Women's Bodies, Women's Wisdom (43 page)

Can Fibroids Be Cancerous?

Fibroids are almost never cancerous. Fewer than one in a thousand turns into a uterine sarcoma, a very rare type of cancer of the uterine muscle. The only way to tell for sure, however, is to take them out and look at them under the microscope. Since the mortality rate for hysterectomy itself is one in a thousand, the risk of surgery is actually greater than the risk of the fibroid being malignant.

The most common problem with fibroids is their tendency to grow and to cause bleeding. But, as many women I’ve worked with have discovered, if the underlying energy patterns, life questions, conflicts, and emotional issues associated with the fibroids are addressed and changed, the fibroids usually do not grow or cause problems.

Are Fibroids Genetic?

Fibroids can run in families. One of my fibroid patients told me that every female in her family for three generations had fibroids. She is planning to be the first woman in her tribe to get to menopause with her uterus intact. She has changed her diet and now is completely free from symptoms.

Just as in a strong family history of alcoholism, in a strong family history of fibroids the individual woman is up against a family belief system, from which it is very difficult to break free. I once read an ar ticle about familial ovarian cancer entitled “My Mother, My Cells,” in which the author articulated her difficulty with inheriting a tendency toward a disease that terrified her and over which she felt she had no control.

In this country, we tend to think of a genetic predisposition as an inevitable “sentence” that we
will
get the disease. However, environ mental factors play a huge role in whether that predisposition ever gets expressed. For example, some individuals with the gene for cystic fibrosis manage to keep the disease under control and live well into their fifties. This was unheard of several decades ago. And many women with very strong family histories of breast cancer never get the disease.

Some women who have strong family histories of fibroids, ovarian cysts, or endometriosis have developed these conditions themselves but have healed from them. One patient summarized a necessary part of this healing when she said, “I’ve finally realized that I am not my mother. I don’t have to live out her life in my body.” In families in which there is a genetic disease, we should study those members who
don’t
get the disease. Most likely they are the individuals who broke the family mold, the ones who did not live out family expectations on a cel lular or other level.

Will My Fibroids Interfere with Pregnancy?

During pregnancy, hormone levels are very high and preexisting fibroids can grow rapidly. If they begin to degenerate, fibroids can sometimes cause uterine contractions that can result in premature delivery. This doesn’t happen with all fibroids, however. I’ve seen women with large fourteen-week-size fibroids get pregnant, carry to term, and go through normal labor and delivery with out
any
problem.

One twenty-nine-year-old woman came to me already twelve weeks pregnant with a large fibroid in the posterior portion of her uterus. The pregnancy had been unplanned, but she was thrilled about it. Her doc tor had told her to have an abortion and then have the fibroid removed before conceiving again. He told her that the fibroid would probably cause the early delivery of a baby who would be so premature that it wouldn’t live. She was very upset about her dilemma and needed a physician who was willing to go along with the pregnancy, knowing that there might be a problem while being open to the possibility that all could go well. Her pregnancy proceeded normally, going to full term without pain, bleeding, or premature labor. She delivered a seven-pound, three-ounce girl after an eight-hour labor. Her fibroid had shrunk to an eight-week size by the time of her six-week postpartum checkup.

Fibroids can result in miscarriage or even infertility, particularly if they’ve distorted the uterine cavity enough. Whether there are problems seems to depend on the location of the fibroid within the uterus and how close it is to the developing baby and placenta. An ultrasound or hysterosalp-ingogram (an X-ray study in which dye is injected into the uterus and tubes) can give you some idea of fibroid location before pregnancy, as can an MRI.

Some pregnant women have fibroids that start degenerating. They end up in the hospital to be watched closely while they rest in bed on pain medication. Generally, fibroids don’t hurt the developing baby unless they cause so much uterine irritability that the uterus starts con tracting and premature labor results. There are no guarantees against developing problems with fibroids during pregnancy because the entire uterus grows, including the fibroid wall. The farther away from the uterine cavity the fibroid is located, the less likely that a woman will have problems. Some doctors are willing to take a wait-and-see attitude about fibroids and pregnancy, suggesting that a woman try to get pregnant and see what happens. Others will suggest that she have the fibroids removed before attempting pregnancy.

