UofL Health - Brown Cancer Center is dedicated to providing you the best care for gestational trophoblastic disease. In our Gynecologic Oncology practice we bring together a team of gynecologic oncologists and other physicians to collaborate and provide a personalized treatment for you.
Gestational trophoblastic disease is a rare form of cancer in women. It happens when the egg and sperm do not combine correctly. Gestational trophoblastic disease starts in the uterus (womb) during the time women can have children.
Gestational trophoblastic disease may first occur as a molar pregnancy. A molar pregnancy is when the egg and sperm join but do not develop into a baby. Instead, the tissue looks abnormal and has many cysts. A molar pregnancy is not cancer and does not go outside of the uterus.
After a molar pregnancy, a woman may develop a gestational trophoblastic tumor. This happens when the abnormal tissue comes back or spreads outside of the uterus. This is sometimes called an invasive mole, choriocarcinoma or placental site trophoblastic tumor. Sometimes this can happen after a normal pregnancy.
Types of gestational trophoblastic disease
There are several types of gestational trophoblastic tumor. These include:
- Complete mole: This is confined to the uterus. The tumor looks like a cluster of grapes.
- Partial mole: This is similar to a complete mole, but parts of a baby may be present. However, the baby is very abnormal and cannot live.
- Invasive mole: This happens when a molar pregnancy invades the muscle of the uterus.
- Placenta-site trophoblastic tumor: Cancer is found in the place where the placenta was attached.
- Choriocarcinoma: Cancer has spread to other places in the body.
There are several risk factors. These include:
- Younger age with pregnancy
- Older age with pregnancy
- History of previous gestational trophoblastic disease
- Asian descent
- Family history of gestational trophoblastic disease
Having these risk factors does not mean that you will get gestational trophoblastic disease. However, if you have these risk factors, discuss them with your doctor.
Some symptoms include:
- Abnormal bleeding in pregnancy
- Severe nausea and vomiting in pregnancy
- Larger uterus in pregnancy
- Severe hypertension in pregnancy
- Abnormal ultrasound in pregnancy
- High pregnancy hormone levels (hCG) in pregnancy
- Continued bleeding after pregnancy
These symptoms do not mean you definitively have gestational trophoblastic disease. However, if these symptoms are present, ask your doctor.
Gestational trophoblastic disease can be hard to diagnose. It may start looking like a normal pregnancy. However, the woman may develop abnormal bleeding, ultrasound findings or labs. These tests may be used to diagnose gestational trophoblastic disease:
- Ultrasound: Abnormal tissue is seen in the uterus
- Pregnancy hormone levels (hCG): Levels will be really high
- Biopsy of abnormal tissue
A definitive diagnosis of gestational trophoblastic disease or molar pregnancy can only be made after surgery to remove the pregnancy. Biopsies of other disease sites may be needed to diagnose the disease.
Gestational trophoblastic diseases may be treated first with surgery. The type of surgery will depend on your age, the type of gestational trophoblastic disease and your plans for having children in the future. Possible surgeries include:
- Dilation and Curettage (D&C): Removal of the pregnancy using suction from the uterus through the vagina.
- Hysterectomy: Removal of the uterus and cervix to remove the disease.
Chemotherapy may be used to treat gestational trophoblastic disease if it recurs or has spread outside of the uterus. Chemotherapy is given to kill the cancer cells in your body. You and your doctor will determine if this is right for you based on where the cancer has spread and other risk factors.
Radiation therapy may be used to kill cancer cells if they have spread to places like the brain, spine or lungs.