Gynecologic Oncology Program

Gestational Trophoblastic Disease

Treatment Options

There are two primary treatments for patients with gestational trophoblastic disease: surgery and chemotherapy. Radiation therapy 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 mole or tumor using one of the following operations:

Dilation and curettage (D&C): The opening of the uterus (the cervix) is stretched (dilated) and the material inside the uterus is removed with a small vacuum-like device. The doctor then gently scrapes the walls of the uterus to remove any material that may remain. This procedure is used only for molar pregnancies, in which the mole has not invaded the muscular tissue of the uterus
Hysterectomy: The entire uterus is removed. The ovaries usually are not removed in the treatment of this disease.

Side effects: The side effects of surgery depend on the location of the tumor, the type of operation, and other factors. Although patients are often uncomfortable during the first few days after surgery, this pain can usually be controlled with medicine. The recovery period after an operation varies from patient to patient.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Most anticancer drugs are injected into a vein (IV) or a muscle; some are given by mouth. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. It is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on.

Side effects: Chemotherapy drugs generally target rapidly dividing cancer cells. However, other cells that also divide rapidly include blood cells, cells that line the digestive tract, and cells in hair follicles. Unfortunately, these healthy cells may also be impacted by the chemotherapy drugs, resulting in side effects such as infections, tiredness, temporary hair loss, mouth or vaginal sores, changes in the menstrual cycle, and infertility. Not all chemotherapy patients develop all of these symptoms, and they usually go away during the recovery period or after treatment stops. Medicines and other treatments are available to control or minimize many of these symptoms.

Radiation Therapy

Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external 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 therapy).

Side effects: The most common side effects of radiation therapy are tiredness, skin reactions(such as a rash or redness) in the treated areas, and loss of appetite. Radiation treatment to the pelvic area may cause the vagina to narrow due to scar tissue. Early menopause and problems with urination are also possible. Radiation therapy may also cause a decrease in the number of white blood cells that help protect the body against infection. Most of these side effects can be treated or controlled and in most cases they are not permanent.

This page was last updated on: March 3, 2008.