Types of Gestational Trophoblastic Disease
There are two basic types of gestational trophoblastic disease: molar pregnancy and gestational trophoblastic neoplasia, which is a form of cancer.
Molar Pregnancy
The most common form of the disease occurs during pregnancy. It involves slow-growing, non-cancerous tumors in your uterus, which are typically surgically removed. During a molar pregnancy, fetal tissue may not develop or may not develop completely.
Gestational Trophoblastic Neoplasia
Sometimes the tumors that form are cancerous and have the potential to spread to other organs. This form of gestational trophoblastic disease can occur after a miscarriage or delivery of a healthy baby.Treatments vary and may include surgery and/or chemotherapy.
Tests for Gestational Trophoblastic Disease
Gestational trophoblastic disease is rare, and the growth of tumors inside your uterus is best treated by a specialist. We use a combination of tests to determine the severity and form of your gestational trophoblastic disease and to identify the exact location of the tumors.
Pelvic Exam
A routine physical exam allows your gynecologist to feel for unusual changes or masses in your vagina, uterus, or cervix.
Blood Tests
Blood tests can reveal elevated levels of human chorionic gonadotropin, a hormone naturally produced by your body that increases when gestational trophoblastic disease is present.
Imaging Tests
Ultrasounds and CT scans can identify the location of tumors. Our gynecologic oncologists use the images to determine the best form of treatment. Scans may be repeated after treatment to monitor progress.
Family history doesn’t always influence gestational trophoblastic disease, but we may refer you to a certified genetic counselor who specialize in hereditary cancer services to determine if cancer found in other family members may impact you. Genetic testing is done by blood test.
Treatments for Gestational Trophoblastic Disease
In most cases, gestational trophoblastic disease does not affect future pregnancies. Our care teams will collaborate on treatment options to tailor surgery, chemotherapy, or radiation therapy to minimize any impact on your fertility and sexual function. After treatment, you may need to avoid getting pregnant for a short period of time to ensure gestational trophoblastic disease doesn’t return.
Dilation and Curettage (D and C)
Known as a “D and C,” this is the most common treatment for gestational trophoblastic disease. Often it is the only procedure necessary to remove a tumor if you have a molar pregnancy. During this outpatient procedure, your cervix will be dilated, and a long, thin plastic catheter with an open tip will be inserted into your uterus. Your doctor will use the tool to safely remove abnormal tissue.
Chemotherapy
If you’re diagnosed with gestational trophoblastic neoplasia, you may undergo chemotherapy after dilation and curettage to kill any remaining cancerous cells.
High-energy X-rays target your tumor and kill cancer cells. Our radiation oncologists are specially trained to deliver radiation and minimize damage to surrounding healthy tissue. This treatment is typically an option for cancerous gestational trophoblastic disease that may spread to organs.
Contraception
To prevent recurrence of gestational trophoblastic disease and to let your body heal, it’s important to not get pregnant while receiving chemotherapy or immediately after treatment. We may recommend contraceptive options until you and your care team determine you’re ready to try to get pregnant again.
Hysterectomy
Hysterectomies are rarely needed to treat gestational trophoblastic disease but may be recommended if your tumor is cancerous or you have completed your childbearing. Hysterectomies are common procedures that remove the uterus through small incisions in the abdomen. This minimally invasive option reduces scarring, minimizes bleeding, shortens your hospital stay, and speeds up your recovery.
