Treatment

The treatment of a GTT depends on the size and location of the tumor, whether the cancer has spread, and the woman’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan.

This section outlines treatments that are the standard of care (best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the Clinical Trials section.

GTTs are typically curable, especially when found early. Women with a GTT may have concerns about how treatment will affect their fertility (ability to become pregnant) and sexual function, and these topics should be discussed with their health care team before treatment begins.

Surgery, chemotherapy, and radiation therapy may all be used to treat a woman with a GTT. Descriptions of each treatment option are listed below.

Surgery

A surgical oncologist is a doctor who specializes in treating cancer using surgery. For a GTT, the extent of surgery depends on the stage of the tumor. Two common surgical options are a procedure called dilation and curettage (D&C) and a hysterectomy. D&C is the removal of the contents of the uterus with a small vacuum-like device, then the walls of the uterus are scraped to remove any material that remains. A D&C is used for a molar pregnancy. A hysterectomy is the removal of the uterus and is used to treat a more advanced tumor.

Following surgery, the woman’s beta hCG level will be monitored with blood tests to make sure it falls into normal levels. If the beta hCG level remains high or increases after an initial drop, it may mean that cancer cells are still present; either in a portion of the original tumor (called a persistent or invasive mole) and/or there is spread to another area. If this occurs, additional treatment will be recommended. Learn more about cancer surgery.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor’s office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time.

Similar to surgery, the type of chemotherapy depends on the stage of the GTT. A low-risk invasive mole or metastatic disease often can be treated successfully with methotrexate (multiple brand names) either alone or in combination with leucovorin (Wellcovorin). Another drug that can be used is dactinomycin (Cosmegen, Lyovac Cosmegen). Approximately 15% of women with low-risk disease will need treatment with a second drug for treatment.

Women with high-risk metastatic disease generally receive combination chemotherapy. The most common treatment is a combination called EMA-CO (etoposide [VePesid, Toposar], methotrexate, dactinomycin, cyclophosphamide [Cytoxan, Clafen, Neosar], and vincristine [Oncovin, Vincasar]). Cisplatin (Platinol) with vincristine and methotrexate has been successful to treat women with a tumor that did not go into remission (a temporary or permanent absence of symptoms) with the above-mentioned treatments.

Treatment results are measured by beta hCG levels. Usually treatment is continued until beta hCG levels are normal, and then one to two additional cycles of treatment may be given.

The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Find out more about common terms used during cancer treatment.