Most of the people who come to Fred Hutchinson Cancer Center for gynecologic cancer care are referred by a primary care provider, internist or gynecologist. About half of these individuals live in the three-county area that includes Seattle. Most of the rest come from the five-state Pacific Northwest region.
People with gynecologic cancer are often at greater risk for breast cancer. At Fred Hutch you will be able to have breast cancer screening, including mammograms and ultrasounds, here at our Women's Center, rather than going to another facility.
You will also have access to the Women’s Wellness Clinic for follow-up care after treatment.
Gestational Trophoblastic Disease
Gestational trophoblastic disease includes several conditions that occur during pregnancy or shortly thereafter. It is a fairly rare cancer that develops in the cells (trophoblasts) that form part of the placenta in a pregnant person. It is also highly treatable, and most women with the disease will be cured.
The pregnancy that triggers GTD may be a miscarriage, a tubal pregnancy or a full-term pregnancy in which a normal baby is delivered.
Any person of reproductive age who has metastatic cancer of unknown primary origin should have a pregnancy test to check her HCG levels to rule out (or confirm) GTD.
There are several types of GTD:
Molar Pregnancy
Conception takes place, but a normal fetus does not develop. Instead, the placental tissue grows very fast, resulting in a tumor. There are about 3,000 molar pregnancies a year in the United States, or about one in every 1,000 pregnancies. (This condition is also called hydatidiform mole.)
There are two types of molar pregnancy, complete mole, in which no fetus is formed, and partial mole, in which a fetus forms but is abnormal and will not survive.
This type of GTD does not spread outside the uterus to other parts of the body.
Choriocarcinoma
Choriocarcinoma may have started from a molar pregnancy or from tissue that remains in the uterus after an abortion, an ectopic pregnancy or the delivery of a baby. This type of GTD can spread from the uterus to other parts of the body.
Placenta-Site Trophoblastic tumor
This is a very rare type of GTD that starts in the uterus where the placenta was attached.
Types of Treatment for Gynecologic Cancer
Today, people with gynecological cancer have better treatment options than they did even a few years ago. If detected in the precancerous stage, some conditions can be halted with a simple procedure.
Definitions
- hCG: Also known as human chorionic gonadotropin, is a hormone that increases during pregnancy. It also increases when a person has GTD.
- Metastatic gestational trophoblastic disease: Despite treatment, gestational trophoblastic disease (GTD) sometimes reoccurs. It may come back in the uterus or in another part of the body. This is metastatic (recurrent) GTD. Although tumors may appear in distant sites--such as the liver or brain--it is not a new cancer, it is a recurrence of the original cancer. In some cases, the cancer has already metastasized, or spread, by the time a someone discovers that she has GTD.
Metastatic GTD can be put into remission with chemotherapy about 85 to 90 percent of the time.
If you have metastatic GTD, Fred Hutch can offer you new medical procedures and treatments, as well as access to clinical trials, that your community provider may not know about.
No one at Fred Hutch will tell you that a diagnosis of metastatic GTD is not serious, but there is hope, especially if the cancer has not spread to the liver or brain, you have not received prior chemotherapy, your last pregnancy was less than four months ago and your blood levels of HCG are low.