What kind of cancer is choriocarcinoma?
This is an aggressive tumour, which is associated with pregnancy in the overwhelming majority of those affected.
The preceding pregnancy could be molar, normal, ectopic or even a miscarriage. The majority (over 5O%) of choriocarcinoma follow a molar pregnancy, about a quarter follow normal pregnancy, and a smaller proportion follow miscarriage or ectopic pregnancies.
Choriocarcinoma is fortunately very sensitive to chemotherapy and the cure rate approaches 100 per cent, especially when it is caught in the early stages.
Does choriocarcinoma follow immediately after the pregnancy?
In most cases, it is discovered within days or weeks.
Unfortunately, in some cases, it may occur several months - even years - after the initial pregnancy, which may make suspicion and therefore diagnosis quite difficult.
What are the symptoms of choriocarcinoma?
This depends on its timing (following the initial pregnancy) and site. Symptoms may include irregular vaginal bleeding, absence of periods, pelvic pain, chest discomfort and/or a cough, with or without blood-stained sputum.
The crucial thing is for the doctor to suspect it and carry out the necessary diagnostic tests.
Do chest symptoms mean the spread of disease outside the womb?
Yes. Chariocarcinoma can spread to the lungs, liver, spleen, kidneys, brain and other organs. It remains treatable, even at this stage. Spread to the brain makes complete cure a little more difficult, but not impossible.
Following a molar pregnancy, what are the chances of a recurrence in a subsequent pregnancy?
About 1 per cent. However, the probability rises quite exponentially following two molar pregnancies. This in itself is a rare occurrence.
What is the recommended contraception during the period of follow-up after a molar pregnancy and before the all-clear?
The combined oral contraceptive pill is the best method. If this cannot be used, for any particular reason, then barrier methods could be employed.
It is important that the pregnancy hormone (hCG) level should return to normal before commencing on the pill.
The intrauterine device (coil), though effective, is not recommended in this situation.