Thursday, February 20, 2020
Cancer

Two recent but separate studies have demonstrated how bitter melon and turmeric could be used to prevent, treat and reduce the progression of cancers.

Commonly called bitter melon, bitter gourd, African cucumber or balsam pear, Momordica charantia belongs to the plant family Cucurbitaceae. In Nigeria, bitter melon is called ndakdi in Dera; dagdaggi in Fula-Fulfulde; hashinashiap in Goemai; daddagu in Hausa; iliahia in Igala; akban ndene in Igbo (Ibuzo in Delta State); dagdagoo in Kanuri; akara aj, ejinrin nla, ejinrin weeri, ejirin-weewe or igbole aja in Yoruba.

Turmeric is a spice that comes from the root of Curcuma longa, a member of the ginger family, Zingaberaceae. In traditional medicine, turmeric has been used for its medicinal properties for various indications and through different routes of administration, including topically, orally, and by inhalation.

In Nigeria, it is called atale pupa in Yoruba; gangamau in Hausa; nwandumo in Ebonyi; ohu boboch in Enugu (Nkanu East); gigir in Tiv; magina in Kaduna; turi in Niger State; onjonigho in Cross River (Meo tribe).

Turmeric, also known as curcuma, produces a root that is used to produce the vibrant yellow spice used as a culinary spice so often used in curry dishes. Though native to India and parts of Asia, and is a relative of cardamom and ginger, turmeric has been domesticated in Nigeria. In Asia, turmeric is used to treat many health conditions and it has anti-inflammatory, antioxidant, and perhaps even anticancer properties.

Meanwhile, Prof. Ratna Ray from Saint Louis University in Missouri, United States (U.S.), and her colleagues, in a recent study on bitter melon, made an intriguing find. In experiments using mouse models, bitter melon extract appeared to be effective in preventing cancer tumours from growing and spreading.

The researchers report their findings in a study paper that now appears in the journal Cell Communication and Signaling. Ray grew up in India, so she was familiar not just with the culinary qualities of bitter melon, but also with its alleged medicinal properties.

This made her curious as to whether or not the plant also harbored properties that would make it an effective aid to anticancer treatments. She and her colleagues decided to put this to the test in a preliminary study by using bitter melon extract on various types of cancer cells — including breast, prostate, and head and neck cancer cells.

Laboratory tests showed that the extract stopped those cells from replicating, suggesting that it might be effective in preventing the spread of cancer. In further experiments using mouse models, the researchers found that the plant extract was able to reduce the incidence of tongue cancer.

So, in their new study, Prof. Ray and team tried to find out what might give bitter melon compounds an edge against cancer cells. This time, they used mouse models to study the mechanism through which bitter melon extract interacted with tumors of cancer of the mouth and tongue.

They saw that the extract interacted with molecules that allow glucose (simple sugar) and fat to travel around the body, in some cases “feeding” cancer cells and allowing them to thrive.

By interfering with those pathways, the bitter melon extract essentially stopped cancer tumors from growing, and it even led to the death of some of the cancer cells. Ray said: “All animal model studies that we’ve conducted are giving us similar results, an approximately 50 per cent reduction in tumor growth.”

Ray and colleagues explained that it remains unclear whether or not bitter melon would have the same effect in humans, but Prof., going forward, this is what they are aiming to find out.

“Our next step is to conduct a pilot study in [people with cancer] to see if bitter melon has clinical benefits and is a promising additional therapy to current treatments,” she noted.

Ray seemed convinced that the plant is, if nothing else, at least a positive contributor to personal health.“Some people take an apple a day, and I’d eat a bitter melon a day. I enjoy the taste,” she said.“Natural products play a critical role in the discovery and development of numerous drugs for the treatment of various types of deadly diseases, including cancer. Therefore, the use of natural products as preventive medicine is becoming increasingly important.”

Meanwhile, a recent literature review investigated whether turmeric may be useful for treating cancer. The authors concluded that it might be but noted that there are many challenges to overcome before it makes it to the clinic. The chemical in turmeric that most interests medical researchers is a polyphenol called diferuloylmethane, which is more commonly called curcumin. Most of the research into turmeric’s potential powers has focused on this chemical.

Over the years, researchers have pitted curcumin against a number of symptoms and conditions, including inflammation, metabolic syndrome, arthritis, liver disease, obesity, and neurodegenerative diseases, with varying levels of success.
Above all, though, scientists have focused on cancer. According to the authors of the recent review, of the 12,595 papers that researchers published on curcumin between 1924 and 2018, 37 per cent focus on cancer.

In the current review, which features in the journal Nutrients, the authors mainly focused on cell signaling pathways that play a role in cancer’s growth and development and how turmeric might influence them. Treatment for cancer has improved vastly over recent decades, but there is still a long path to tread before we can beat cancer. As the authors note, “the search for innovative and more effective drugs” is still vital work.

In their review, the scientists paid particular attention to research involving breast cancer, lung cancer, cancers of the blood, and cancers of the digestive system. The authors concluded: “Curcumin represents a promising candidate as an effective anticancer drug to be used alone or in combination with other drugs.”

According to the review, curcumin can influence a wide range of molecules that play a role in cancer, including transcription factors, which are vital for Deoxy ribonucleic Acid (DNA)/genetic material replication; growth factors; cytokines, which are important for cell signaling; and apoptotic proteins, which help control cell death.

Alongside the discussions surrounding curcumin’s molecular influence over cancer pathways, the authors also addressed the possible issues with using curcumin as a drug. For instance, they explain that if a person takes curcumin orally — in a turmeric latte, for example — the body rapidly breaks it down into metabolites. As a result, any active ingredients are unlikely to reach the site of a tumour.

