Treatment Choices

I have been diagnosed as having a large fibroid tumor located basically on the left side of my lower abdomen. It gives me no problems except for severe constipation–no heavy bleeding, no real pain and that is inconsistent, relieved by my daily walking regimen,etc. I will be 49 next month and in what most people would call exceptionally good health: 5’9″, 115 lbs. (I have always been on the slender side; it runs in the family). Few occurances (two) of cancer in the immediate family,no strokes, no heart attacks,no diabetes, no circulation problems–some rspiratory ailments and father had high blood pressure–I don’t. I do have have a high anxiety level.

The ob-gyn I have seen recommended traditional surgury: remove the fibroid and the uterus, keeping the ovaries if I wished. He said I was not a good candiate for laparascopic surgury because the fibroid was so large nor was dilation a good idea because I was so small in the birth canal. Lupron shots (three, one per month) were an alternative, but the tumors would likely grow back.

It took seven years for this one to show up–I had a myomectomy by dilation at that time, easily done because that tumor grew out the canal and could be seen. This one was not there then. I could also wait, he said, on menopause and continue taking Pericolace to aid my intestinal function which I rather not do if I could avoid. If untreated, he said, damage to my kidneys and intestines could result in the future from the pressure.

I have about decided, following a second opinion, to go with the shots and keep an eye on things in case the tumor begins to grow back. I have heard and read that laparascopy can be used even to remove large fibroids.

Would you please give me your opinion of my situation? My doctor is a kind and caring person, but I need more information and do not wnat straight surgury if avoidable. Also, are there side effects with the shots? I usually have no side effects from medicine when other people around me are having fits with theirs.

Thank you for your time.

Betsy Mordecai

Dear Betsy-
I NEVER recommend Lupron shots to patients, as it only disrupst the female hormone system, and once the treatment is stopped the growth of the tumors begins again. It buys patients some time, but at a questionable risk. It may also push you over the edge into menopause.
I also do not recommend waiting for surgery-you need to have the tumor removed. Beside the potential for kidney and colon damage, once you begin any form of hormone replacement therapy after menopause, and most women do, your tumor will start to grow again. Surgery will probably become imminent, and now at a later age in your life, when it is less safe. I do not believe in hysterectomy for fibroids, you are a perfect candidate for our FAS procedure. We would safely remove the tumor, but allow you to keep your uterus.
I would not postpone the inevitable, nor waste time with temporary solutions. Good Luck