLucas credits traditional training for gynecologists as one of the reasons that doctors recommend hysterectomy, particularly for women who do not want more children. But he also blames fear and lack of skills.
"In some cases, there is a disconnect between the interventional radiologist and the gynecologist; some gynecologists may perceive the procedure as a radiological alternative that can potentially threaten their own patient base," he explains. "Moreover, gynecologists may lack the skills necessary to offer such minimally invasive alternatives, and for this reason, they may direct their patients toward more traditional procedures which they can perform."
Is uterine fibroid embolization a possibility for every woman suffering from fibroids?
According to Dr. McLucas, a woman may be a candidate for uterine fibroid embolization if she fits into any of the following categories:
- She is experiencing symptoms of uterine fibroids.
- She has a desire to retain her uterus and pursue hysterectomy alternatives.
- She does not desire surgery.
- She is a poor surgical candidate (e.g., because of obesity, bleeding disorders, anemia).
- She is not pregnant.
What criteria should women keep in mind when choosing a doctor to perform uterine fibroid embolization?
As with any procedure, finding the best doctor is imperative to successful treatment. Uterine fibroid embolization is performed by a physician trained in the field of interventional radiology; this includes gynecologists, interventional cardiologists, vascular surgeons and interventional radiologists. Make sure your doctor is trained in the field of interventional radiology and has a history of performing uterine fibroid embolization. Dr. McLucas also recommends that you ask the physician how many procedures he or she has performed and beware of someone who has not done at least 100 procedures.
For more information on fibroids, visit Fibroids.com.