Have you ever heard of the name Choriocarcinoma? This may be a new word for you. This is actually a very rare and somewhat serious cancer. But don't worry, let's talk about it in detail. This condition is often associated with pregnancy. Therefore, it is very important to be aware of this.
What is Choriocarcinoma?
Simply put, choriocarcinoma is a type of cancer that forms in your uterus or ovaries and can spread very quickly. There are two main types of this as well.
The most common type of choriocarcinoma that occurs during pregnancy is called Gestational Choriocarcinoma . This belongs to a group called Gestational Trophoblastic Disease (GTD). GTD is a cancerous condition that develops in cells that originate from the placenta during pregnancy. As you know, the placenta is the most important part of the body that provides oxygen and nutrition to the baby through the umbilical cord.
Choriocarcinoma is most commonly seen in women who have had a molar pregnancy . A molar pregnancy is a condition in which a hydatidiform mole develops in the uterus instead of a fetus due to a defect in the fertilization of the egg and sperm. It can also occur after an ectopic pregnancy , miscarriage, or even a normal delivery.
The most dangerous thing about this cancer is that it can spread very quickly to other parts of the body. For example:
- Lungs
- Uterine muscle layer
- Lymph nodes
- Liver or kidneys
- Brain
- Blood vessels
But the good news is that in most cases, this choriocarcinoma condition can be completely cured with chemotherapy .
What are the types of choriocarcinoma?
As we mentioned earlier, there are two types of choriocarcinoma:
1. Gestational Choriocarcinoma: This is the most common type. It can develop during pregnancy or shortly after pregnancy.
2. Non-gestational Choriocarcinoma: This can affect both men and women. It is a type of germ cell tumor. In women, it can occur in the ovaries or the uterine lining, but it is not related to the placenta. In men, it can occur in the testicles.
How common is this disease?
Gestational Choriocarcinoma (GCT) accounts for about 5% of GTD cases. Even in a country like the United States, GTD cases occur in about 0.1% of all pregnancies. So, consider this: GCT is even rarer. It occurs in less than 7 out of 100,000 pregnancies in the United States. This means that it is a very rare condition in Sri Lanka as well.
What are the symptoms of Choriocarcinoma?
A person with choriocarcinoma, especially one who has recently been pregnant, may experience symptoms such as:
- Irregular vaginal bleeding
- Pelvic pain
If the cancer spreads to other parts of the body, other symptoms may occur, such as:
- If it spreads to the lungs: cough, difficulty breathing.
- If it spreads to the vagina: heavy bleeding, abnormal discharge, and vaginal lumps.
- If it spreads to the brain: Seizures, headaches.
- If it spreads to the kidneys or liver: abdominal pain.
What are the reasons for this?
Choriocarcinoma occurs when cells that form the placenta (called trophoblasts) become cancerous. It can develop early in pregnancy or later. About 50% of people who develop choriocarcinoma have had a previous molar pregnancy. A molar pregnancy is when a fluid-filled sac develops inside the uterus instead of a fetus.
In non-gestational choriocarcinoma, cells in the ovaries, testicles, or uterus start to produce a hormone called human chorionic gonadotropin (hCG) . When viewed under a microscope, these cells look similar to trophoblast cells.
How quickly does Gestational Choriocarcinoma grow?
There is no specific time frame for this to develop. It can appear months or even years after pregnancy. However, it is considered a very fast-spreading, aggressive type of cancer.
What are the risk factors for this condition?
Anyone who has been pregnant (whether through a miscarriage, ectopic pregnancy, termination of pregnancy, or normal delivery) can develop choriocarcinoma. However, you are at higher risk if you have had a molar pregnancy.
Other risk factors are:
- Being under 20 years of age or over 40 years of age at the time of pregnancy.
What are the complications of this condition?
Choriocarcinoma can be fatal if left untreated because it spreads very quickly. However, with treatment, many people can achieve remission or complete cure. As with other cancers, early detection and treatment are the best ways to achieve good results.
