Gestational trophoblastic disease (GTD), also called gestational trophoblastic tumor (GTT), refers to a group of abnormalities in which tumors grow inside a woman's uterus.
The abnormal cells start in the tissue that would normally become the placenta; the organ that develops during pregnancy to nurture the fetus. GTD is most often found because of abnormal signs or symptoms during a pregnancy. Most women with GTD are diagnosed early as a result of routine blood tests and ultrasounds done during early pregnancy. Often, a woman is diagnosed with GTD before any symptoms appear.
A baby may or may not develop during these types of pregnancies.
Two types of GTD exist:
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Choriocarcinoma (a type of cancer)
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Hydatidiform mole (also called a molar pregnancy)
Treatment
Your treatment plan will depend on a number of factors, including your overall health, the location of the tumor, and if the cancer has spread. GTDs are usually curable, especially when found early, as they often are. Your doctor will discuss your various treatment options and how they will affect your fertility and sexual function. These issues will be considered when planning your treatment.
Surgery
Depending on the severity of the tumor, different surgical options are available:
- Dilation and curettage: Also called suction D&C, this is often a good choice for women who wish to preserve their fertility. Your doctor will dilate the cervix and using a small vacuum-like device (curette), will remove the contents of the uterus and scrape its walls
Hysterectomy: The uterus is removed in this procedure, ensuring that all of the tumor cells in the uterus are removed. This, however, is not a guarantee that all the cancer cells from your body are gone. You may have:
- Abdominal hysterectomy, (removal through the abdomen)
- Vaginal hysterectomy (removal through the vagina)
- Laparoscopic hysterectomy (small holes made in the abdomen for the instruments, with the uterus removed through a small hole made in the vagina)
Future pregnancies are not possible once this procedure is performed.
Chemotherapy
Chemotherapy drugs are used to kill cancer cells. The medicine is delivered through the bloodstream, either intravenously or orally. Because the medication reaches all areas of the body, doctors use it in cases where the cancer has metastasized (spread). Women in the low-risk group will generally receive a single drug; women in a higher-risk group will receive a combination of drugs, often at higher doses.
Radiation therapy
Radiation therapy uses high-energy X-rays to kill cancer cells. This is reserved for GTD that has spread and is not responding to chemotherapy. The radiation therapy most often used with GTD is external beam radiation therapy, which is a radiation beam aimed at the cancer from a machine outside the body. It is similar to undergoing an X-ray.
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