Choriocarcinma and Hydatidiform Mole

Posted by Chantel Martiromo, Article By Kyle J. Norton  

A. Choriocarinma
Cancer of Choriocarinma is a malignant and aggressive cancer, started from the abnormal and uncontrollable cells growth in the trophoblatistic tissue, that is part of embryo and normally become the placenta as a result of something going wrong during pregnancy due to random chance.
Placenta is the organ by which the fetus received nutrients and oxygen from the mother.

B. Molar pregnancy or Hydatidiffrom mole
Molar pregnancy or Hydatidiffrom mole is also started from the trophoblastic tissue, normally is non cancerous but sometimes, it may invade the uterine wall (invasive mole) as a result of a sperm fusing with an with nucleus or something going wrong during pregnancy causing forming of a mass resembling the bunch of grape.

The two types of molar pregnancy are complete molar and partial molar pregnancy.
a. Complete mole pregnancy happens when a single sperm combining with an egg which is deficient with lost its DNA. The sperm that would otherwise fertilize the egg are then left to reduplicate themselves to form a complete 46 chromosome set.

Generally no fetus results from a complete molar pregnancy. Complete hydatidiform moles have a higher risk of developing into choriocarcinoma and happened in 1 out of 1200 pregnancy.

b. Partial mole pregnancy
A partial mole pregnancy occurs when two separate sperm fertilize the same egg, resulting of the nucleus containing one maternal set of genes and two paternal sets. With a partial molar pregnancy, there may result an actual fetus and placenta but fetus is most likely to develop into a partial mole.

Symptoms
1. Abnormal bleeding
The normal cause of molar pregnancy may occur as early as 2 months into your pregnancy or as late as 4 months.
2. Severe nausea and vomiting
Due to higher than normal levels of hormone human chorionic gonadotrophin (hCG).
3. Early preeclampsia
Early high blood pressure and and protein found in the urine after 20 weeks of pregnancy
4. Abdominal or pelvic cramps

It can be caused by the process of expeling of the mole, rupture of the mole or the break off of the capillaries in uterus due to moler expansion.

5. High blood pressure

It may be caused by hormonal changes.

6. Hyperthyroidism
As a result of extremely high levels of hCG effects the production of normal thyroid-stimulating hormone (TSH)
7. No fetal movement or heart tone detected in either Choriocarcinma or Hydatidiform Mole.
8. Etc.

Causes and risk factor
1. Defect ovum
Fuse with a defect of an egg by a sperm
2. Abnormalities within the uterus

Abnormalities within the uterus increase the risk of miscarriage.

3. Nutritional deficiencies

Deficiency of certain nutrients such as vitamon A, carotene folic acid, etc. can increase the risk of Choriocarcinma and Hydatidiform Mole.

4. Age
Women over 40 years of age have an increased risk.
5. Heredity
Women who carry mutations in the gene NLRP7 has a increased risk of molar pregnancy.
6. Diet
Diets low in protein, folate, and carotene increases the risk of molar pregnancy.
7. Personal history
History of miscarriage and/or molar pregnancy increase the risk of gestational trophoblastic tumor
8. Rapid uterine growth
Large than normal uterus or the stage of pregnancy
9. Etc.

Diagnosis and tests
1. Blood test
The human chronic gonadotrophin (BHCG) blood test will indicate a very high levels of BHCG due to trophoblastic tissue.
2. Ultrasound
The mole resembles a bunch of grapes usually can be seen son an ultrasound.

Preventions
1. Diet

Although there are no specific diet mentioned by experts to prevent Choriocarcinma and Hydatidiform Mole, since deficiency of nutrients is one of the risk factors, maintaining a pregnancy diet should be helpful in reducing the risk of Choriocarcinma and Hydatidiform Mole.
1. Broccoli
Broccoli Contains high amount of vitamin C, beta carotene, folate and other important vitamin and minerals which are necessary for the healthy pregnancy.

2. Cold water fish

Cold water fish contain high amount of essential fatty acid, vitamin B2, Vitamin B3, vitamin D, iron and many other vital nutrients.

