Gestational Trophoblastic Disease: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 07/2017

ON THIS PAGE: You will read about your medical care after treatment for GTD is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with GTD doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the tumor has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Follow-up treatment for GTD always includes measuring beta hCG levels in the blood, typically every 1 to 2 weeks until the hormone level is normal for 3 tests in a row. After that, beta hCG levels should be monitored every month for the first year, every 4 months for the second year, then once a year for the third and fourth years.

Women are encouraged to talk with their doctors about the recommended amount of time to wait before becoming pregnant after reaching normal levels of beta hCG.

  • After a molar pregnancy, women will have their beta hCG levels checked every week, until the levels are normal for 3 straight weeks. After that, beta hCG levels will be checked every month until the levels are normal for 6 consecutive months.  

  • After GTN, women will have their beta hCG levels checked every week, until the levels are normal for 3 straight weeks. After that, beta hCG levels will be checked every month until the levels are normal for 12 consecutive months.

While beta hCG is being regularly checked, women should use reliable birth control. After the beta hCG checkups are done, women may become pregnant at any time.

Women with a history of GTD should have a beta hCG check after each pregnancy, even if the pregnancy was completely normal.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of GTD originally diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects, called late effects, may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of tumor, your individual treatment plan, and your overall health. If chemotherapy was given, talk with your doctor about possible long-term side effects based on the specific drug(s) used. Different drugs and doses can cause different side effects. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the GTD treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their gynecologic oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of tumor, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your GTD care will lead your follow-up care, be sure to share your treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a diagnosis of GTD. You may use the menu to choose a different section to continue reading in this guide.