Gestational trophoblastic disease treatments

Treatment for GTD typically includes surgery and/or chemotherapy. Surgery is usually the first treatment option for molar pregnancies, which account for most cases of GTD.

The two main types of GTD are:

• Hydatidiform moles (also known as molar pregnancies)
• Gestational trophoblastic neoplasia (GTN)

Both types have the possibility of becoming cancerous, so treatment is necessary for the health of the mother. GTD is usually treatable if it’s caught early.

The type of treatment recommended depends on the type, stage and risk of the GTD. Speak with your cancer care team about your concerns, particularly regarding fertility and the desire to have children as this may impact which treatment is recommended.

Surgery

Common surgical options for GTD include:

Suction dilation and curettage (D&C) and hysterectomy: The doctor removes the tissues from the uterus by suctioning the uterus walls, then scraping them. Commonly used in the case of a molar pregnancy, a D&C helps preserve a woman’s fertility. Side effects may include vaginal bleeding, scarring, cramping, infection, and blood clots. In most cases, a D&C is the only surgical treatment a GTD patient needs.

Hysterectomy: In some cases, either to reduce the risk of recurrence or to treat PSTT or ETT, a hysterectomy is performed. In a hysterectomy, the uterus and cervix are typically removed. Women who undergo a hysterectomy are no longer able to get pregnant. Side effects may include vaginal bleeding, infection, and pain.

There are two types of hysterectomies commonly used for GTD:

• Simple hysterectomy removes the uterus and cervix.
• Supracervical hysterectomy removes the body of the uterus, while the uterine cervix remains intact.

These procedures may be performed via a traditional incision across the stomach, or with a technique called a laparoscopic hysterectomy, which uses multiple small incisions.

Chemotherapy

Chemotherapy may be used alone as a treatment, or in combination with surgery. It’s commonly used to treat molar pregnancies.

Chemotherapy treatments use medication, administered orally or intravenously, to travel through the bloodstream and kill cancer cells. It’s an appropriate treatment for molar pregnancies and certain types of GTN. The treatment may be given over several weeks, with the specific drug used dependent on the type and stage of cancer.

Though useful for destroying cancer cells, chemotherapy also may harm healthy cells, leading to side effects. When undergoing chemotherapy, you may experience side effects such as:

• Nausea and vomiting
• Fatigue
• Hair loss
• Infection
• Numbness in the fingers and toes

Alert your care team if you experience any side effects, and they may be able to try another type of chemotherapy drug that will be better tolerated. Generally, chemotherapy is appropriate for patients without pre-existing health conditions, as these may make it harder to tolerate the treatment.

Radiation

GTD may sometimes be treated with external radiation therapy. This treatment uses a machine to send high-energy radiation to specifically target cancer tumors.

Your care team may provide more details if this treatment is recommended, including how many courses of radiation you may need.

Clinical trials

If a clinical trial is available, it may offer some GTD patients new types of treatment not yet available to the general public. Clinical trials also also provide a way to help improve medical care for future patients. Ask your care team whether any current clinical trials are recruiting patients.

Next topic: What are the risk factors for gestational trophoblastic disease?