At Penn Medicine, we take a precision medicine approach to determine the best treatment plan for your unique medical history. Our gynecologic oncologists will communicate regularly with other Penn specialists and members of your care team to provide comprehensive, integrated care. And we are experienced in creating fertility-sparing treatment plans when current or future pregnancy is a consideration.
Learn more about Penn Medicine’s fertility preservation program
Gestational trophoblastic disease treatments at Penn Medicine
Although most cases of gestational trophoblastic disease (GTD) are benign (not cancer) tumors, Penn doctors will follow up for six months after treatment to see if the growth has returned or become cancerous.
Treatment for GTD depends on:
- Age
- Type of GTD
- If the tumor has spread
- The number, location, and size of tumors in the body
- Blood level of beta human chorionic gonadotropin (β-hCG), a hormone that the body makes during pregnancy
- How soon the tumor was diagnosed after the pregnancy began
- If GTD occurred after a molar pregnancy, miscarriage, or normal pregnancy
- Previous treatment for GTD
Gestational trophoblastic disease chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given before or after surgery, or on its own as a treatment for gestational trophoblastic neoplasia.
The chemotherapy type and delivery method depends on the type and stage of the cancer being treated:
- Combination therapy is treatment with more than one anticancer drug.
- Neoadjuvant therapy is given before surgery to shrink a tumor in order to more easily remove it.
- Systemic chemotherapy is taken by mouth or injected into a vein or muscle. It then enters the bloodstream to reach cancer cells throughout the body.
- Regional chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity (such as the abdomen), to treat cancer in those areas.
- Intraperitoneal (IP) chemotherapy is delivered directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.
Gestational trophoblastic disease surgery
At Penn Medicine, our minimally invasive techniques, such as robotic-assisted surgery, have become the standard of care for treating gynecologic cancers. If you have surgery for gestational trophoblastic disease (GTD), your doctors will follow up with regular blood tests to measure your levels of beta-HCG, a hormone that can be a sign of GTD.
Two types of surgery are most often used to treat GTD:
Suction curettage, also called a dilation and curettage (D & C) with suction evacuation, is a procedure that opens (dilates) the cervix, which is the opening of the uterus, and uses a small instrument to remove the lining of the uterus. This may be done if you have a molar pregnancy.
A hysterectomy is a surgery to remove the uterus. This option is most often used if you do not want to become pregnant in the future. Hysterectomies can be full or partial. A radical hysterectomy removes the uterus and its surrounding tissues. This often includes an examination of the lymph nodes, to see if the cancer has spread.
Hysterectomy can be performed as an open procedure or through the vagina. Vaginal hysterectomy can be done as a minimally invasive procedure, using a laparoscope or robot-assisted surgery.
Penn Medicine’s team of experienced surgeons perform a variety of types of hysterectomy and a high volume of gynecologic cancer surgeries every year. Your doctor will consider your medical history, stage of cancer, and current health conditions to determine the type of surgery that’s right for you.
Gestational trophoblastic disease radiation
Radiation therapy, which uses high-energy X-rays to kill cancer cells, is generally not used to treat GTD except in special circumstances. For example, radiation may be used in certain cases to treat cancer that has spread to other parts of the body.
For those cases in which radiation therapy is used, Penn Radiation Oncology has the most advanced equipment and technology available to treat cancer. Our radiation oncologists are recognized leaders in using techniques that target radiation precisely to the treatment area while sparing normal tissue.
Gestational trophoblastic disease support services
Oncology navigators are focused on patients and committed to making sure that you receive the best possible care. They are experts in navigating complex health care situations and serve as a consistent point of contact and a reliable source for advice, support and direction for you and your family.
While conventional medicine plays a critical role in cancer treatment, integrative medicine and wellness programs can help you enhance your quality of life, minimize or reduce the side effects of cancer and cancer treatment, as well as promote healing and recovery. Our integrative oncology services for gestational trophoblastic disease can supplement traditional cancer treatments.
Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. We can work with you and your family to integrate supportive programs into your overall care plan while ensuring your health and safety.
Services include:
- Acupuncture
- Nutritional counseling and services
- Mindfulness-based stress reduction therapy
- Reiki therapy
- Yoga
- Exercise and rehabilitation
Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of cancer support programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social-work counseling, nutrition counseling, psychological counseling and spiritual counseling.
The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.
Palliative care provides physical, emotional and spiritual care that can enhance your quality of life. It can be used to complement traditional cancer therapies or when curative therapies are no longer an option. Services include palliative chemotherapy, radiation therapy and surgery, as well as psychological counseling, art therapy and support groups for patients and families.
Penn Medicine offers a full range of at-home health care services, including specialized therapies and medications, for patients with cancer and cancer-related conditions.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.