Gestational Trophoblastic Disease Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Cellular Classification of Gestational Trophoblastic Disease
Gestational trophoblastic disease (GTD) may be classified as follows:Hydatidiform mole (HM).Complete HM.Partial HM.Gestational trophoblastic neoplasia.Invasive mole.Choriocarcinoma.Placental-site trophoblastic tumor (PSTT; very rare).Epithelioid trophoblastic tumor (ETT; even more rare). Choriocarcinoma, PSTT and ETT are often grouped under the heading gestational trophoblastic tumors. HMHM is defined as products of conception that show gross cyst-like swellings of the chorionic villi that are caused by an accumulation of fluid. There is disintegration and loss of blood vessels in the villous core. Complete HMA complete mole occurs when an ovum that has extruded its maternal nucleus is fertilized by either a single sperm, with subsequent chromosome duplication, or two sperm, resulting in either case in a diploid karyotype. The former case always yields a mole with a karyotype of 46 XX, since at least one X chromosome is required for viability and a karyotype of 46 YY is rapidly
Cervical Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage IVB Cervical Cancer
No standard chemotherapy treatment that provides substantial palliation is available for patients with stage IVB cervical cancer. These patients are appropriate candidates for clinical trials testing single agents or combination chemotherapy employing agents listed below or new anticancer treatments in phase I and II clinical trials.Standard treatment options:Radiation therapy may be used to palliate central disease or distant metastases. Chemotherapy. Tested drugs include the following:Cisplatin (15%–25% response rate).[1,2]Ifosfamide (31% response rate).Paclitaxel (17% response rate).[4,5,6]Ifosfamide-cisplatin.[7,8]Irinotecan (21% response rate in patients previously treated with chemotherapy).Paclitaxel/cisplatin (46% response rate).Cisplatin/gemcitabine (41% response rate).Cisplatin/topotecan (27% response rate).Treatment options under clinical evaluation:New anticancer drugs in phase I and phase II clinical trials.Information about ongoing clinical trials
Gestational Trophoblastic Disease Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview
Most hydatidiform moles (HMs) are benign and are treated conservatively by dilation, suction evacuation, and curettage. However, since they carry a risk of persistence or progression to malignant gestational trophoblastic disease (GTD), they must be followed carefully with weekly serum human chorionic gonadotropin (hCG) levels to normalization. Monthly follow-up for 6 months is generally recommended, although the duration of this phase of follow-up is not based on empiric study.Prompt institution of therapy for GTD and continuing follow-up at very close intervals until normal beta-hCG titers are obtained is the cornerstone of management. When chemotherapy is instituted, the interval between courses should rarely exceed 14 to 21 days, depending on the regimen used. It is recommended that patients receive one to three courses of chemotherapy after the first normal beta-hCG titer, depending on the extent of disease. The modified World Health Organization (WHO) Prognostic Scoring System
Cervical Cancer Prevention (PDQ®): Prevention - Health Professional Information [NCI] - Evidence of Benefit
Human PapillomavirusEpidemiologic studies to evaluate risk factors for the development of squamous intraepithelial lesions (SIL) and cervical malignancy demonstrate conclusively a sexual mode of transmission of a carcinogen. It is now widely accepted that human papillomavirus (HPV) is the primary etiologic infectious agent.[2,3,4] Other sexually transmitted factors, including herpes simplex virus 2 and Chlamydia trachomatis, may play a cocausative role. The finding of HPV viral DNA integrated in most cellular genomes of invasive cervical carcinomas supports epidemiologic data linking this agent to cervical cancer. More than 80 distinct types of HPV have been identified, approximately 30 of which infect the human genital tract. HPV types 16 and 18 are most often associated with invasive disease. Characterization of carcinogenic risk associated with HPV types is an important step in the process of developing a combination HPV vaccine for the
Cervical Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Get More Information From NCI
Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Endometrial Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent Endometrial Cancer
Recurrent endometrial cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus, the pelvis, in lymph nodes in the abdomen, or in other parts of the body.
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early,it may be easier to treat. By the time symptoms appear,cancer may have begun to spread. Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the ...
Cervical Cancer Prevention (PDQ®): Prevention - Health Professional Information [NCI] - nci_ncicdr0000062762-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Cervical Cancer Prevention
Gestational Trophoblastic Disease Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Gestational Trophoblastic Disease
Hydatidiform Mole (HM)HM (molar pregnancy) is disease limited to the uterine cavity. Gestational Trophoblastic NeoplasiaDefinitions: FIGOThe Féderation Internationale de Gynécologie et d'Obstétrique (FIGO) and the American Joint Committee on Cancer (AJCC) have designated staging to define gestational trophoblastic neoplasia; the FIGO system is most commonly used.[1,2] Some tumor registrars encourage the recording of staging in both systems.FIGO staging system (and modified World Health Organization [WHO] prognostic scoring system)The FIGO staging system is as follows:Table 1. Gestational Trophoblastic Neoplasia (GTN)a,bFIGO Anatomical StagingFIGO = Féderation Internationale de Gynécologie et d'Obstétrique; hCG = human chorionic gonadotropin; iu = international unit; WHO = World Health Organization.a Adapted from FIGO Committee on Gynecologic Oncology.b To stage and allot a risk factor score, a patient's diagnosis is allocated to a stage as
Cervical Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Options for Recurrent Cervical Cancer
Treatment of recurrent cervical cancer may include the following:Pelvic exenteration followed by radiation therapy combined with chemotherapy.Chemotherapy as palliative therapy to relieve symptoms caused by the cancer and improve quality of life.Clinical trials of new anticancer drugs or drug combinations.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent cervical cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.