Johns Hopkins Medicine has opened a new center for
treating and investigating the causes of uterine fibroids,
a medical condition that afflicts millions of American
women. The center will specialize in state-of-the-art
therapies for the condition and in the rapid application of
new research to the treatment of these mostly benign
growths of the wall of the uterus.
Fibroids, which can vary in number and range in size
from as small as a pea to as large as a grapefruit or small
melon, may result in excessive bleeding, anemia,
infertility and excessive pressure on the bladder and
bowel. An estimated one-third of the 600,000 hysterectomies
performed each year in the United States are due to
fibroids.
"Linking clinical practice to medical research is the
best way we have of determining why fibroids affect some
women and not others, and in deciding when to intervene
medically or surgically," said gynecologic surgeon John
Griffith, an assistant professor at the School of Medicine
and director of the new Fibroid Center, which is located at
Johns Hopkins facilities at Green Spring Station. "We
anticipate using the vast epidemiological and genetics
expertise at Hopkins to learn more about why fibroids
disproportionately afflict more black American women. We
also hope to be able to predict growth patterns so that
there will be less of an impact on childbearing.
Johns Hopkins' research-based resources distinguish
its program from others in the field, said Griffith, who
will lead a team of a dozen faculty and 40 staff that
includes interventional radiologists, reproductive
endocrinologists, geneticists, nurses and public health
experts.
On the treatment side, the Hopkins team will emphasize
minimally invasive techniques that focus on removing or
shrinking fibroids instead of surgically removing the
entire uterus. Particular attention will be paid to
preserving the uterus for women who have not completed
childbearing.
The cause of fibroids is unknown, but excess estrogen
is believed to play a role in their development, and
hormone therapy is often used to shrink tumors.
"For benign fibroids, many women undergo hysterectomy,
the most common abdominal surgery for women in the United
States, said interventional radiologist Hyun Kevin Kim, an
assistant professor. "Our goal is to develop and offer new,
minimally invasive therapies for women."
Kim added that laparoscopic, or minimally invasive,
procedures are the current trend, allowing physicians to
shrink fibroids and avoid the complications, inconvenience
and pain associated with open surgical options. Uterine
artery embolization is one such procedure, in which tiny
plastic pellets are used to block blood flow to the fibroid
tumors, starving them of nutrients and oxygen. The pellets
are implanted using a thin catheter threaded from the groin
to the uterine arteries. Although embolization requires
pain medication and an overnight hospital stay, the
recovery period lasts slightly longer than one week.
Another current treatment option uses ultrasound
energy to shrink fibroid tumors. Magnetic resonance imaging
is used to guide the focused ultrasound therapy to fibers
of the tumor. Although the procedure can require the
patient to spend up to three hours in the MRI, there are no
incisions or hospital stayovers.
Griffith said that the goal of the Hopkins center is
to conduct evidence-based research comparing treatment to
determine which procedure is best for particular women. No
definitive answer to what should be done currently exists,
he said, either for patients or physicians.
More information about Hopkins Fibroid Cen-ter and its
services is available at
womenshealth.jhmi.edu/gyn/conditions/fibroids.html.