3. Spinach
Spinach contains high levels of antioxidants such as Vitamin C, vitamin E, and esstential minerals such as magnesium, betaine, iron that helps to reduce the risk of oxidation, enhance the absorption of oxygen and prevents anemia, low birth weight, and premature delivery.

4. Whole grains

Vitamin B1, Raises energy level and regulates nervous system

5. Soy milk or milk

Soy milk or milk contains high amount of calcium, it helps to Create strong bones and teeth, and prevent blood clots, helps muscles and nerves function

6. Lean beef

Lean beef contains high amount of iron that helps to enhance the production of red blood cells, thus promote production of hemoglobin, prevent anemia, low birth weight and premature delivery. Protein is necessary the process of cell signaling and ligand binding.

7. Bean
As a legumes, It is vital for the production of amino acids, cells repairs, improves diabetics' blood glucose control, lower blood pressure, lower cholesterol levels, etc.

8. Nuts and seeds

Nuts and seeds contains a richest source of omega 3 fatty acids and thus help to improve immunity and reduce high cholesterol and zinc helps in production of insulin and enzymes.

9. Etc.

2. Nutritional supplements
As above, there is no mentioned that nutritional supplement can help to prevent Choriocarcinma and Hydatidiform, Since nutrient deficiency is one the risk factor, intake of nutritional supplement should be helpful for a healthy pregnancy
1. Vitamin E
Vitamin E not only is a free ragical scavengers' antioxidant, but also enhances our body forms and uses red blood cells and muscles.

2. Carotene
Carotene is a precursor of vitamin A, another free radical scaverging antoxidant that promotes bones and teeth grow

3. Vitamin

VitaminD enhances the absorption of calcium and phosphorus of which promote strong teeth and bones. Vitamin D can be made by exposing to sun light or taking as supplement.

4. Vitamin C
Vitamin C is an antioxidant that protects our body from free radical cause of oxidation, absorbs iron and promotes healthy immune system.

5. Vitamin B1(Thiamin)

The imporant of vitamin B1 is to raise energy level and prevent nervous symptoms during pregnancy.

6. Vitamin B3 (Niacin)

Vitamin B3 promotes healthy skin, normalize the functions of nerves cells and improves digestive system in absorbing nutrients.

7. Folate

Folate plays a important role in DNA synthesis and cell division, thus supporting the normal development of placenta for a healthy pregnancy and prevents spina bifida and other neural tube defects

8. Calcium

Calcium is vital for maintaining or creating strong bones and teeth, preventing blood clots and enhancing the muscles and nerves function

9. Iron

Iron is essential in production of hemoglobin of which enhances the obsorption of oxygen and prevents anemia, low birth weight, and premature delivery.

10. Protein

It is necessary for the production of amino acids and cells repair.

11. Zinc
Zinc beside supports normal growth and development during pregnancy, it also is impotant for cellular metabolism and promotes immune function, protein synthesis, DNA synthesis and cell division.

12. Etc.

Treatments
The main objective of any treatment is to cure since Choriocarcinma and Hydatidiform Mole and related Trophoblastic Tumors are curable
1. Surgery
Most patients with invasive or non invasive Choriocarcinma and Hydatidiform Mole and related Trophoblastic Tumors are required surgery. While non invasive cancer patients are not needed further treatment, invasive cancer usually needed to combine the treatments, such as radiation therapy. Types of surgery include those of above.
a. Therapeutic termination (Suction corettage)
Therapeutic termination is the termination of a pregnancy by the removal or expulsion of the content of uterus by using a mechanical suction machine. It can be performed under local or general anesthesia. In most case, due to hormone produced by the mole, it can cause enlarged ovarian cysts but they will soon disappear after surgery. Sample from the surgery will be tesr and blood test will be required after a few weeks to check for BHCG, if the levels are still high, chemotherapy will be used to kill the remaining cancer cells.

2. Chemotherapy
After surgery, if sample found to contain tumor cells of and/or blood test showed high levels of BHCG , chemotherapy will be used to kill the remaining cancer cells. combination of drug will be used in chemotherapy will be used to kill the remaining cancer cells such as methotrexade. etoposide, platium. etc. depending to the evidence of metastases from other tests, such as chest X ray, TC scan.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
Most women with the treatments above have been cured and some of them have become pregnant and delivered a healthy baby.

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