Gestational Trophoblastic Disease: Treatment

Treatment for hydatidiform moles will involve emptying the uterus of abnormal cells during a surgical procedure called Dilation and Curettage.  This may be done in the operating room under the assistance of an ultrasound.  The abnormal tissues can be removed and the Pathologists can examine them under a microscope. Your doctor will need to monitor the pregnancy hormone (bHCG) levels in the body.

Treatment for the different types of GTN will depend on the type of disease, stage, and the risk group the patient falls into.  The risk group will take into consideration following factors:

  • Age of patient
  • Type of pregnancy before the cancer was diagnosed
  • How soon was the cancer diagnosed after the pregnancy began
  • Level of b-hCG hormones in blood
  • Size of largest tumor
  • Where the tumor has spread and number of metastatic sites in body
  • Has the tumor been treated before with chemotherapies?

Combining all the information, your doctor will discuss with you your risk group.  For low risk disease, patients usually receive less aggressive chemotherapies.  Treatment is given until the b-hCG level is normal for at least 3 weeks after treatment ends.  If the level does not normalize, or for high-risk disease, patients will undergo more aggressive chemotherapy regimens which typically include a combination of anti-cancer drugs.  Rarely, radiation therapy, especially if cancer has spread to the brain, can also be given.

For the rare Placental-Site Gestational Tumor (PSTT) and Epithelioid Trophoblastic Tumors (ETT), treatment for early stage disease include removing the uterus, or a total hysterectomy.  Treatment for high stage disease may include a combination of chemotherapy and surgery.