Fibroids (also known as leiomyomas) are non-cancerous growths that grow in or around the wall of the uterus. In many cases, they cause no problems. But for some women, fibroids can cause heavy, painful periods, a feeling of fullness in the pelvic or lower abdominal area, frequent urination, pain during sex, low back pain, pregnancy complications (like miscarriage or preterm labor) and infertility.

Fibroids are most commonly found in women in their 40s and early 50s. Up to 80 percent of women will develop the condition by 50. Risk is higher in African-Americans, women with a family history of fibroids, those who are obese and women who eat a lot of red meat and ham.

Using MR-Guided Focused Ultrasound

One treatment option for fibroids is MR (magnetic resonance)-guided focused ultrasound (MRgFUS). The technique uses a highly focused beam of ultrasound energy to destroy target cells.

First, the patient lies on her stomach on a special table. Doctors use magnetic resonance imaging (MRI) to take three-dimensional images of the pelvic area. Then, high energy ultrasound waves are focused onto a small spot in the target tissue. Paul Curtis, M.D. is an Interventional Radiologist with Virtua Health in Voorhees, NJ. He says the technique focuses over 300 ultrasound beams onto a single end point, resulting in a very high concentration of energy and heat in the target tissue. It’s similar to the concept of using a magnifying glass to focus the sun’s rays onto a leaf or pile of grass to start a fire. The target area is heated to about 185 degrees F for about 15 minutes. The beams are then refocused onto another spot. The process is repeated until all the tissue has been treated. Total treatment time is about three hours. Doctors continually monitor the MRI images throughout treatment to ensure the entire area has been treated. The targeted tissue is gradually broken down and removed naturally by the body over several months.

MRgFUS for Bone Metastases

Researchers say, after the lungs and liver, bone is the third most common site of cancer metastasis. Nearly all patients with advanced prostate cancer have bone metastases. It also affects up to 90 percent of women with end stage breast cancer.

Currently, treatment for metastases-related bone pain is limited and quality of life for patients is poor. Pain medications may not eliminate the symptoms or last long enough, or may cause unwanted side effects. An alternative treatment, radiation therapy, is effective for 70 to 80 percent of patients, but often only provides temporary relief.

Now, researchers are testing the use of MRgFUS for patients' bone pain from bone metastases. Andre Konski, M.D., Radiation Oncologist with Fox Chase Cancer Center in Philadelphia, PA says the ultrasound beams are focused on the periosteum, the membrane covering the bone that contains the blood vessels and nerves. The treatment destroys the nerves in the target area and disrupts the pain signal. Konski says most patients start to see an improvement in symptoms within a couple of days.

Researchers are still recruiting for a clinical trial on MR-guided ultrasound for patients with pain from bone metastases. The trial is taking place at 8 sites in the U.S. (a list follows). For information, go to: http://www.mycancerpain.org. Neal Kassell, M.D., Neurosurgeon with the University of Virginia Health System, says, in the future, MRgFUS may be used for many different conditions, like cancer, Parkinson’s disease, stroke and epilepsy. It may even be used to release concentrated doses of encapsulated medication in a target area.

BONE METS TRIAL SITES: University of California Los Angeles, Los Angeles, CA
University of California at San Diego, San Diego, CA
Brigham and Women’s Hospital, Boston, MA
Lahey Clinic, Burlington, MA
Cornell University, New York, NY
Fox Chase Cancer Center, Philadelphia, PA
Methodist Hospital, Houston, TX
SightLine Medical Center, Houston, TX

For information about the MR-guided focused ultrasound technology: InSightec

Researchers are currently recruiting for a clinical trial on MR-guided focused ultrasound as a treatment for patients with pain from bone metastases. For information, go to: http://www.mycancerpain.org

For general information on fibroids: National Institute of Child Health and Human Development
National Uterine Fibroids Foundation
National Women’s Health Information Center
National Women’s Health Network