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Gestational Trophoblastic Disease
Defining GTD and One Woman's Triumph Over the Illness
By Lisa A. Goldstein
Christine Grabowski lost a baby at 10 weeks gestation. An ultrasound showed a slowing, then a stopped heartbeat. Living in Alexandria, Va., at the time, Grabowski then had a D&C. Since standard procedure is to send a sample to pathology, a couple of weeks later, she found out the pregnancy had been a molar. As a result, she was told she had a 4 percent chance of developing Gestational Trophoblastic Disease (GTD).
GTD, what?
That was Grabowski's reaction, too. The National Institutes of Health (NIH) describes it in simple terms: a quick growing form of cancer that occurs in a woman's uterus after a pregnancy, miscarriage or abortion. It is usually metastatic, which means it spreads to other places in the body.
"[GTD] covers a spectrum of diseases ranging from that of molar pregnancies to that of more advanced cancers known as choriocarcinoma," says Dr. Joseph Kelley, director of the Division of Gynecologic Oncology at the University of Pittsburgh Medical Center. "It is considered the most curable of gynecologic malignancies. Disease occurs in less than one per thousand pregnancies throughout the world, although there may be some geographic factors which predispose individuals to the development of this condition."
The cancer forms in the tissues that develop after a baby is conceived. In approximately 50 percent of cases, according to the NIH, the woman had a hydatidiform mole, or a molar pregnancy. This is a noninvasive, localized tumor that develops as a result of an aberrant fertilization event, like two sperm fertilizing one egg or sperm fertilizing an empty egg – one without Mom's genetic material, Dr. Kelley says.
In some cases, GTD isn't diagnosed by mere pathology. Women can experience the following symptoms – as listed by the UpToDate online series, which provides the most current information from physicians to physicians – listed in decreasing order of frequency:
- Vaginal bleeding
- Enlarged uterus
- Pelvic pressure or pain
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