Fibroid Surgery India – Energy Pulse

Fibroid Surgery India – Energy Pulse

Using focused ultrasound energy to remove fibroid or wonder diabetes drug Sitagliptin, innovation is the buzzword

LAST WEEK, my mail inbox threw up two interesting medical developments. Not that there aren’t many each week, but these two related to diseases which matter a lot to Indians. Although there isn’t any connect between the two, I thought they must be highlighted for the benefit of all those who suffer from the problems.

In fact, the moment I read about the first issue — a new treatment for uterine fibroids — my mind raced back to a conversation which a friend recently had with me regarding his wife. Barely in her thirties, she was diagnosed with a fibroid in her uterus and had been advised surgery before it turned malignant. Since both my friend and his wife were apprehensive about the complications of a surgery, we had talked about newer developments in the field and how the trauma to the patient could be minimised.

The mail I got addressed this particular issue. “In a tremendous leap forward in the Treatment of uterine fibroids in India, MRgFUS (MR guided focused ultrasound) is an innovative and non-invasive therapy for treatment of the problem, using focused ultrasound waves. The procedure can last as long as three hours,” it stated.

For those not in the know, it is estimated that 20-50% women have or will have fibroids at some point in their lives. They are rare in women under the age of 20 and most common in women during the reproductive age groups. Uterine fibroids can become such a major health problem for women suffering from it that performing their routine task at workplace and home becomes very difficult. There have also been many instances where the presence of fibroids has hampered the proper formation and growth of the foetus in the womb.

What’s worrisome, up to 80% of women with uterine fibroids show no symptoms. However, if they do, it will involve heavier menstrual flow or menstrual period for a longer duration, increased menstrual cramping, backache, irregular or unpredictable bleeding, lower abdominal pressure, constipation, abdominal bloating, infertility and miscarriage.

• AVERAGE COSTS

  MR guided focused ultrasound

  Rs 75,000

• Hysterectomy

  Rs 50, 000 to Rs 60, 000

• Laparoscopy

  Rs 30, 000 (comparatively lesser as compared to the above treatment because of lesser days of hospitalisation)

  Rates differ from city to city

Fibroids are the primary reason for surgical removal of the uterus, accounting for most of the hysterectomies performed. At present, two surgical procedures available to remove uterine fibroids are myomectomy (fibroid removal from the uterus) and hysterectomy (uterus removal).

In this backdrop, let’s understand the new treatment procedure in detail. Actually, MRgFUS can be compared to using a magnifying glass to focus the sun’s energy on a single point to burn a leaf. In this procedure, focused ultrasound energy is directed at a small area of the fibroid. Patients are given a sedative and pain medication before the procedure for relaxation. The treatment takes place with the patient lying on the table inside the MR scanner. The energy causes the temperature of the cells to rise high enough to cause thermal ablation (killing of the cells) without impacting other tissues. The procedure is repeated with pulses of energy until the entire area is treated.

Importantly, this advanced medical treatment is conducted in an outpatient setting, without the need for general anaesthesia or hospitalisation — greatly reducing recovery time and the risks of side effects. Following the treatment, the symptoms are relieved as the body gradually expels the treated tissue over a period of month. Within one-three days, you can return to your daily routine and begin the road to improved quality of life without distressing symptoms.

Although doctors are still waiting for more data on its efficacy, the new treatment promises a radical change in the way the problem has been addressed till now, and may provide an easy and most convenient option for removing fibroids.

That said, I will now move on to the second issue which drew my attention. This was about a new class of drugs for the management of diabetes in type II patients. Diabetes, as most of you would know, is a growing epidemic that is showing no sign of slowing down and is the fifth leading cause of death, globally. Currently more than 194 million people worldwide are suffering from diabetes. India is considered to be the diabetic capital of world, with the largest population of diabetic patients, more that 30 million, as per WHO estimates. Patients with diabetes are at risk of slow and irreversible damage to organs such as heart, kidneys and eyes, which account for increased morbidity and mortality associated with the disease.

Of course, there have been many path-breaking research — and as many new drugs — in this field over the last decade or so. These have also helped bring about a sea change in the way the disease is understood and treated. Much on these lines, a new class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors claims to enhance the body’s own ability to lower blood sugar (glucose) when it is elevated. Known as Sitagliptin, this drug has been approved to be taken once daily — in a single dose, or in combination — by type 2 diabetes patients.
Explains Dr Nikhil Tandon, professor of endocrinology at All India Institute of Medical Science (AIIMS), New Delhi: “DPP-4 inhibitors represent an innovative and different approach to treating type II diabetes, a disease that is rapidly increasing in prevalence and exacting huge costs on a personal and global level. Approximately two out of three adults being treated are not achieving target blood sugar levels, suggesting that current therapies have significant limitations. Sitagliptin is an exciting new option that effectively lowers blood sugar levels by harnessing the benefits of the hormone which is already present in the body. Importantly, the profile of side effects observed with Sitagliptin was as good as placebo. In fact, the drug was well tolerated in large controlled clinical trials.”

The good news doesn’t end here. Sitagliptin, already available in around 70 countries, is now going to be available in pharmacies in India on prescription from physicians.