With this in mind, some researchers are trying to design ways of delivering curcumin into the body and protecting it from undergoing metabolisation. For instance, researchers who encapsulated the chemical within a protein nanoparticle noted promising results in the laboratory and in rats.

Although scientists have published a great many papers on curcumin and cancer, there is a need for more work. Many of the studies in the current review are in vitro studies, which means that the researchers conducted them in laboratories using cells or tissues. Although this type of research is vital for understanding which interventions may or may not influence cancer, not all in vitro studies translate to humans.

Relatively few studies have tested turmeric’s or curcumin’s anticancer properties in humans, and the human studies that have taken place have been small-scale. However, aside from the difficulties and limited data, curcumin still has potential as an anticancer treatment.

Scientists are continuing to work on the problem. For instance, the authors mention two clinical trials that are underway, both of which aim to “evaluate the therapeutic effect of curcumin on the development of primary and metastatic breast cancer, as well as to estimate the risk of adverse events.”

They also refer to other ongoing studies in humans that are evaluating curcumin as a treatment for prostate cancer, cervical cancer, and lung nodules, among other diseases. The authors believe that curcumin belongs to “the most promising group of bioactive natural compounds, especially in the treatment of several cancer types.”

However, their praise for curcumin as an anticancer hero is tempered by the realities that their review has unearthed, and they end their paper on a low note: “Curcumin is not immune from side effects, such as nausea, diarrhea, headache, and yellow stool. Moreover, it showed poor bioavailability due to the fact of low absorption, rapid metabolism, and systemic elimination that limit its efficacy in diseases treatment. Further studies and clinical trials in humans are needed to validate curcumin as an effective anticancer agent.”

Meanwhile, an earlier study published in journal Current Pharmacology Reports established that besides diabetes, bitter melon is effective in treating other chronic diseases such as cancer and Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS).

The study is titled “Bitter Melon as a Therapy for Diabetes, Inflammation, and Cancer: a Panacea?” The researchers noted: “Over the last few decades, multiple well-structured scientific studies have been performed to study the effects of bitter melon in various diseases. Some of the properties for which bitter melon has been studied include: antioxidant, anti-diabetic, anticancer, anti-inflammatory, antibacterial, antifungal, antiviral, anti-HIV, anthelmintic, hypotensive, anti-obesity, immuno-modulatory, anti-hyperlipidemic, hepato-protective, and neuro-protective activities. This review attempts to summarize the various literature findings regarding medicinal properties of bitter melon. With such strong scientific support on so many medicinal claims, bitter melon comes close to being considered a panacea.”

According to Food as Medicine: Functional Food Plants of Africa published 2017 by CRC Press, “…Dietary use of bitter melon or its juice decreases blood glucose levels, increases High Density Lipo-protein (HDL)/good cholesterol, and decreases triglyceride levels, thus exhibiting antiatherogenic qualities. Extract of bitter melon in supplement form has been widely used as a traditional medicine for diabetic patients.

When administered alone, it has a modest hypoglycemic effect at doses of at least 2000 mg/day. This botanical supplement enhances the cellular uptake of glucose and promotes insulin release, potentiating its effect, and in animal studies has been shown to increase the number of insulin-producing beta cells in diabetic animals. Bitter melon has also been found to reduce adiposity and oxidative stress in addition to reducing blood triglycerides and Low Density Lipo-proteins (LDL)/bad cholesterol.”

Tap water may be the cause of one in 20 cases of bladder cancer in Europe each year, a major study suggests. Researchers have linked drinking, showering and bathing in the water to more than 6,500 cases of the disease in 26 countries across the continent.

They estimate 1,356 bladder cancer diagnoses in Britain since 2005 were caused by contaminated water, making up a fifth of all cases in the European Union (EU).

Long-term exposure to a group of chemicals called trihalomethanes (THMs) is thought to be the cause. The chemicals, shown to be carcinogenic in animal studies, are formed as an unintended byproduct when water is disinfected with chlorine at supply plants.

As well as being drunk, steam given off in the shower can allow tap water to seep into people’s pores, and so too can prolonged periods in the bath. Earlier research has found an association between THMs and bladder cancer, but this is the first to estimate the scale of the problem. Some 10,000 people are diagnosed with bladder cancer each year in the United Kingdom (UK), making it the tenth most common form of the disease.

The latest study estimates nine per cent of them are caused by exposure to water contaminated with THMs.The findings are published in the journal Environmental Health Perspectives. Scientists from the Barcelona Institute for Global Health (ISGlobal) set out to analyse the presence of the chemicals in drinking water in all 28 EU states between 2005 and 2018.

They did this by sending questionnaires to bodies responsible for the national water quality. Data was obtained for 26 countries – all except Bulgaria and Romania. The scientists probed levels of THMs in water at the tap, in the distribution network and at water treatment plants.

To make estimates as accurate as possible, the researchers also used other sources including open data online, reports and scientific literature. The findings revealed considerable differences between countries. Average THM levels were above legal levels in nine countries – Britain (24.2ug/l) , Spain, Portugal, Poland, Cyprus, Estonia, Hungary, Ireland and Italy.

The European Union has said the maximum limit is 11.7 micrograms per litre (ug/L). The European Union has said the maximum limit of THMs in water should be 11.7 micrograms per litre (ug/L). Researchers estimated the number of attributable bladder cancer cases using incidence rates and levels of THMs.

Analysis suggested Cyprus had highest percentage, with a quarter of diagnoses linked to the chemicals. Joint second-wort were Ireland and Malta, where one in six bladder cancer patients (17 per cent) are thought to have developed it from exposure to tap water.

