Overview Gestational trophoblastic tumor, a rare cancer in women, is a disease in which cancer (malignant) cells grow in the tissues that are formed following conception (the joining of sperm and egg). Gestational trophoblastic tumors start inside the uterus, the hollow, muscular, pear-shaped organ where a baby grows. This type of cancer occurs in women during the years when they are able to have children.
Tumor Types There are two types of gestational trophoblastic tumors: hydatidiform mole and choriocarcinoma.
If a patient has a hydatidiform mole (also called a molar pregnancy), the sperm and egg cells have joined without the development of a baby in the uterus. Instead, the tissue that is formed resembles grape-like cysts. Hydatidiform mole does not spread outside of the uterus to other parts of the body.
If a patient has a choriocarcinoma, the tumor may have started from a hydatidiform mole or from tissue that remains in the uterus following an abortion or delivery of a baby. Choriocarcinoma can spread from the uterus to other parts of the body. A very rare type of gestational trophoblastic tumor starts in the uterus where the placenta was attached. This type of cancer is called placental-site trophoblastic disease.
Symptoms Gestational trophoblastic tumor is not always easy to find. In its early stages, it may look like a normal pregnancy. A doctor should be seen if there is vaginal bleeding (not menstrual bleeding) and if a woman is pregnant and the baby hasn’t moved at the expected time.
Treatment Different types of treatment are available for patients with gestational trophoblastic tumor. Some treatments are standard (the currently used treatment, often referred to as “standard of care”), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Two kinds of standard treatment are used: surgery (taking out the cancer) and chemotherapy (using drugs to kill cancer cells). Radiation therapy (using high-energy x-rays to kill cancer cells) may be used in certain cases to treat cancer that has spread to other parts of the body.
Surgery The doctor may take out the cancer using one of the following operations:
• Dilation and curettage (D & C) with suction evacuation is stretching the opening of the uterus (the cervix) and removing the material inside the uterus with a small vacuum-like device. The walls of the uterus are then scraped gently to remove any material that may remain in the uterus. This is used only for molar pregnancies. • Hysterectomy is an operation to take out the uterus. The ovaries usually are not removed in the treatment of this disease.
Chemotherapy Chemotherapy uses drugs to kill cancer cells. It may be taken by pill or put into the body by a needle in a vein or muscle. It is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the uterus. Chemotherapy may be given before or after surgery or alone.
Radiation Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation).