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Friday, December 06, 2019

New treatment for a medical condition is the result of research, trial and error, without knowing at the outset if all that work will deliver the hoped-for cure. Dr. Scott Chudnoff, a resident of Bergenfield and chair of obstetrics and gynecology at Stamford Hospital in Connecticut, has just tasted the sweetness of success. After leading clinical trials for transcervical ablation, a non- invasive surgical procedure to remove fibroids in women, the FDA approved the treatment in August and Dr. Chudnoff has begun performing the procedure at Stamford Hospital.

Transcervical ablation uses a probe that is passed through the cervix with a needle that also has smaller needles within, and delivers radio waves to destroy the tumor without affecting the surrounding tissue.

“There are no cuts,” Dr. Chudnoff said. “It’s quick—20 minutes to an hour, depending on how many fibroids there are, and the size. Patients go home the same day.”

Dr. Chudnoff expects that the treatment will increase in popularity as physicians learn about it and receive training. The paper he wrote is now part of the certification process for an ob/gyn to become board certified. He is working with patients and insurance companies to address the financial costs of the procedure.

Fibroids are mostly benign tumors of the uterus that are present in 25 to 50% of all women. While many fibroids can be left alone without treatment, others can grow—Dr. Chudnoff once removed a 10-pound fibroid—causing pain and abnormally heavy bleeding. Previously, the only way to cure fibroids was with a hysterectomy, the complete removal of a woman’s uterus. Drugs are available that treat the symptoms but don’t treat the fibroids directly. They put women into menopause and when the drugs stop, the fibroids came back.

“These treatments are not ideal for most women,” Dr. Chudnoff said. “A hysterectomy is very invasive and means a woman cannot have children. Plus, there are implications for psychological health, women’s definition of themselves, as well as their intimate functioning.”

Dr. Chudnoff has spent much of his career trying to bridge the gap in treatment for fibroids.

“It never sat well with me that there were no alternative treatment options,” he said. “My research has started with the premise that that there must be a way to destroy fibroids without damaging the tissue of the uterus.”

The road to Dr. Chudnoff’s success began in 2004 when he spoke with colleagues at a conference who had developed a device that destroyed fibroids using the needles within a needle pattern, and a circulating energy source. Dr. Chudnoff became the lead author in a study using this device. After insertion of a laparoscopic camera into a woman’s stomach, ultrasound guidance identified the primary fibroids and helped to direct the needle into them. That trial was successful and the device was approved by the FDA.

However, Dr. Chudnoff still envisioned a procedure using a device that didn’t have to be inserted with surgical incisions. He found another group that had developed a similar probe but this one was designed to be inserted through the cervix. The clinical trials resulted in just the outcome he was looking for––a non-invasive procedure that reduced fibroid size and blood loss so that the patient felt much better.

“This is the beauty of sharing information at conferences,” he said. “There are different approaches and technologies.”

Dr. Chudnoff’s war on fibroids is part of his dedication to enhancing women’s health. He opened up a multi-specialty center at Stamford Hospital where women can see several specialists in one visit, such as an ob/gyn, endocrinologist, diabetes and nutrition specialists.

“Women’s health issues don’t get the same attention,” he said. “If men had fibroids, they’d be storming the halls of Congress for a cure.”

By Bracha Schwartz