Spain (11 per cent) and Greece (10 per cent) were not much better. At the opposite extreme was Denmark, where less than 0.1 per cent of cases were caused by THM water contamination. In Holland it was just 0.1 per cent of cases and Germany 0.2 per cent. THMs could be blamed for 0.4 per cent of cases in Austria and Lithuania. In total, the researchers estimated that 6,561 bladder cancer cases per year are attributable to THM exposure in the European Union.

The study authors say if the 13 countries with the highest averages were to reduce their THM levels to the EU average, 2,868 annual bladder cancer cases could be avoided.

Chloroform is the most infamous type of THM, which the World Health Organisation (WHO) describes as ‘probably carcinogenic to humans’.Co-study author Manolis Kogevinas, a researcher from ISGlobal, said: “Over the past 20 years, major efforts have been made to reduce trihalomethanes levels in several countries of the European Union, including Spain.

“However, the current levels in certain countries could still lead to considerable bladder cancer burden, which could be prevented by optimising water treatment, disinfection and distribution practices and other measures.”

A spokesperson for Britain’s Department for Environment, Food and Rural Affairs said: “This Government takes the safety of our drinking water extremely seriously, and have a robust monitoring regime in place which tests for a wide range of chemicals, including trihalomethanes, to ensure the public can have absolute faith in the water coming from their taps.

“The latest figures from 2018 found only four samples out of 11,900 exceeded the legal limits, and firm action was taken in each of these four cases.”

A study in September last year discovered 22 carcinogenic substances in water across the United States (U.S.).Despite the fact that most of the water systems they tested were within federal limits on each of these toxins, the scientists estimated that their cumulative effects could be dire over the course of Americans’ lifetimes.

Exposure to arsenic, products of disinfectant chemicals and traces of radioactive chemicals like uranium and radium had the most substantial effects on cancer risks. Over 1.7 million new cases of cancer are diagnosed in the US each year. In the same time period, over 600,000 people die of the disease.

Better prevention strategies, earlier detection and better treatments – like the immunotherapies that are revolutionizing the disease’s future – have driven cancer mortality down dramatically. Yet the disease’s elimination is no where in sight. In part, this is because its roots are many, and difficult to control.

Rather than being triggered by any one thing, genetics, what you eat, where you live, how you eat and, of course, the water you drink all play roles in raising or lowering cancer risks.

Some chemicals, like arsenic are nearly impossible to keep out of water in certain places. For example, in some areas of Illinois, the soil is rich in arsenic, a toxic, carcinogenic heavy metal, linked to liver and bladder cancers.

Arsenic seeps into the ground water, and winds up in our bodies. It also leaks into the water supply from many types of manufacturing plants.US water systems treat drinking water with chlorine – a non-carcinogenic cleaning chemical – in an attempt to reduce or eliminate the metal.

Previous research has suggested that there is a link between depression and tea drinking. Now, a new study is investigating this relationship further.

Depression is common among older adults, with 7% of those over the age of 60 years reporting “major depressive disorder.”

Accordingly, research is underway to identify possible causes, which include genetic predisposition, socioeconomic status, and relationships with family, living partners, and the community at large.

A study by researchers from the National University of Singapore (NUS) and Fudan University in Shanghai raises another possibility. It finds a statistically significant link between regular tea drinking and lower levels of depression in seniors.

While the researchers have not yet established a causal relationship between tea and mental health, their findings — which appear in BMC Geriatrics — show a strong association.

Reading the tea leaves

Tea is popular among older adults, and various researchers have recently been investigating the potential beneficial effects of the beverage.

A separate study from the NUS that appeared in Aging last June, for example, found that tea may have properties that help brain areas maintain healthy cognitive function.

“Our study offers the first evidence of the positive contribution of tea drinking to brain structure and suggests a protective effect on age-related decline in brain organization.”

Junhua Li, lead author

That earlier paper also cites research showing that tea and its ingredients — catechin, L-theanine, and caffeine — can produce positive effects on mood, cognitive ability, cardiovascular health, cancer prevention, and mortality.

However, defining the exact role of tea in preventing depression is difficult, especially due to the social context in which people often consume it. Particularly in countries such as China, social interaction may itself account for some or even all of the drink’s benefits.

Feng Qiushi and Shen Ke led the new study, which tracks this covariate and others, including gender, education, and residence, as well as marital and pension status.

The team also factored in lifestyle habits and health details, including smoking, drinking alcohol, daily activities, level of cognitive function, and degree of social engagement.

In addition, the authors write, “The study has major methodological strength,” citing a few of its attributes.

Firstly, they note, it could more accurately track an individual’s tea-drinking history because “instead of examining tea-drinking habit [only] at the time of survey or in the preceding month/year, we combined the information on frequency and consistency of tea consumption at age 60 and at the time of assessment.”

Once the researchers had classified each person as one of four types of tea drinker according to how often they drank the beverage, they concluded:

“[O]nly consistent daily drinkers, those who had drunk tea almost every day since age 60, could significantly benefit in mental health.”

13,000 study participants

The researchers analyzed the data of 13,000 individuals who took part in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2005 and 2014.

They discovered a virtually universal link between tea drinking and lower reports of depression.

Other factors seemed to reduce depression as well, including living in an urban setting and being educated, married, financially comfortable, in better health, and socially engaged.

The data also suggested that the benefits of tea drinking are strongest for males aged 65 to 79 years. Feng Qiushi suggests an explanation: “It is likely that the benefit of tea drinking is more evident for the early stage of health deterioration. More studies are surely needed in regard to this issue.”

Looking at the connection the other way around, tea drinkers appeared to share certain characteristics.

Higher proportions of tea drinkers were older, male, and urban residents. In addition, they were more likely to be educated, married, and receiving pensions.

Tea drinkers also exhibited higher cognitive and physical function and were more socially involved. On the other hand, they were also more likely to drink alcohol and smoke.