Will the Fibroids Grow? Will They Go Away?

Many women with fibroids are told that hysterectomy should be performed when their fibroids are relatively small so that a more risky and complicated hysterectomy in the future, should the fibroids grow, will not be necessary. Studies have shown that there is little or no justification for this.
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Fibroids do grow sometimes, but not always. They tend to grow quite briskly during the years just before menopause, when hormonal levels fluctuate widely, then shrink dramatically after menopause. One of my perimenopausal, or “almost menopausal,” patients, age forty-nine, whom I followed for more than twenty years, could easily feel her fibroids through her ab dominal wall by pressing down with her fingers. She said that her fi broids grew up to her belly button just before her period and shrank down to just above her pubic bone within three days after her period was over. Fibroids often change size during each menstrual cycle, reaching their peak during ovulation and just before the menstrual period begins. They can also grow during periods of stress. Fibroids can be followed by a physician or other qualified health care provider with an exam every six months to a year. There’s no reason to rush into sur gery, unless you have repeated episodes of severe bleeding that cannot be controlled with hormonal treatments or other measures.

Sometimes fibroids go away completely. I recently met a religious woman who had been scheduled for hysterectomy because of fibroids. She prayed about them daily. Six weeks later, when she went back to her doctor, the fibroids were gone and she didn’t require the surgery.

One of my patients, a forty-three-year-old musician and sound healer named Persis, first came to see me with a fibroid the size of a four-to-five-month pregnancy. After two years of a strict diet, reflective inner work, massages, and therapeutic sound, her very large fibroid uterus returned almost to normal.
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I rarely see fibroids shrink as much as hers did. This shrinkage was not because of menopause. She is still having normal periods. Here is her story.

In the summer of 1988, I was diagnosed with endometriosis and a grapefruit-size fibroid tumor. The preceding years had been filled with increasingly excruciating pain that left me almost blacking out while driving. I had gotten used to being in pain for two weeks, then recovering from the exhaustion in the next two weeks, and had become terrified of getting my period.

The doctor I was seeing at the time told me about all the alternatives for correcting the problem. His favorite was hysterectomy—“At your age you don’t need your uterus anyway,” he said. Then there was hormone therapy to stop the periods for one to two years: “Your voice will drop, and you will lose your sexual desire.” And the last offer he made was that I could continue with the pain and bleeding until menopause.

Since I wanted to keep my body whole, didn’t particularly like the idea of giving up my womanhood to hormone therapy, and couldn’t tolerate the pain, I looked for other treatment. I made a commitment to my life. I accepted the responsibility for taking care of myself. I ac cepted the loving help of others. I began a very strict regimen of mac robiotic diet, sitz baths, exercise, and meditation. Looking back, I don’t know how I fit all that into my busy life. I do know that I am a changed person.

I also began gently to search out the reasons behind my “woman’s troubles.” I accepted my codependent nature and began opening up to the pain of my childhood and young adulthood. The pain in my belly was a culmination of a lifetime of pains. I knew just cutting it out wouldn’t “fix” all the other pains in my life.

I now have little pain and feel extraordinarily well. I am and al ways will be in process throughout my life. Through meditation and sound healing on myself, I have renewed my inner faith. I accept my life and my ability to heal myself as well as to help others heal. As I do for others, I do for myself.

If I Undergo Fibroid Removal Treatment, Will the FibroidsGrow Back?

The answer to this question must be individualized. In general, a woman who is within five years of menopause when she has her fibroids treated is not likely to have them grow back, because her estrogen levels will be decreasing naturally. If the underlying energy pattern, emotional issues, or hormonal levels associated with the fibroids haven’t changed, then other so-called seedling fibroids can start to grow. Women who change their diets dramatically, however, decrease the likelihood that the fibroids will return. In the women whose fibroids I have treated, I have rarely seen them recur or get worse. This is probably because of the law of attraction. Women who resonate with my approach are highly motivated to take responsibility for their own healing. I recommend di etary change, body work, homeopathy, and other alternative methods, even for those women who choose fibroid removal as their treatment. Surgery or fibroid ablation alone will not change the fundamental pat tern in their bodies that encouraged the fibroids to grow. It is vital to listen to what our bodies are trying to teach us and affirm our ability to be whole.

