Definition Choriocarcinoma is a rare form of cancer in tissue in the reproductive system. This type of cancer usually affects women, but also includes a very rare type of testicular cancer in men.
Choriocarcinoma in women usually follows a pregnancy, and is more common after a molar pregnancy. A molar pregnancy is one in which a foetus does not develop. A tumour made up of abnormal cells develops instead of a foetus. The tumour of the molar pregnancy is usually benign, or non-cancerous. Molar pregnancies are more common in less developed parts of the world where nutrition is poor. Choriocarcinoma is also more common in those areas.
What is going on in the body? Choriocarcinoma develops from reproductive tissue cells, which are very active. When these cells undergo cancerous changes, they grow and multiply very rapidly. A tumour forms and sheds cancer cells into the bloodstream at an early stage. The cancer cells in the bloodstream develop new cancers in other parts of the body, a process known as metastasis. If choriocarcinoma is not treated successfully, it is quickly fatal due to the damage caused by these tumours.
What are the signs and symptoms of the disease? Choriocarcinoma generally causes no symptoms until the cancer is widespread and damages major organs. Then the symptoms will be related to the organs that are involved.
What are the causes and risks of the disease? The exact cause of choriocarcinoma is unknown. A woman whose diet is low in protein and other nutrients is known to be at higher risk for molar pregnancies. A woman who has had a molar pregnancy is at high risk for choriocarcinoma.
What can be done to prevent the disease? Improving the nutrition of all pregnant women may prevent some cases of choriocarcinoma. Any woman who has had a molar pregnancy should be monitored carefully. Treating the cancer early is much more successful than treating late-stage disease.
How is the disease diagnosed? After a molar pregnancy is diagnosed and removed, blood samples will be taken. Beta-HCG, a tumour marker, will be measured. If the levels do not drop over time, CT scans are used to look for a tumour remaining in the uterus, or one that has spread elsewhere. If a tumour is found, a biopsy is done to confirm the presence and type of cancer. In men, a piece of tissue removed from a tumour, usually in the testicle, may show this form of testicular cancer.
What are the long-term effects of the disease? Choriocarcinoma is rapidly fatal if not successfully treated.
What are the risks to others? Choriocarcinoma is not contagious, and poses no risk to others.
What are the treatments for the disease? Treatment of choriocarcinoma can be very effective, particularly in its early stages. Chemotherapy is given because the cancer is usually widespread by the time it is diagnosed. The chemotherapy medications are introduced into the bloodstream and are delivered throughout the body. The treatment requires large doses of medication to be effective.
When the cancer has spread to the brain, radiation therapy may be given to the brain. Unfortunately, choriocarcinoma that has spread to the brain or the liver is very difficult to treat.
What are the side effects of the treatments? The side effects of chemotherapy depend on the medications used. Most side effects can be managed and go away when treatment ends. A woman who has been successfully treated for choriocarcinoma after a molar pregnancy may be able to have a normal pregnancy later.
What happens after treatment for the disease? The person will be closely followed to make sure the cancer does not recur. If the cancer does not respond to therapy, the person will be closely followed for responses while other therapies are tried.
How is the disease monitored? Blood samples are taken periodically to measure the level of beta-HCG. An increase in the level could indicate the cancer has recurred. CT scans may also be done to measure the response of the tumour to treatment, or to check for recurrence.
If the treatment is successful, monitoring can be done less often. Many women are successfully cured of this cancer. Men with this form of testicular cancer do not respond as well to treatment.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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