Qiushi previously published the results of the effect of tea drinking on a different population, Singaporeans, finding a similar link to lower rates of depression. The new study, while more detailed, supports this earlier work.

Currently exploring new CLHLS data regarding tea drinking, Qiushi wishes to understand more about what tea can do, saying, “This new round of data collection has distinguished different types of tea, such as green tea, black tea, and oolong tea so that we could see which type of tea really works for alleviating depressive symptoms.”

A blemish is the term for any mark on the skin. There are many different types of blemish.

Most blemishes are harmless, but some people may wish to treat them for cosmetic reasons.

Certain blemishes may indicate an underlying condition, such as skin cancer, which requires prompt medical treatment.

In this article, we outline the different types of blemish that people may have and the treatment options available in each case.

Types

There are many different types of skin blemish. Some examples include those below.

Acne

Acne is a skin condition that occurs as a result of the skin producing too much oil. Different factors can cause excess oil production, including:

  • overactive oil glands
  • hormonal changes during puberty, menstruation, or the menopause
  • stress, anxiety, or depression, which can also affect hormones

There are several different types of acne, which vary in their appearance. Some examples include:

Blackheads

Blackheads are small, dark spots on the surface of the skin. They resemble trapped dirt but actually consist of oil that has become stuck inside the pore. When this oil reacts with air, it becomes black.

Whiteheads

Whiteheads are small, round blemishes that are white or skin-colored. They develop as a result of oil and dead skin cells blocking the pores.

Papules

Papules are small, hard, red bumps on the skin. These develop when excess oil, bacteria, and dead skin cells travel deeper into the skin, causing inflammation.

When lots of papules cluster together, this can give the skin a rough, sandpaper-like texture.

Pustules

Pustules are raised, red spots that contain yellow or white pus. They occur when oil, bacteria, and dead skin cells collect under the skin, causing infection.

Nodules

Nodules are large skin blemishes that develop when a pore becomes clogged. Oils mix with dead skin cells and bacteria that then become trapped deep in the skin. The excess oil and bacteria lead to infection and inflammation inside the skin.

This type of skin blemish can cause acne scarring.

Acne cysts

A break in the lining of a pore can cause oil and bacteria to spread to the surrounding skin. An acne cyst is a membrane that has formed around the infected area.

Cysts appear as large, swollen, red blemishes. They may be very painful to the touch.

Like nodules, cysts can cause permanent acne scarring.

Hyperpigmentation

Hyperpigmentation is a type of blemish that appears darker than other areas of skin. It is common and usually harmless.

Hyperpigmentation can occur as a result of genetic factors, sun damage, or acne scarring.

Freckles are a type of hyperpigmentation that a person can inherit the tendency to develop. They are small, flat spots that may be red, brown, tan, or black. They can appear anywhere on the body.

Sunspots or “age spots” are another type of hyperpigmentation. These small spots or patches can develop on areas of the skin that get a lot of sun exposure.

Acne scarring can also cause dark spots to remain on the skin once the acne has cleared.

Melasma

Melasma is a type of hyperpigmentation that can develop during pregnancy or when a person takes birth control pills.

The hormonal changes that take place lead to an increase in melanin. Melanin is the pigment that gives skin its coloring. The overproduction of melanin can make the skin darker.

Ingrown hair

Sometimes, hairs can curl back on themselves or grow sideways into the skin, which can result in red, itchy bumps forming. Doctors refer to these skin blemishes as ingrown hairs.

Hair removal techniques, such as waxing, shaving, or plucking, can all cause ingrown hairs.

Birthmarks

Birthmarks are blemishes that appear on the skin of a newborn baby. They can appear either at birth or shortly afterward. Some birthmarks disappear over time, while others may be permanent.

Experts are still not sure what causes birthmarks to form. However, these skin blemishes can sometimes develop as a result of:

  • blood vessels not forming properly
  • skin pigment cells clumping together, creating moles or patches of darker skin
  • an overgrowth of skin that creates raised patches of thickened skin

A birthmark will look different than the skin surrounding it. These types of skin blemish can be any size and may vary greatly in appearance. They may be:

  • flat or raised
  • similar to a bruise or stain
  • any color, including pink, red, brown, or tan

Birthmarks are generally harmless, but some marks that appear on a baby’s skin can signal an underlying condition. It is best to have a dermatologist check any birthmarks just to be sure.

Some harmless birthmarks can also get larger quickly, which can be alarming. Talking with a dermatologist can help people know what to expect regarding birthmark growth.

Cold sores

Cold sores are painful, red, fluid-filled blisters that form on the lips or around the mouth. They occur as a result of infection with the herpes simplex virus.

Cold sores are highly contagious, so people should avoid intimate contact with others until the sores have healed to avoid passing the virus on.

Skin cancer

Some types of blemish can be a sign of skin cancer. Being aware of the signs to look out for can help people spot skin cancer early.

Some potential signs of skin cancer include:

  • a new mole or mark that grows quickly
  • a mole or mark that bleeds or itches
  • a blemish that changes in shape, size, or color
  • a mole that is asymmetrical or has rough, irregular edges
  • a mole that is larger than 6 millimeters

A person should see a doctor if they develop a new or unusual skin blemish that has any of the above characteristics.

Treatments

Although many types of skin blemish do not require treatment, some people may wish to treat them for cosmetic reasons. The type of skin blemish will determine the treatment options.

Acne treatment

People may be able to treat acne blemishes with topical creams, such as benzoyl peroxide.

These products can help dry out the skin and get rid of acne-causing bacteria.

Washing the face twice daily with a cleanser containing benzoyl peroxide or salicylic acid can help treat certain types of acne. In addition, medications called retinoids may help unclog the pores.

