Information for Patients with Molar Pregnancies or Choriocarcinoma

Diagnosis and treatment of choriocarcinoma

In this section we refer to choriocarcinoma as a malignancy developing within the placenta during an otherwise normal pregnancy.

This is a rare illness with 10-20 cases each year in the UK from nearly one million pregnancies. The illness can become apparent occasionally during the last few weeks of pregnancy, but more commonly in the first few months after delivery. The most frequent problems are persistent bleeding or problems from the disease spreading to the lungs. The illness can sometimes take a while to diagnose, however the elevated hCG level in a woman who is not pregnant is highly supportive of the diagnosis.

The treatment for choriocarcinoma takes place initially as an in-patient at Charing Cross and generally with EMA-CO chemotherapy. Fortunately choriocarcinoma is a highly sensitive to chemotherapy, with a very high expectation of cure once diagnosed.

EMA-Co chemotherapy is intense, with treatment given weekly. Treatment alternates weekly between the EMA treatment that requires an overnight stay in hospital and the following week the CO treatment that is given as an outpatient in the day unit at Charing Cross or your local hospital. In individually patient with particular medical issues the treatment may be altered slightly.

Treatment for choriocarcinoma usually takes 4 months to complete and the cure rate is over 95%. The hCG results and treatment graph of a patient who developed choriocarcinoma 3 months after the delivery of her baby are shown in Fig 8. Now more than 2 years later she remains well with a normal hCG level and is planning on having another baby soon.

Fig 8

The treatment in choriocarcinoma is continued for 6-8 weeks after the hCG level has reached normal and then the follow-up is as described in the timetable of hCG follow up.

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