Fallopian tubes, ovaries, uterus, cervix, vagina. You’re familiar with your body and you know all about these amazing parts of your anatomy. You’re a self-proclaimed gynecologic rock star!
But then you start hearing about some other terms. Uterine fibroids, myomas, and sarcomas. Um. What are they? Are they good? Are they bad? Does everybody have them? What do you do about them?
Relax. It’s OK not to know. Most women don’t hear these terms until they start experiencing some gynecologic issues. Then a quick googling of symptoms brings up these unfamiliar words, and women are left a little confused and a lot overwhelmed.
Let’s figure this out together.
Uterine fibroids
Definition
Uterine fibroids are growths found inside (you guessed it) the uterus. They can grow as a single tumor or as a cluster. They can be big, or they can be small. One definite thing about fibroids—they’re VERY common. Up to 80% of women have fibroids by the age of 50.1 And the good news is that they’re almost always noncancerous. This means they’re not cancerous at the time of discovery, they’re not associated with an increased risk of uterine cancer, and they almost never develop into cancer.2 (Phew.)
Symptoms
Many women with fibroids don’t have any symptoms (the doctor might discover them during an unrelated procedure).2 However, other women may experience symptoms that can be very hard to live with on a daily basis. Symptoms of fibroids can include painful and heavy periods, pelvic pain, bloating, frequent urination, difficulty emptying your bladder, constipation, and back and leg pain.2
Diagnosis and treatment
Women who don’t have fibroid-related symptoms usually don’t need treatment for their fibroids. Basically, if fibroids aren’t causing problems, doctors like to leave them alone (but check in on them on a regular basis). On the other hand, women who suffer from fibroid-related symptoms can find relief through a range of treatment options.
Doctors may first recommend nonsurgical methods like birth control or IUD to help control the symptoms. Minimally invasive surgeries may also be considered. The MyoSure® tissue removal procedure lets doctors see the inside of the uterus so they can remove fibroid tissue without cutting the uterus. Another option is the Acessa® laparoscopic radiofrequency ablation procedure, which delivers heat into the fibroid to shrink the fibroid tissue and alleviate symptoms. A hysterectomy, which is surgery to remove the uterus, may also be discussed depending on a patient’s individual circumstances; however, it’s important to know that minimally invasive surgeries provide a way for some patients to relieve fibroid symptoms without removing the uterus. If you have fibroid symptoms, ask your doctor whether minimally invasive treatment is an option for you.
Uterine myomas
See all the info above about uterine fibroids.
Wait. What?
Yes, uterine fibroids and uterine myomas are the same thing, just with a different name. You may run across the term “myomectomy,” which is the name for the surgery to remove fibroids (aka, myomas).
Ah, now it’s all coming together. But to avoid confusion, we generally stick with “fibroids.” Simpler is better.
Uterine sarcomas
Definition
Unfortunately, uterine sarcomas are not the same thing as uterine fibroids. Uterine sarcoma is a cancer that forms in the muscles or tissues that support the uterus (it’s different from endometrial cancer, a disease in which cancer forms in the tissue that lines the uterus).3 Compared to other types of uterine cancers, uterine sarcomas are rare and make up only 2% to 5% of all uterine cancers.4 Most uterine sarcomas occur in women over the age of 40 (the average age at diagnosis is about 60 years old).4
Symptoms
Symptoms of uterine sarcomas include bleeding that is not part of menstrual periods, bleeding after menopause, a mass in the vagina, pain or a feeling of fullness in the abdomen, and frequent urination.3 You can see some overlap of symptoms with uterine fibroids, but while fibroids can cause heavy bleeding during your period, sarcomas may cause abnormal bleeding when you don’t have your period.
Diagnosis and treatment
If your doctor thinks you might have uterine sarcomas, they will perform a physical exam and take your medical history.5 Then they will do a pelvic exam by inserting a gloved finger or two into your vagina and rectum to feel for anything unusual.5 They may also use a speculum to look inside your vagina. Most of this should sound familiar to you if you go for regular visits with your gynecologist.
Your doctor may also perform a transvaginal ultrasound to examine your uterus and ovaries.5 However, sometimes uterine sarcomas and fibroids look similar on an ultrasound, so your doctor may also perform a biopsy (remove tissue) and then examine the cells under a microscope.5 MyoSure tissue removal, which allows the doctor to see the tissue they’re removing, may be used instead of more traditional techniques that don’t allow the doctor to see inside the uterus.
If your doctor determines that you do have uterine sarcomas, treatment can depend on a lot of factors, such as the stage of your cancer, your age, your health, and if you plan to have children in the future.6 Surgery to remove the cancer may focus on just removing the cancerous tumors or may involve a hysterectomy (removal of the uterus). Radiation, chemotherapy, and hormone therapy are sometimes used to help lower the risk of the cancer coming back after surgery.6
Now you’re in the know
So now you have a better understanding of what makes fibroids, myomas, and sarcomas similar and what makes them different. But very few of us are experts, so keep asking questions! Of course, if you have concerns that you may be suffering from these conditions, please talk directly with your doctor.
REFERENCES: 1. U.S. Department of Health & Human Services Office on Women’s Health. Uterine fibroids. https://www.womenshealth.gov/a-z-topics/uterine-fibroids. Accessed February 1, 2023. 2. Mayo Clinic. Uterine fibroids. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288. Accessed February 1, 2023. 3. National Cancer Institute. Uterine Sarcoma Treatment (PDQ®)–Patient Version. https://www.cancer.gov/types/uterine/patient/uterine-sarcoma-treatment-pdq#_7. Accessed February 1, 2023. 4. American Cancer Society. What is uterine sarcoma? https://www.cancer.org/cancer/uterine-sarcoma/about/what-is-uterine-sarcoma.html. Accessed February 1, 2023. 5. Cleveland Clinic. Uterine sarcoma. https://my.clevelandclinic.org/health/diseases/16408-uterine-sarcoma#diagnosis-and-tests. Accessed February 1, 2023. 6. American Cancer Society. Treating uterine sarcoma. https://www.cancer.org/cancer/uterine-sarcoma/treating.html. Accessed February 1, 2023.
Important Safety Information
MyoSure Tissue Removal System
MyoSure tissue removal system is intended to remove unwanted tissue from the uterus. During a MyoSure procedure, a trained gynecologist inserts the MyoSure device through your vagina and then removes the unwanted tissue from inside the uterus. Use of the MyoSure system is not appropriate for patients who are or may be pregnant, or have signs or symptoms of a pelvic infection, cervical cancer, or previously diagnosed uterine cancer. As with any surgical procedure, there are potential risks including but not limited to internal injury, excessive bleeding, and complications related to anesthesia. Temporary side effects may include cramping, bleeding, fever, and nausea. This information is not medical advice. Please discuss the risks and benefits with your doctor to find out if the MyoSure procedure may be right for you.
Acessa ProVu System
The Acessa ProVu system is intended to identify and shrink symptomatic uterine fibroids. The Acessa ProVu system is used by trained physicians during laparoscopic surgery under general anesthesia. Rare but serious risks of this procedure include, but are not limited to, infection, internal injury, blood loss and complications related to laparoscopic surgery and/or general anesthesia. This procedure is not recommended for women who are planning future pregnancy. This information is not medical advice. Please discuss the risks and benefits with your doctor to find out if the Acessa procedure may be right for you.