Acne treatments can take time to have a noticeable effect. People may need to wait 6–8 weeks for them to work.

For persistent acne, a dermatologist may suggest a topical or oral prescription medication. Some prescription treatments for acne and hyperpigmentation can cause side effects.

People should discuss any potential side effects with their dermatologist before starting treatment.

Some people may also find that certain dietary and lifestyle changes can help reduce stress levels and balance hormones.

Hyperpigmentation and melasma treatment

The following treatments may help reduce hyperpigmentation and melasma:

  • over-the-counter or prescription medicine containing hydroquinone, which works by lightening darker patches of skin
  • prescription cortisone or tretinoin cream
  • laser treatment

In some cases, melasma disappears after a woman has given birth or is no longer taking hormonal contraception.

Ingrown hair treatment

Some tips for preventing ingrown hairs include:

  • shaving only in the direction of hair growth
  • using a shaving gel
  • using only clean, sharp razors

For existing ingrown hairs, an exfoliating scrub can help release trapped hairs from under the skin.

Birthmark treatment

If people want to treat a birthmark, they may consider the following options:

  • laser therapy
  • medications, such as propranolol, timolol, or corticosteroids, which can shrink certain birthmarks
  • surgery to remove a birthmark that may be harmful

People may also use makeup to cover any blemishes or discolored skin that they wish to disguise.

Cold sore treatment

Cold sores tend to clear up on their own within 2 weeks. A dermatologist may also prescribe an oral or topical antiviral medicine to treat cold sores.

Skin cancer treatment

Skin cancer is very treatable if a person begins treatment in the early stages of the disease. The treatment that a person receives will depend on the type of skin cancer. Some possible treatment options include:

  • surgical removal of cancerous cells
  • topical medication to kill cancerous cells
  • radiation therapy

When to see a dermatologist

Some people may choose to see a dermatologist if they wish to treat a blemish for cosmetic reasons or if the blemish is causing them psychological distress.

A person should see their dermatologist immediately if they have a skin blemish that takes on any of the following characteristics:

  • grows quickly
  • changes in size, shape, or color
  • bleeds or itches

These could be signs of skin cancer or another serious skin condition that requires immediate treatment.

Summary

A blemish is any type of mark on the skin. Most blemishes are harmless, but people may choose to treat them for cosmetic reasons.

Certain types of skin blemish may be more serious. People should see a doctor or dermatologist if they develop a blemish that has any of the characteristic signs of skin cancer. This type of cancer is highly treatable if a person begins treatment during the early stages of the disease.

People should see a doctor or dermatologist if they have any concerns about a skin blemish or skin condition. These healthcare professionals can diagnose the condition and then recommend appropriate treatments.

Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

A team at George Mason University, Fairfax, VA, has uncovered another electronic cigarette health concern. This time, it relates to stroke risk.

In recent years, the popularity of e-cigarettes has soared.

A 2016 study found that 10.8 million adults in the United States were current e-cigarette users. It is common for people to switch from traditional cigarettes to the e-variety because they think they are a healthier option.

But newly issued health warnings have pointed to the potential risks of smoking e-cigarettes. In June 2019, the U.S. saw an outbreak of lung injuries associated with e-cigarettes.

Experts believe that vitamin E acetate — an ingredient found in some e-cigarettes containing THC — may be the link.

In December 2019, the Centers for Disease Control and Prevention (CDC) reported that more than 2,500 individuals from the U.S., Puerto Rico, and the U.S. Virgin Islands were hospitalized or died as a result of using vapes, e-cigarettes, or associated products.

Recent studies, albeit small-scale, have found both benefits and risks to e-cigarettes.

One study that appears in PNAS found that nicotine from e-cigarette smoke caused lung cancer in mice as well as precancerous growth in the bladder.

However, a second study, appearing in the Journal of the American College of Cardiology, noted a significant improvement in vascular health within a month of a traditional smoker switching to e-cigarettes.

A trend among the young

Despite their nicotine content, the variety of e-cigarette flavors available has led to the products becoming a trend among young adults. There is also a concern this habit could lead to conventional cigarette smoking.

Equally worrying findings have come from a new study that appears in the American Journal of Preventive Medicine. The study found that young adults smoking both traditional and e-cigarettes face a significantly higher risk of stroke.

Using data from the 2016-17 Behavior Risk Factor Surveillance System (BRFSS), the study examined smoking-related responses from a total of 161,529 people aged between 18 and 44.

Just over half of the respondents were female, with 50.6% identifying as white and just under a quarter identifying as Hispanic.

The team calculated the adjusted odds ratios for strokes among those who currently smoked, former smokers who now used e-cigarettes, and people who used both.

“It’s long been known that smoking cigarettes is among the most significant risk factors for stroke,” says lead investigator Tarang Parekh from George Mason University.

“Our study shows that young smokers who also use e-cigarettes put themselves at an even greater risk.”

Tarang Parekh

An important message and a ‘wake-up call’

The study identified that young adults who smoked both traditional and e-cigarettes were almost twice as likely to have a stroke compared with conventional cigarette smokers.

This risk rose to almost three times as likely when compared with non-smokers. Results also showed there was no clear advantage to switching from traditional cigarettes to e-cigarettes.

However, people using e-cigarettes who had never smoked before did not display an increased stroke risk. This may be down to factors including young age and normal heart health.

This study relied on self-reported data, which is a limitation. However, the findings prove the need for large-scale, long-term studies to confirm which detrimental health effects e-cigarettes are causing and which ingredients are responsible.

“This is an important message for young smokers who perceive e-cigarettes as less harmful and consider them a safer alternative,” Parekh states.

According to Parekh, the results are “a wake-up call” for policymakers to urgently regulate e-cigarette products “to avoid economic and population health consequences.”

