BDO: What are some of the newer treatments for fibroids?
Dr. Linda Bradley: The new treatment options are many fold and I would say patients really need to stay tuned. we’re getting ready to look at probably in 2018 at least one new medical drug that will be used by mouth, taken orally that can be used to stop periods and to shrink fibroids. These are called progesterone modulator drugs which also modulate the other hormone that’s made as we have estrogen and progesterone so that’s a drug.
There are another two drugs that are being actively studied, one of the drugs is currently available in Canada and in Europe and has been there for more than three years and is coming to the US. There are new surgical treatments using different types of energy sources from radiofrequency which is the type of energy that we can use for purpose of this discussion to kind of vaporize or desiccate or dry out fibroids. Some of those can be used inside of the uterine cavity where we just put a probe inside. Some may have to go through the belly button where we have small probes that can desiccate and treat with ultrasound and with also what we call bipolar energy emerging.
Getting smarter about uterine fibroid embolization and/or uterine artery embolization in terms of the particles that may work better to shrink the fibroids, MRI focused ultrasound, different types of IUDs and medical therapy. I think we’re seeing a ramping up of new treatments, there’s been something rather stale in terms of our specialty and what we’ve been able to offer patients.
Also using drugs that we’ve been around a long time that has had sadly a negative press about their use. One being the Mirena IUD which may be very helpful for certain select group of women who have fibroids and a unique location and letting women know about its safety. An IUD that’s been around since 2000 with such a minimal uptick intake of women to using this. Knowledgeable physicians can more accurately and appropriately offer patients treatment. (2:28), another great drug it has been around 30 or 40 years not used at all in the US hardly. Been available since 2009 2010.
I don’t know why doctors don’t use this drug, it’s like it’s a wonder drug in my mind. We studied that drug as a part of a trial at the Cleveland Clinic as well as other international doctors to look at this. Part of it is that in medicine sadly it takes a long time for doctors to change. The primary focus for many years is cut it out. Women are saying we don’t want our uterus removed, we want babies or we want to have a sense of wholeness, they’re concerned about their sexuality sometimes. Also, women just want to fill intact.
There are times I do hysterectomies. But in when I was training years ago that was the only option that you had. we now know that if you want a baby find a doctor and a center that can help you because the majority of the time we can find something, a medicine, a treatment, an alternative, working collaboratively with other doctors and team members from radiology that will allow a patient to have her uterus if that’s what she desires.
Second opinion appointments are very important, becoming knowledgeable. Knowledge is power and to go into your physician’s office not confrontational but just a knowledgeable. Just like me buying a car if I act like I know, getting my car fixed I don’t know anything about a car. but I’ll look over at the guy and say well act like I know what I’m talking about and I don’t feel like there’s this pull over my eyes.
So going in with your physician with your history, with your imaging test, not being wishy-washy, letting someone know what your desires are. Doctor I really want a baby tell me the options based on what my fibroid looks like. Having an easygoing conversation is very important. I often say bring somebody with you to your office appointment. Sometimes patients don’t hear what we say and so that other set of eyes and ears have your questions written down and make sure you haven’t forgotten something. And making and keeping follow appointments if the physician has arranged for that.
The doctor-patient relationship is a special union. I’m speaking for myself I take it as a part of my Hippocratic oath to take care of patients and to look at their mind their body and their spirit and to be able to do those things that we have scientific evidence for and to make women aware of things that will likely improve their health and their quality of life. I think partnerships with the doctor is very important