Gestational Trophoblastic Disease, from the CureRays guide library.

Gestational trophoblastic disease is a rare group of tumors that grow from the tissue that would normally become the placenta; it is highly treatable and one of the most curable of all cancers.

What it is.

Gestational trophoblastic disease (GTD) is a rare group of conditions in which abnormal cells grow from the trophoblast — the tissue that would normally form the placenta during pregnancy. It can begin after any kind of pregnancy, including a normal pregnancy, a miscarriage, or a molar pregnancy (a pregnancy in which the placental tissue grows abnormally and no healthy baby develops). Most GTD is not cancerous and is called a hydatidiform mole, but in some cases it becomes a true tumor that can grow into the wall of the uterus or spread elsewhere — this cancerous form is called gestational trophoblastic neoplasia (GTN). Common signs include unusual vaginal bleeding after a pregnancy or miscarriage, a uterus that is larger than expected, or severe nausea. Doctors monitor GTD using a simple blood test for the pregnancy hormone hCG, which these tumors produce; a rising or stubbornly high hCG level signals that treatment is needed. The encouraging news is that GTN is among the most curable of all cancers — it responds extremely well to chemotherapy, and the great majority of women are cured and can still have healthy pregnancies later.

How radiation treats it.

Radiation uses focused high-energy beams to damage the DNA inside cancer cells so they can no longer grow and divide. For gestational trophoblastic disease, chemotherapy — not radiation — is the main treatment, because these tumors are remarkably sensitive to chemotherapy and most women are cured without ever needing radiation. Radiation has a specific, limited role: it is used mainly when choriocarcinoma has spread to the brain, where radiation alongside chemotherapy helps control the disease and reduce the risk of dangerous bleeding. It can also occasionally help control bleeding or treat a stubborn deposit of tumor in one location. When radiation is used, it is planned carefully to focus on the target and protect healthy tissue, and treatments themselves are quick and painless. Your care team will explain whether radiation has any role in your specific situation; for the large majority of women with this disease, it does not.

The ways we can treat it.

Whole-brain radiation. When choriocarcinoma spreads to the brain, radiation to the whole brain may be added alongside chemotherapy to control disease and prevent bleeding, helping achieve cure even in advanced cases.

Targeted (stereotactic) radiation. For a small number of brain spots, focused stereotactic radiation can treat the area precisely while sparing surrounding healthy brain.

Radiation for local control. Rarely, radiation is used to control bleeding or treat a stubborn deposit of tumor in a specific spot when chemotherapy and surgery are not enough.

Questions we hear often.

Is gestational trophoblastic disease curable? Yes — it is one of the most curable of all cancers. Most molar pregnancies are cured by removing the tissue, and even the cancerous form (gestational trophoblastic neoplasia), including cases that have spread, is cured in the great majority of women with chemotherapy.

Will I be able to have children afterward? Usually, yes. Most treatment preserves the uterus, and the large majority of women go on to have normal, healthy pregnancies. Your team will ask you to avoid pregnancy during the hCG monitoring period so your blood tests stay easy to interpret.

Will I need radiation? Most women do not. Chemotherapy is the main treatment because these tumors are so sensitive to it. Radiation is reserved for specific situations, mainly when the cancer has spread to the brain, and your team will tell you if it applies to you.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.