“We have begun understanding the health impact of e-cigarettes and concomitant cigarette smoking, and it’s not good.”

Tarang Parekh

Bitter melon, or bitter gourd, has served as a traditional Indian remedy for centuries. Recently, bitter melon extract supplements have been gaining popularity as an alternative medication for diabetes. Now, new research in mice seems to suggest that bitter melon extract may help fight cancer.

Bitter melon (Momordica charantia), also known as bitter gourd, is a “relative” of both cucumber and zucchini. It originated in the South Indian state of Kerala.

It later became more widespread, with China first importing the fruit in the 14th century. It then spread to regions of Africa and to the Caribbean.

Traditionally, bitter melon has helped treat many health concerns, and it has recently gained some popularity as a natural remedy against diabetes.

The fruit is also a staple of certain Asian cuisines, adding to local dishes’ unique flavor through its specific bitterness.

Recently, Prof. Ratna Ray — from Saint Louis University in Missouri — and her colleagues made an intriguing find. In experiments using mouse models, bitter melon extract appeared to be effective in preventing cancer tumors from growing and spreading.

The researchers report their findings in a study paper that now appears in the journal Cell Communication and Signaling.

An ancient remedy coming to light again

Prof. Ray grew up in India, so she was familiar not just with the culinary qualities of bitter melon, but also with its alleged medicinal properties.

This made her curious as to whether or not the plant also harbored properties that would make it an effective aid to anticancer treatments.

She and her colleagues decided to put this to the test in a preliminary study by using bitter melon extract on various types of cancer cells — including breast, prostate, and head and neck cancer cells.

Laboratory tests showed that the extract stopped those cells from replicating, suggesting that it might be effective in preventing the spread of cancer.

In further experiments using mouse models, the researchers found that the plant extract was able to reduce the incidence of tongue cancer.

So, in their new study, Prof. Ray and team tried to find out what might give bitter melon compounds an edge against cancer cells.

This time, they used mouse models to study the mechanism through which bitter melon extract interacted with tumors of cancer of the mouth and tongue.

They saw that the extract interacted with molecules that allow glucose (simple sugar) and fat to travel around the body, in some cases “feeding” cancer cells and allowing them to thrive.

By interfering with those pathways, the bitter melon extract essentially stopped cancer tumors from growing, and it even led to the death of some of the cancer cells.

“All animal model studies that we’ve conducted are giving us similar results, an approximately 50% reduction in tumor growth,” says Prof. Ray.

It remains unclear whether or not bitter melon would have the same effect in humans, but Prof. Ray and colleagues explain that, going forward, this is what they are aiming to find out.

“Our next step is to conduct a pilot study in [people with cancer] to see if bitter melon has clinical benefits and is a promising additional therapy to current treatments,” she notes.

Prof. Ray seems convinced that the plant is, if nothing else, at least a positive contributor to personal health.

“Some people take an apple a day, and I’d eat a bitter melon a day. I enjoy the taste,” she says.

“Natural products play a critical role in the discovery and development of numerous drugs for the treatment of various types of deadly diseases, including cancer. Therefore, the use of natural products as preventive medicine is becoming increasingly important.”

Prof. Ratna Ray

In last week’s Thursday’s edition of the Guardian Newspaper, I wrote generally on the fruit berries. Having done that I have also seen the richness of individual berries in the group of fruits in what is called berries. For this reason I have decided to write about four of the commonest fruits in this group.

It is important for us to know that there are berries in such shops as Shoprite, SPAR etc. In other words, these fruits can easily be found and bought here in Nigeria.

Strawberries are juicy and delicious nutrient-rich fruits, which are full of antioxidants. Minerals and vitamins commonly found in strawberries are potassium, calcium, magnesium, iron and vitamin CC.

Health benefits of strawberries

Boosts the immune system
Strawberries are a powerful source of vitamin C, which is an established immune booster. Vitamin C is also a well-known antioxidant. It is a fast working antioxidant, which effectively neutralises free radicals and contributes to the effectiveness of the Vitamin Antioxidant Defense System. Consumption of one serving of strawberries is sure to provide one half of our body’s daily requirement of vitamin C

Helps to prevent cancer
Vitamin C, the antioxidant neutralizes free radicals that would have destroyed cells and DNA and possibly cause cancer (vitamin C boosts the immune system). Ellagic acid is a phytonutrient that is also found in strawberry. Ellagic acid has been found to exhibit anti-cancer properties by suppressing cancer growth. Lutein and zeaxanthin (zeathanins) are free fatty acids also found in strawberry. They are antioxidants, which mop up free radicals and prevent oxidative stress damage of cells.

Ensures healthy vision
Strawberry, by its antioxidant function can help to prevent cataract formation. Cataract can lead to blindness in old age. The UV rays from the sun causes the release of free radicals from the protein in the lens. Sufficient vitamin C in the system neutralizes these free radicals and prevents damage to the lens of the eyes. Also, vitamin C functions in strengthening of the cornea and retina of the eye.

Cholesterol Lowering Effect
Strawberries are included in the list of heart-healthy foods. Ellagic acid and flavonoids in strawberries are antioxidants, which prevent the build up of plaques on the walls of arteries by the LDL (bad) cholesterol in the blood circulation. The anti-inflammatory effect of ellagic acid and flavonoids also prevent heart disease.

Reduction of inflammation
Arthritis, which is inflammation of the joints have also been found to respond positive to the antioxidants and phytochemicals in strawberries. An elevated C-reactive protein is an indication of inflammation. This CRP has been shown to decrease in those who consume strawberries regularly.

Effect on blood pressure
Potassium is richly found in strawberries – about 134mg per serving. Potassium is a buffer against the negative effect of sodium in the cell, which leads to a reduction of the blood pressure.

