When is chemotherapy recommended for gestational trophoblastic disease?

Gestational trophoblastic disease includes molar pregnancy and forms such as choriocarcinoma. After a molar pregnancy is treated, the care team follows the pregnancy hormone hCG with blood tests. Chemotherapy may be discussed when hCG stays detectable, stops falling as expected, rises again, or tests and scans show disease outside the uterus. It can also be used when the disease returns or affects organs such as the lungs or brain. The regimen depends on the disease features, hCG pattern, spread, previous treatment, and general health.

Keep every hCG test and review appointment, and tell the team about bleeding, breathlessness, headaches, or pain. Ask how long pregnancy should be avoided during monitoring and treatment, which contraception is suitable, and when future pregnancy can be considered. Discuss the proposed medicines, treatment setting, side effects, and the plan for checking hCG after treatment. Tell the team about medicines and any possibility of pregnancy. Read more about [Chemotherapy](/treatments/systemic-therapy/chemotherapy/).

Seek urgent care for heavy vaginal bleeding, severe abdominal pain, fainting, sudden weakness, severe headache, confusion, seizures, chest pain, or serious breathing difficulty. During chemotherapy, contact the treatment team promptly for fever, chills, repeated vomiting, or new breathlessness. Do not wait for the next hCG appointment if symptoms are rapidly worsening.

What is my hCG pattern showing? Does it meet the reason for chemotherapy? Has the disease spread, and which areas need checking? What treatment and monitoring schedule is planned? When can pregnancy be considered safely?