There are women that go years after knowing that they have fibroids and not doing anything about it, and that may be because the treatment options that have been provided to them are not quite in line with what they think they want. An interventional radiologist may be able to provide that minimally invasive treatment option.
It’s not uncommon for Dr. Theresa Caridi to see patients in tears from years of discomfort, heavy bleeding and other symptoms related to uterine fibroids, or noncancerous growths on the uterus.
Some can’t make it to work without having an accident in the car; others miss work completely. And nearly all come to Caridi with one common goal: Symptom relief without major surgery.
“It’s a big issue and it’s common, so women are looking for ways to treat fibroids that improves their quality of life and makes their life manageable,” said Caridi, an assistant professor in the Division of Vascular and Interventional Radiology at MedStar Georgetown University Hospital, who explained that uterine fibroids affect about one-third of women.
“There are women that go years after knowing that they have fibroids and not doing anything about it, and that may be because the treatment options that have been provided to them are not quite in line with what they think they want. An interventional radiologist may be able to provide that minimally invasive treatment option,” she said, noting that hysterectomy is one of the most common treatments a gynecologist will offer for this non-life-threatening condition.
Those with symptomatic fibroids wait, on average, three and a half years before seeking treatment, often because they are not satisfied with the surgical options offered, especially if it means losing their uterus, said Caridi. However, by way of a uterine artery embolization (UAE), Caridi and other interventional radiologists are able to provide relief with a minimally invasive method that uses a small tube (catheter) and imaging technology to target treatment to the fibroids. The treatment starves the fibroid of its blood flow, taking away the oxygen and nutrients that supply it while leaving the uterus intact.
“It allows these fibroids to basically go from a nice, ripe symptomatic fruit, to shriveling up to a prune, so they can’t produce those symptoms that they used to cause for a woman,” Caridi said.
“And [the patient] essentially goes home with a glorified Band-Aid … on the spot where we entered.”
Interventional radiologists can use an embolization technique to help treat a number of other women’s health issues, including adenomyosis, postpartum bleeding and chronic pelvic pain (or pelvic congestion syndrome). Embolization can also be used to treat men’s health conditions, such as benign prostatic hyperplasia (BPH), which causes uncomfortable urinary symptoms in nearly 50% of men 50 and older and only increases with age. This treatment is called prostatic artery embolization, or PAE. Interventional radiologists also treat varicoceles, the enlargement of the vein leading to and within the scrotum resulting in pain or infertility, with a minimally invasive outpatient embolization procedure.
Caridi said patients who seek treatment from interventional radiologists can expect the same level of care they receive from other physicians, with consultations and clinical visits. Interventional radiologists also provide coordinated care and work alongside a patient’s referring physician to help assess images, discuss strategies and decide on the best course of treatment.
“Ultimately, our goal is to find an individualized plan for [the patient’s] particular need,” Caridi added.
She recommends patients curious about different treatment options consult with an interventional radiologist, “even if they’ve been struggling with a condition or symptoms for a long time.” The Society of Interventional Radiology’s doctor finder tool keeps a database of interventional radiologists practicing in the U.S. and around the world.
“There may be an option that they haven’t heard of, and that option may be interventional radiology,” Caridi said.