Increase intake of fibre
Fibre helps in the healthy digestion of food in the intestine and prevents conditions such as constipation and diverticulitis. Fibre also helps to reduce the absorption of glucose in the blood. Strawberries are a good source of fibre.

Medical experts have called for the adoption of preventive measures to address the rising cases and mortality resulting from cancer in Nigeria.

Though, the experts noted that available cancer statistic for Nigeria is under-estimated since cancer registration in Nigeria is markedly incomplete, a research conducted by International Agency for Research on Cancer (IARC) in 2018 had, however, noted that about 115,950 new cancer cases, 70,327 cancer deaths and 211,052 prevalent cases (5-year) were recorded in the period under review.

But Cancer Epidemiologist and Surgical Oncologist, who is the Chief Executive Officer, Lakeshore Cancer Center, Professor Chukwumere Nwogu and other medical experts, who gathered at the 2019 annual oncology conference of the Lagos-based Cancer Center, to discuss ways to “Improving Cancer Outcomes in Nigeria,” believed that early detention, lifestyle changes as well as concerted efforts of government and private players could reduce the spread of the disease.

The experts, who decried cases of breast cancer, said among the solutions to avoiding cancer, especially breast cancer and remaining healthy are control of alcohol intake, adequate breastfeeding and consumption of vegetables in daily meals.“18 million cases are recorded annually with about 1 million deaths. Cancer is a great problem all over the world. Hence, we need a lot of work on it,” Nwogu said.

He said there was need to pay more attention to some practices including varieties of meal with pertinent attention to vegetable.“Vegetable should be part of our food. We should start inculcating that at home and at restaurants.

“How can one person alone consume a full bottle of wine? I’m not saying you should not drink. However, moderation is key when consuming alcohol or wine. The more the intake of alcohol, the higher the risk,” the oncologist said.

Nwogu named modifiable risk factors to include obesity, exercise, alcohol; breastfeeding and hormone replacement therapy.According to him, one of three cases of cancers is preventable, potentially curable and can be palliated effectively therefore there is need for increase cancer awareness, improve knowledge and capacity while plans should be evidence-based, priority driven and resource-appropriate.

Nwogu also made case for training and education, adding that connectivity remained crucial as well as access to care.In a joint research on Oncology Emergencies, a Consutlant Medical Oncologist, Dr. Okezie Ofor and Consultant Medical Oncologist, Nottingham University Hospitals, Dr. Azeez Salawu, said it is important to have adequate support systems in place for patients on systemic anticancer treatments.

They noted that many oncology emergencies are reversible or at least have reversible symptoms, while stressing that early recognition remained critical while multidisciplinary working is key to improving outcomes in cancer including a leading Cancer Epidemiologist and Surgical Oncologist, who is the CEO, Lakeshore Cancer Center, Professor Chukwumere Nwogu

Uterine fibroids are noncancerous growths that grow in the wall of the uterus. When fibroids cause heavy bleeding or painful symptoms, and other treatments are ineffective, a doctor may recommend surgery.

Fibroids are common, but it is challenging for doctors to determine what percentage of people have them, as not everyone experiences symptoms. According to various estimates, fibroids may affect between 20% and 80% of the female population under the age of 50 years.

Although fibroids can sometimes grow to the size of a grapefruit or even larger, they are often very small. Many people with fibroids are unaware that they have them. People with asymptomatic fibroids do not require surgery or other treatments.

However, other people experience abdominal pain, pressure, bloating, pain during sex, frequent urination, and heavy or painful periods. These individuals may require surgery.

In this article, learn more about surgery for fibroids, including the types, risks, and what to expect.

Types

There are several different surgical approaches to treating fibroids. The types of surgery that a person can have will depend on the location of the fibroid.

A doctor will usually recommend more conservative options, such as medication, before considering surgery.

In cases where medication and other treatments do not work, surgical options include the following:

Myomectomy

Myomectomy is a surgical procedure that removes fibroids. Depending on the location of these growths, a surgeon may also have to remove other tissue in the process. Surgeons offer different myomectomy techniques.

The traditional technique is quite invasive as it uses a relatively large cut. This incision may go from the bellybutton to the bikini line or run horizontally along the bikini line. Some surgeons also perform laparoscopic surgeries, which use smaller incisions but require more skill.

Although a myomectomy preserves the uterus, women who wish to become pregnant should speak to a doctor about the possible complications. Those with very large or deeply embedded fibroids may only be able to have cesarean deliveries after this procedure.

New fibroids may develop after a myomectomy, which means that it is not a permanent solution for everyone.

Radiofrequency ablation procedure

Radiofrequency ablation destroys fibroids using either an electric current, a laser, cold therapy, or ultrasound. It requires only a small incision.

However, it can cause dangerous pregnancy complications, such as scarring and infection, so doctors do not recommend it for those who are planning future pregnancies.

Radiofrequency ablation may be a good option for people considering a hysterectomy who want a less invasive procedure.

Endometrial ablation

Endometrial ablation does not remove fibroids, but it can help relieve heavy bleeding.

During endometrial ablation, a surgeon uses a range of techniques — which may include heat, electric current, freezing, lasers, or wire — to destroy the lining of the uterus. These techniques reduce or stop heavy bleeding.

This procedure is less invasive than some other surgical options. Sometimes, doctors can even perform it on an outpatient basis in their office.

This procedure may prevent women from being able to get pregnant in the future, so it is not a good option for those who would still like to have children.

Fibroid or artery embolization

A doctor can locate the blood vessels that feed into the fibroid and disrupt their blood supply. During this procedure, they will insert a tube into blood vessels that supply the fibroid and then inject tiny particles that block the fibroid’s blood supply. The lack of blood shrinks the fibroids.

