Businesswoman Neha Mehra, (name changed on request), 35, waited five years for a non-surgical treatment for fibroids — non-cancerous tumours in the uterus — to arrive in Delhi. And she’s happy for it.
Last month, her problem was treated in a three-hour-long session as she lay on her abdomen inside a unique MRI scanner-cum-ultrasound machine. Called High Intensity Focused Ultrasound (HIFU), the machine is an advanced non-invasive treatment option available at New Delhi’s Indraprastha Apollo Hospitals.
“There are no cuts, no anaesthesia or any risks associated with a surgery. Obviously, I was more relaxed mentally and was back to work the next day,” said Mehra. All she felt was a slight sensation in the lower abdomen as concentrated ultrasound waves passed through her uterus to treat the fibroids.
The cost for the procedure is the same as surgery: R1 lakh for one session. Usually, most women need just one session to get treated.
Mehra’s problems started five years ago when she started feeling an
excruciating pain in her lower abdomen during her periods. Her menstrual cycle, too, became longer, at times lasting up to a fortnight.
One in five women suffer from
uterine fibroids during the reproductive age. Though the exact cause is not known, studies have shown their growth is related to the female hormone,
“One in three women in the child-bearing age have at least one hormonal disorder. However, more women in their mid-30s are now being diagnosed with hormonal problems earlier found only in women over the age of 50,” said a senior gynaecologist at New Delhi’s All India Institute of Medical Sciences. “Changing lifestyles — such as women having children at a later age — could be a cause ,” she added.
Fibroids are slow-growing tumours that may or may not produce symptoms such as excessive bleeding, severe abdominal pain and cramps. If there are no symptoms, gynaecologists just keep a close watch using an ultrasound. But in the presence of symptoms, they advise the uterus be removed.
As fibroids often reoccur, most doctors suggest the removal of the uterus — hysterectomy — if the woman does not plan to have any more children.
Uterine fibroids generally occur after the age of 45, but women 35 years and younger are being diagnosed with the growth. Since a significant number of them have not had children, uterus removal is not recommended.
The other method to remove the fibroids surgically is called myomectomy, which involves killing fibroid cells by cutting off blood supply to them using a minimally-invasive procedure called uterine fibroid embolisation.
HIFU is particularly useful for women who do not want surgery or cannot have one due to medical conditions such as uncontrolled high blood pressure and diabetes. The new technology liquifies tumours using heat generated by focusing ultrasound waves on them. One session lasts for up to four hours.
“Once the fibroid is imaged using an MR scan, the same machine is fitted with an ultrasound system. The patient is then asked to lie on her belly and the ultrasound rays are focused on the fibroid at a temperature that shrinks them,” said Dr Harsh Rastogi, senior consultant, department of radiology, Apollo Hospital. The hospital is the first in north India to install the machine and within two months of installation, 11 women have been treated.
“It’s not a technician’s job. A trained radiologist is needed to operate the machine, as there is a possibility of healthy tissues getting damaged if the operator is untrained,” said Dr Rastogi.
Though women get quick relief from pain and pressure symptoms after treatment, it takes anywhere between three to six months for the tumours to shrink completely. “The solid form liquifies instantly with heat, but it takes months for the tumours to shrink altogether. We advise an ultrasound in the first, third and sixth month post-treatment to track the treatment,” said Dr Sohani Verma, senior consultant gynaecologist Apollo.
Since, it is a new technique,
gynaecologists are still referring patients cautiously.
“Knowing the risks involved in the surgery, this is a good option. But there is no data to show its long-term effects. We need to see how the technology develops,” said Dr Verma.