Female Cancers
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How is GTT diagnosed and treated?


 - Gestational trophoblastic tumors (GTT)
How is GTT diagnosed?

GTT can be difficult to diagnose, in part because it often doesn’t cause many symptoms.
If you or your doctor suspects you may have GTT, you will likely have both urine and blood tests to check your levels of the hormone human chorionic gonadotrophin (hGC), which will be elevated if you have GTT.

Ultrasounds can also play a key role in diagnosing GTT. And if you’ve recently had a baby, or been through a miscarriage or an ectopic pregnancy, the doctor will examine the placenta to see if it’s healthy. This is a routine procedure.

The process of diagnosing a molar pregnancy can be different than diagnosing other forms of GTT, though in both cases your doctor will check for levels of hGC in the blood and urine, and order an ultrasound.

If these tests indicate that you may have a molar pregnancy, you will likely then have a minor operation most commonly known as a D and C (dilatation and curettage), to remove the abnormal tissue.  

What is the treatment for GTT? 

Molar pregnancy is generally treated quite effectively – and cured – with the D and C, which removes the abnormal tissue. In some cases, instead of having the operation, women will be given a tablet that makes the womb contract and empty itself. Once a molar pregnancy has been removed, doctors will still closely monitor the hGC levels in the blood and urine.
Nearly all women who are diagnosed with molar pregnancy or any other form of GTT will be referred to one of a few specialist centers in the UK for follow up monitoring.
Generally, about 15 percent of women who have gone through a complete molar pregnancy will need additional treatment, in the form of chemotherapy.
Treatment for other forms of GTT, such as persistent trophoblastic disease and choriocarcinoma, varies depending on the type of disease, and the stage at which it’s caught.
Most women with GTT will have already had a D and C (to treat a molar pregnancy). If the condition persists, doctors will generally order a course of chemotherapy, either by injection – which is enough in most cases – or occasionally by drip into the vein.

In the rare cases where tumors have spread to the brain, chemotherapy can be injected into the fluid around the spinal cord.
In the rare cases where a D and C and chemotherapy are not enough, women may need to have more drastic surgery – likely a hysterectomy – to get rid of GTT. Radiotherapy is rarely recommended as a treatment option for GTT.


Samantha Fields
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