Doctors can do this procedure on an inpatient or outpatient basis, and recovery is usually fairly straightforward. Fibroids do not typically grow back after embolization.

While pregnancy is sometimes possible after fibroid embolization, doctors do not know enough about the risks. Therefore, they do not recommend this procedure for women who wish to get pregnant.

Magnetic resonance-guided focused ultrasound surgery

In magnetic resonance-guided focused ultrasound (MRgFUS), a doctor uses an ultrasound to heat and destroy fibroids.

This procedure can target the individual fibroids and avoid affecting the surrounding healthy tissue. A doctor will do an MRI scan to determine whether a person is a suitable candidate for MRgFUS. They may not recommend MRgFUS if the fibroids are too large or too close to any bones or the bowel.

MRgFUS may be a good option for women who plan to get pregnant, as it leaves the uterus intact. However, more data is necessary to confirm its safety for these individuals.

Hysterectomy

A hysterectomy is a surgery to remove the uterus and, sometimes, the ovaries. A hysterectomy permanently eliminates uterine fibroids.

This procedure is not an option for anyone planning a future pregnancy, as it removes the womb. Some people opt to leave the ovaries in place so that they continue producing estrogen.

A surgeon may be able to perform a laparoscopic hysterectomy, which uses several small incisions and a tiny camera to help the surgeon see inside the abdomen. An open hysterectomy requires a large incision between the bellybutton and the bikini line.

Another option is a vaginal hysterectomy, which is the approach that most people prefer. In this procedure, a surgeon will remove the uterus through the vagina.

A vaginal hysterectomy may not be possible if the uterus or fibroid is too large to fit through the vagina.

Individuals who undergo an open hysterectomy may have a longer recovery time. Doctors usually recommend a hysterectomy only for those whose fibroids are very large or significantly interfere with their quality of life.

People who have other reproductive health issues, such as endometriosis, may find that a hysterectomy provides significant relief from fibroids and other symptoms.

Morcellation

Morcellation is a procedure that reduces the size of fibroids so that a surgeon can remove them through a tiny incision in the abdomen. A doctor may use morcellation during a myomectomy, hysterectomy, or other surgery.

However, the Food and Drug Administration (FDA) caution that morcellation carries significant risks.

While fibroids are not cancerous, uterine cancer is more common in people having fibroid surgery than experts previously thought.

It can also be difficult to tell the difference between a fibroid and a type of cancer that looks the same. According to the FDA, morcellation may inadvertently spread cancer that resembles a fibroid.

Is surgery necessary?

Not everyone with fibroids needs treatment. In most cases, there is no reason to treat fibroids that cause no symptoms.

Some people with fibroids can treat symptoms successfully with medication, including hormonal birth control pills. Others alleviate fibroid symptoms by using pain relievers and other management strategies.

Before considering surgery, people can ask a doctor about other treatment options. The doctor should also provide clear details about the risks and benefits of each surgical procedure.

Fibroids can shrink or disappear after menopause, so people nearing menopause whose symptoms are not severe may wish to postpone treatment.

Benefits

The benefits of surgery depend on the type of surgery and can vary from person to person. For example, there is no chance that the fibroids will grow back after a hysterectomy. However, they may regrow following other procedures.

Some potential benefits include:

  • reduced bleeding
  • relief from pain or pressure
  • removal of fibroids
  • the potential that fibroids will either not grow as large or not regrow at all

Risks

Most people who have fibroid removal surgery have no serious complications, but they may experience pain or bleeding following surgery and will need time to recover.

However, a small number of people do face serious complications. The specific complications and their likelihood depend on the type of surgery that a person chooses, but they can include:

  • anesthesia-related risks
  • infections
  • heavy bleeding
  • failed surgery
  • regrowth of fibroids
  • damage to the uterus or other surrounding organs
  • in the case of morcellation, spreading cancer

How does fibroid surgery affect fertility?

The effects of fibroid surgery on fertility depend on the type of surgery. A hysterectomy or endometrial ablation usually makes pregnancy impossible.

Some procedures that may affect fertility but will not necessarily prevent pregnancy include:

  • morcellation
  • embolization
  • radiofrequency ablation

A myomectomy does not typically affect fertility. However, any surgery on the uterus can potentially damage the reproductive organs and affect future pregnancies.

Recovery

Most fibroid removal surgeries require general anesthesia. A person may need to stay overnight in the hospital, so the hospital staff may advise them to bring an overnight bag.

Invasive surgeries, such as a hysterectomy or a nonlaparoscopic myomectomy, typically have the longest recovery time.

A person can try the following to help ease recovery:

  • asking a doctor about the specific recovery timeline for the chosen surgery
  • asking a doctor about laparoscopic procedures and talking to a specialist with experience in minimally invasive surgery
  • following the doctor’s self-care and recovery instructions
  • getting help from a loved one in the days following surgery

Other treatment options

In most cases, a doctor will recommend trying other treatments before pursuing surgery.

Treatments for fibroids include:

  • Birth control pills. Hormonal contraceptives may slow fibroid growth and prevent heavy, painful periods.
  • Pain medication. Prescription and over-the-counter pain relievers may help with fibroid pain, especially period-related fibroid pain.
  • Iron supplements. For people with heavy bleeding that causes anemia, iron supplements may help.
  • Gonadotropin-releasing hormone agonists (GnRH). These drugs may help shrink fibroids. Some doctors recommend them prior to surgery to make fibroid removal easier.

Summary

Surgery can be lifechanging for people whose fibroids interfere with their quality of life, as it can improve many aspects of their health.

All surgeries present some risks, however, so it is vital to explore all treatment options. A doctor can provide advice on which surgeries might be appropriate. A person may also wish to consider seeking a second opinion before agreeing to surgery.