Supportive care for gestational trophoblastic disease

Supportive care for gestational trophoblastic disease (GTD) helps people meet physical, practical, emotional and spiritual needs. There are many programs and services available to support you.

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of gestational trophoblastic disease (GTD). It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from GTD and adjusting to life after treatment is different for each person, depending on the stage of the GTD, the type of treatment and many other factors. The end of treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for GTD may have the following concerns.

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body.

GTD and its treatments can affect a person’s self-esteem and body image because it may result in body changes, such as:

• scars
• hair loss
• skin changs

Some of these changes can be temporary. Others will last for a long time or be permanent.

Find out more about coping with body image and self-esteem worries.

You may have concerns about future pregnancies after treatment for GTD. Although there is a higher chance that GTD can develop again, it’s more likely that you will have a normal pregnancy.

It is usually recommended that you wait at least 6 months before getting pregnant after a hydatidiform mole and at least 1 year before getting pregnant after cancerous GTD (also called gestational trophoblastic neoplasia, or GTN). This is because the chance of recurrence is greatest during this time. It is also because both pregnancy and GTD can cause high levels of human chorionic gonadotropin (hCG or b-hCG), so it would be hard to tell which one is causing it. This can lead to delays in finding and diagnosing a recurrence. Researchers have found that a pregnancy in the first 6 months after treatment for cancerous GTD can also increase the chance of miscarriage.

Talk to your healthcare team about using an effective contraceptive method, such as oral birth control, during this time. Intrauterine devices (IUDs) should be avoided at least until hCG tests are negative because there is a risk that they could injure the uterus.

If you do get pregnant after GTD, your healthcare team will closely follow your pregnancy. They will do an ultrasound in the first trimester (often at 6 and 10 weeks) to check for GTD.

hCG levels should be checked about 6 weeks after all future births, miscarriages or abortions. After birth, the healthcare team will look at the placenta under a microscope to check for signs of GTD.

It is common to have less interest in sex around the time of diagnosis and treatment. But it is very possible to have strong, supportive relationships and a satisfying sex life after GTD.

If sexual problems occur because of GTD treatments, talk to your healthcare team about ways to manage them.

Find out more about sexuality and cancer.

Women who have been treated for GTD may also have concerns about the following:

• loss of pregnancy associated with a hydatidiform mole
• being unable to get pregnant after a hysterectomy (removal of the uterus)
• fatigue
• difficult emotions, such as anxiety, anger and confusion

You may find it helpful to speak to a counsellor for support with these concerns.

To make decisions that are right for you, ask your healthcare team questions about supportive care.