FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[READER ADVISED NOT GO TO CANADA FOR FIBROID TUMOR TREATMENT]

Question: I am a 51-year-old woman and I have had no "female complaints" until about 3 years ago. I started having very heavy menstrual bleeding. After several exams and a D&C, I was told I have fibroids. What are my treatment options? I've read about a "uterine balloon therapy" that is done in Canada. How would I make contact with a doctor there for this treatment?

Answer: Fibroid tumors are often referred to by their more technical name, "leiomyoma" and occur in 25 to 30 percent of all women. Regardless of their name, they cause menstrual period symptoms like yours in most of those with them. In reproductive age women they may also cause difficulty with fertility or with continuing a pregnancy.

There are a variety of possible treatments for fibroids. The age of the woman, whether she is pregnant or may wish to become pregnant, the location of tumor, its size and the person's general health help determine which treatment is right for her.

The fibroid tumor is stimulated to grow by the presence of estrogen, one of the normal female hormones. Because of this, there are several hormonal treatments that often reduce the size of the tumor and also lessen the severity of the symptoms it produces. As I suspect you know, the estrogen levels drop significantly as a woman goes through menopause. This change often brings about improvement or total elimination of the symptoms caused by the tumor. This is a form of "natural" hormonal therapy.

Hormonal treatment may be used alone or in conjunction with surgical treatment. Surgery may be as simple as the D&C you had. For other women, specific removal of the offending fibroid tumor or tumors, or removal of the entire uterus may be necessary. There are quite a few ways a surgeon can remove just the fibroid tumors. The use of high-tech instruments and lasers are best for some conditions. The balloon therapy you mentioned is one of these newer techniques. In another form of treatment, the blood supply to the tumor is blocked, thereby causing it to die. In women who no longer desire to have more children, a hysterectomy may be recommended.

There are a number of procedures and medications available in other parts of the world that are not available in our country. It depends upon the success of the specific therapy whether the government is damned for maintaining conservative protective barriers or praised for keeping a harmful treatment away from our shores. In the latter case, however, there is almost never much news coverage about the problems related to using the so-called "new and better" treatment because they aren't news here. They may be very big news in the countries where citizens are suffering from the consequences of the prematurely approved treatment.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.