Evidence-Based Approach for Secondary Prevention of Uterine Fibroids (The ESCAPE Approach)

Abstract

Uterine fibroids (UFs) are common tumors in women of reproductive age. It is imperative to comprehend UFs’ associated risk factors to facilitate early detection and prevention. Simple relying on surgical/pharmacological treatment of advanced disease is not only highly expensive, but it also deprives patients of good quality of life (QOL). Unfortunately, even if the disease is discovered early, no medical intervention is traditionally initiated until the disease burden becomes high, and only then is surgical intervention performed. Furthermore, after myomectomy, the recurrence rate of UFs is extremely high with the need for additional surgeries and other interventions. This confused approach is invasive and extremely costly with an overall negative impact on women’s health. Secondary prevention is the management of early disease to slow down its progression or even halt it completely. The current approach of watchful observation for early disease is considered a major missed opportunity in the literature. The aim of this article is to present an approach named the ESCAPE (Evidence-Based Approach for Secondary Prevention) of UF management. It comprises simple, inexpensive, and safe steps that can arrest the development of UFs, promote overall reproductive health, decrease the number of unnecessary surgeries, and save billions of health care systems’ dollars worldwide.

Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness

“…Consuming bell peppers can provide a significant boost to the immune system, helping the body fight off infections and illnesses. Moreover, bell peppers contain antioxidants, which are beneficial compounds that can help prevent the growth of UFs by combating oxidative stress and reducing inflammation [ 10 , 55 ].…”

“…Clinical trials have reported significant reductions in UF size with long-term vitamin D supplementation, with an excellent safety profile and no reported adverse events [ 71 , 72 ]. The use of vitamin D (4000 IU/day) was introduced in our previous ESCAPE approach to manage UFs [ 10 ].…”

“…A small pilot study showed reduced UF volume and symptom improvement in some participants with EGCG administration, but larger, well-designed clinical trials are needed to establish efficacy and optimal dosage [ 76 ]. The use of EGCG (800 mg/day) was suggested in our ESCAPE approach in order to manage UFs [ 10 ] ( Figure 1 ).…”

“…A small pilot study showed reduced UF volume and symptom improvement in some participants with EGCG administration, but larger, well-designed clinical trials are needed to establish efficacy and optimal dosage [76]. The use of EGCG (800 mg/day) was suggested in our ESCAPE approach in order to manage UFs [10] (Figure 1). The figure highlights the influence of dietary choices on uterine fibroid (UF) risk, emphasizing the importance of consuming fiber-rich vegetables such as leafy greens, cruciferous vegetables, carrots, sweet potatoes, and bell peppers, along with fruits like berries, citrus fruits, apples, pineapple, and kiwi.…”

“…Our team is actively pursuing the application of the ESCAPE approach by preparing a clinical trial named ERADICATE-UF. The existing approach of watchful observation for early disease is recognized as a significant missed opportunity in the literature [ 9 , 10 ].…”