Treatment

At no point is it appropriate for a doctor to make dictatorial treat ment recommendations about what any woman should do with her uterus. There is no right and wrong. Instead, it’s best to offer women ways to think about their uterus, ovaries, and body, so that when they need to make a decision about hormones, drugs, surgery, or fibroid ab lation, they’ll know what their personal truth is regarding those organs. More treatments for fibroids are now available than ever before. Once a woman has gathered the facts about treatment choices, she can tune in to her own inner guidance to decide which is the best for her.

For many women, just knowing that they have a choice in the matter is a huge relief. Some women interpret surgery, for example, as further abuse, when they have not freely chosen to undergo it. Incest survivors sometimes tell me that the very thought of an invasive proce dure in their body, particularly of a gynecological nature, feels just like rape. Obviously, alternative modes of treatment should be tried in these cases, rather than allowing the abuse cycle to once again be ignited.

The following section illustrates different treatment approaches to problems in the uterus. There is no one right way to treat uterine problems. Each of these women mentioned in this section needed help for fairly straightforward and common symptoms, and each chose a differ ent treatment. Only one woman wanted a hysterectomy. Each woman was able to arrange treatment that respected her individual choice. Medical technology, when consciously used in an individualized treat ment, can be a major aid in healing women’s lives. To claim that hysterectomy is always the wrong or inferior choice is as dualistic and harmful as claiming that all natural remedies are quackery. I do not ad dress the specific psychological and emotional issues connected with “blocked energy in the pelvis” for any of these cases. Not all women are open or ready to explore their deep issues, and I respect their choice to wait for the right time.

Conservative: Watch and Wait

If a woman’s fibroids aren’t causing her any problems, I recommend a pelvic exam every six months to a year, depending upon her situation. I also recommend a sonogram (ultra sound) initially to be sure that the problem is a fibroid and not an ovar ian cyst or tumor. Sonograms can measure fibroid size and check the ovaries. Conservative treatment is sometimes called “benign neglect” or the “tincture of time.” Very often it’s the best therapy. By the way, one often cannot see the ovaries when an enlarged uterus is blocking the view. This doesn’t necessarily mean that there is something wrong with the ovaries and that you need a procedure to find out.

Hormone Therapy: Synthetic Progestin or NaturalProgesterone

To women whose primary symptom is bleeding, I suggest synthetic progestin or natural progesterone as a treatment, to keep the lining of the uterus from building up too much. In many cases this therapy works very well to control bleeding and is much more benign than major ab dominal surgery. Progesterone or progestin is an option for women who are unable to change their diets or whose symptoms aren’t alleviated by dietary changes. Some women become depressed while they are on synthetic progestin; others feel bloated or premenstrual or get headaches. Bioidentical (or natural) progesterone is generally free of these side effects and is my first choice. Since each woman’s life situation is different, her medical treatment needs to be individualized.

GnRH Agonists

GnRH (gonadotropin-releasing hormone) agonists such as Lupron and Synarel are synthetic hormones that cause the pituitary gland to shut down the function of the ovaries. After about one month on these drugs, a woman’s body becomes artificially menopausal. Her estrogen levels fall very low, and her periods cease. The cyclic stimulation of her fibroid tissue ceases, and in most cases the fibroids shrink in size. GnRH agonists are used in select cases to shrink fibroids before surgery or to shrink them enough so that surgery is not necessary. Some physicians use these drugs to keep a woman’s fibroids asymptomatic until she reaches menopausal age, at which point the fibroids naturally shrink. In this way, she can avoid surgery. It takes about three months to get the maximum effect from these drugs, but most women need to be on them for only two months in order to get significant shrinking for a myomec tomy. Not everyone gets the same result because not all fibroids are created equal.
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