How is Choriocarcinoma diagnosed?
A doctor uses these tests to diagnose choriocarcinoma:
- A pelvic exam or physical examination is performed to check for any lumps.
- A blood test is done to check the level of hCG (human chorionic gonadotropin). People with choriocarcinoma have very high levels of hCG.
- Blood tests to check liver and kidney function.
- Complete Blood Count (CBC).
- Pelvic ultrasound.
- CT scan (Computed Tomography - CT scan).
- MRI scan (Magnetic Resonance Imaging - MRI).
- Chest X-ray.
These tests can also help the doctor find out if the cancer has spread.
How is Choriocarcinoma treated?
Doctors treat choriocarcinoma based on its stage. The stage of the cancer is how the doctor classifies the cancer, based on factors such as the size of the tumor and whether it has spread outside the uterus. Your overall health and your personal preferences are also considered when developing a treatment plan.
The main treatment for choriocarcinoma is chemotherapy. Chemotherapy is a type of medicine that kills cancer cells.
Some people may need a hysterectomy, radiation therapy, or a combination of these treatments.
After treatment, your doctor will continue to check you for any recurrences (follow-up exams).
Can choriocarcinoma cancer be cured?
Yes, choriocarcinoma can be cured. It can usually be cured with chemotherapy. If it is caught early, before it has spread to other parts of the body, the chances of a cure are much higher.
Healing can be a little more difficult in these cases:
- If you have previously had chemotherapy and it failed.
- If this disease develops after a full-term pregnancy or childbirth.
- If the hCG level is greater than 40,000 mIU/ml (milli-international units per milliliter) before starting treatment. (hCG is a hormone produced by the placenta during pregnancy).
- If you had symptoms for more than four months before starting treatment or if you were pregnant.
Can choriocarcinoma be prevented?
No, choriocarcinoma cannot be prevented. However , if you have had a molar pregnancy, it is very important to talk to your doctor about your risk of choriocarcinoma.
How long can you live with Choriocarcinoma?
Choriocarcinoma in its early stages has a good outlook. The survival rate for people with low-risk gestational choriocarcinoma is almost 100%. The survival rate for people with high-risk gestational choriocarcinoma is 94%.
Non-gestational choriocarcinoma (the type not related to a previous abnormal pregnancy/placental tissue) has a slightly worse prognosis. It is also less chemosensitive to chemotherapy, meaning chemotherapy may not be as effective in killing cancer cells.
Can Stage 4 Choriocarcinoma be cured?
Stage 4 choriocarcinoma means that the cancer has spread to other parts of your body, such as your brain or liver. Your doctors will talk to you about this. However , there is still a chance that the disease will go into remission.
Can I have another baby if I had choriocarcinoma?
Maybe. Many people have been able to have children again after treatment for choriocarcinoma. It depends on your diagnosis. If you want to have children, talk to your doctor about it. They can then give you the best treatment.
When should I see a doctor?
If you have unusual vaginal bleeding or lower abdominal pain, especially if you have had a molar pregnancy before, be sure to see a doctor.
Choriocarcinoma is a rare but serious cancer. It's normal to feel stressed when you receive a diagnosis like this. However, the prognosis for choriocarcinoma is usually very good. Talk to your doctor about any concerns or questions you may have. They are there to answer your questions and provide you with the best possible treatment.
The most important things to remember (Take-Home Message)
- Choriocarcinoma is a rare and rapidly spreading cancer that can be associated with pregnancy.
- Those who have had a molar pregnancy are at higher risk.
- Be aware of symptoms such as unusual vaginal bleeding and lower abdominal pain.
- This condition can often be cured with chemotherapy.
- Early detection and treatment are very important.
- If you have any doubts or symptoms, seek medical advice immediately. Don't worry, doctors are ready to help you.
` Choriocarcinoma, cancer, pregnancy, placenta, chemotherapy, molar pregnancy, hCG
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