1. Pregnancy Gone Awry
Gestational trophoblastic tumors develop in a woman's uterus, but these tumors aren't considered uterine cancer. These tumors develop only in women of childbearing age, because the genesis of the tumor comes from the earliest union of a sperm and an egg. If two sperm fertilize one egg, or if a sperm fertilizes an egg with no genetic material to form a viable fetus, the cells can continue to grow without control or order. Some types of gestational trophoblastic tumors, called hydatidiform moles, are not cancerous. Others can invade healthy tissues or spread to other parts of the body.
2. Who's At Risk
Any woman of childbearing age can develop this cancer, but researchers have identified some risk factors that increase the chances of developing gestational trophoblastic tumors. Some risk factors center on modifiable lifestyle choices, but not enough for doctors to make specific prevention recommendations. Most patients with these tumors are under 20 or over 40. Women with many sexual partners and women who take birth control are at risk. Women who experienced a previous hydatidiform mole have a greater chance of having another molar pregnancy, although the risk is still very small.
3. Diagnosing a Rare Tumor
Symptoms of gestational trophoblastic tumor can be subtle, but a woman should consult her doctor about any vaginal bleeding that accompanies pregnancy. In addition, if a pregnancy proceeds without any movement of the fetus at the normal stage of development, a doctor may test for this rare tumor. The doctor will conduct a sonogram to get an image of the growing fetus to see whether any abnormalities that suggest a tumor rather than a normal pregnancy exist. In another type of gestational trophoblastic tumor, the woman develops cancer after a normal pregnancy. The presence of the hormone HCG in the absence of a pregnancy is a sign of gestational trophoblastic tumor.
4. Treatment for All Stages
Surgery is a common treatment for gestational trophoblastic tumors. A woman may have a D and C, where a doctor scrapes out the contents of the uterus with a surgical instrument under local anesthetic. If the tumor involves the placenta, or the woman is finished with childbearing, the doctor may advise a hysterectomy, which removes the entire uterus. Patients usually don't need to have their ovaries removed, so the surgery doesn't trigger menopause. If the tumors have spread from the uterus to other parts of the body, the doctor may recommend chemotherapy.
5. Prognosis Variables
Even when a gestational trophoblastic tumor has spread to organs far from the uterus, such as the lungs, a woman's chance of cure is high with modern treatments. Good prognostic indicators include an HCG level lower than 10,000, tumors smaller than 5 cm in size and fewer than eight metastatic tumors. Unfavorable disease features include tumors that occur more than a year after pregnancy, brain or liver tumors or prior unsuccessful chemotherapy treatments.
