New Laser Surgery Could Treat Fibroid Tumors With Less Pain

Lasers can be used to shrink fibroid tumors, British physicians report, a finding that may offer women a minimally invasive alternative to hysterectomies.

About 20% to 40% of women over the age of 35 are afflicted with fibroids, which are bundles of muscle fiber and connective tissue that grow inside the uterus. Fibroids, when small, produce no symptoms but can grow very large, causing severe pelvic pain and pressure, back problems, severe cramping and heavy periods.

Dr. Wladyslaw M. Gedroyc of St. Mary’s Hospital in London performed the new procedure, called laser ablation, on 40 women.

In the procedure, magnetic resonance imaging (MRI) is used to guide four needles through the abdominal wall and into the center of the fibroid. Tiny lasers are then inserted through the needles to “cook” cells of the fibroids, so that scar tissue forms and the fibroids shrink.

Gedroyc reported Nov. 27 at a Chicago meeting of the Radiological Society of North America that the treatment was successful in 35 of the women, with fibroids shrinking by an average of 37%. The procedure takes about two hours, and the woman can go home four hours later, he said.

“Most women don’t even take pain pills after the procedure,” Gedroyc added.

Arthritis Drug Could Also Slow Progression

A drug already approved for treating advanced rheumatoid arthritis is also useful for blocking progression of the disorder’s early stages, according to a new study.

The drug is called etanercept, trade-named Enbrel, and it effectively reduces pain and swelling of joints in later stages of arthritis.

Dr. Joan Bathlon of Johns Hopkins University School of Medicine coordinated a multicenter study of 632 patients in the earliest stages of rheumatoid arthritis. Half were given methotrexate pills, the standard treatment for initial symptoms, and half were given regular infusions of etanercept.

The team reported in the Nov. 30 New England Journal of Medicine (https://www.nejm.com) that etanercept acted more quickly to decrease symptoms and to slow joint damage. The progress of the disease was stopped completely in 72% of the etanercept patients and 60% of the methotrexate group. Etanercept caused only half as many severe side effects as methotrexate. The chief disadvantage of the new drug is its cost: While methotrexate costs about $1,000 per patient per year, etanercept costs about $12,000.

Etanercept blocks the activity of an immune system chemical called tumor necrosis factor-alpha, which has been implicated in the damage caused by rheumatoid arthritis. Another new arthritis drug called infliximab (trade-named Remicade) actually destroys tumor necrosis factor-alpha in the blood.

In a separate study, a team headed by Dr. Peter E. Lipsky of the University of Texas Southwestern Medical Center at Dallas studied infliximab in 428 patients who had active rheumatoid arthritis even though they were taking methotrexate. Half received infliximab and half a placebo; all continued to receive methotrexate.

The team reported in the same issue of the New England Journal of Medicine that a sustained reduction in symptoms was obtained by 51.8% of those receiving the new drug, but in only 17% of those receiving methotrexate alone.

An estimated 6 million Americans, most of them women, suffer from rheumatoid arthritis. Symptoms include joint stiffness and pain and great fatigue.

Sex Might Qualify as Heart-Healthy Activity

Frequent sex can sharply reduce a man’s risk of having a heart attack or stroke, according to British researchers. Dr. Shah Ebrahim and his colleagues at the University of Bristol studied 2,400 men in the Welsh town of Caerphilly. The men, who had no history of major diseases, were asked a variety of questions, including how often they had sex, and then monitored for 10 years.

Ebrahim reported Nov. 28 at the World Stroke Congress in Melbourne, Australia, that men who had sex three or four times weekly were half as likely to suffer a major heart attack or stroke as those who had sex less frequently. Ebrahim concluded that sex should be redefined as vigorous activity in guidelines for the amount of exercise necessary to prevent heart disease.

Estrogen’s Connection to Brain, Parkinson’s

Going through menopause appears to kill cells in women’s brains by depriving them of estrogen, a finding that may help explain why the hormone has been shown to have a protective effect in some studies.

Dr. Csaba Leranth and her colleagues at Yale University removed the ovaries from female monkeys, depleting their bodies of estrogen, and monitored the survival of brain cells.

They reported in the December Journal of Neuroscience that more than 30% of the dopamine-secreting cells in the substantia nigra region of the brain were gone. Destruction of these cells by environmental chemicals or other agents has previously been shown to produce Parkinson’s disease, and the new findings may help explain why women are more likely to develop Parkinson’s after menopause than before.

The number of cells could be restored if estrogen administration began within 10 days, but not if it was delayed 30 days, the researchers found. Leranth cautioned that women should not use these findings in considering whether to begin estrogen replacement therapy until they have been verified by further studies.

Urine Test Developed for Alzheimer’s

Researchers at the University of Pennsylvania Medical Center say a simple urine test can help diagnose Alzheimer’s disease and assess its severity. The test involves a chemical called isoprostane, which is formed from fats and lipids when they are oxidized.

Alzheimer’s is difficult to diagnose; the usual approach is to eliminate all other possibilities. Some recent studies have suggested that high levels of a protein called tau in cerebrospinal fluid are present in Alzheimer’s victims, but measuring them requires a painful spinal tap.

Dr. Domenico Pratico and his colleagues measured levels of isoprostane in the blood, urine and cerebrospinal fluid of 35 Alzheimer’s patients and 25 healthy volunteers. They reported in the November Annals of Neurology that Alzheimer’s patients had significantly higher levels of isoprostane in their blood, urine and cerebrospinal fluid and that these levels correlated well with levels of tau protein in the spinal fluid.

If the study is replicated, they said, urine tests could ease diagnosis and monitoring of Alzheimer’s.

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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.