Follow up for invasive mole and choriocarcinoma

An invasive mole is a cancer that can form in the womb after an abnormal type of pregnancy called a molar pregnancy. It is also called persistent trophoblastic disease (PTD). Choriocarcinoma is a very rare cancer that can occur after a normal pregnancy, a molar pregnancy, a miscarriage or a termination of pregnancy (abortion).

All women who have had an invasive mole or choriocarcinoma are monitored closely to look for any signs of it coming back after treatment. 

The length and type of follow up you have depends on:

  • the treatment you had
  • which specialist centre is looking after you

What does follow up involve?

You have follow up at one of the UK specialist centres. These are:

  • Charing Cross Hospital, London
  • Weston Park Hospital, Sheffield

You have regular urine tests, blood tests or both to check your level of human gonadotrophic hormone (hCG). You have these tests during your treatment, and for some years afterwards. 

After treatment, you usually have tests every week for the first 6 weeks. These usually become less frequent over time. And you see your specialist team about 6 weeks after treatment. They will explain what tests you need and how often you need to have them. 

Your follow up depends on factors such as:

  • the risk score of your disease
  • the treatment you have had
  • the results of your hCG tests

Tests might also vary slightly depending on your treatment centre.  

The specialist centre will send you a pre paid kit for your tests which you post back to the centre for checking. If you are having blood tests, your GP surgery may be able to do them for you. They should send the blood sample, with your urine sample if you've done one, to the specialist centre. 

Your treatment centre will send you the kits when you need them. So you must let them know if your contact details change.

Future pregnancy

Your periods might stop or become irregular during chemotherapy. But for most women, they return to normal after a few months.

It is important not to get pregnant until your doctors say it is safe. If you have had chemotherapy treatment, UK guidelines recommend that you wait for 12 months from when you finished the chemotherapy before trying to become pregnant. It is fine to use hormonal contraception such as the pill or implants. 

If you do become pregnant before they recommend it, it is very important to let your specialist team know. Your hCG levels will go up with a normal pregnancy, so they won’t be able to monitor your GTD using your hCG levels. After you have had your baby you will need to have hCG tests.

  • The Management of Gestational Trophoblastic Disease (4th edition)
    Royal College of Obstetricians and Gynaecologists, September 2020

  • Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    MJ Seckl and others
    Annals of Oncology, 2013. Volume 24. Pages vi39-vi50

  • FSRH Guideline: Contraception after Pregnancy
    The Faculty of Sexual and Reproductive Healthcare, 2020

  • Gestational Trophoblastic Disease – a guide to management at Weston Park Hospital
    Accessed January 2023

  • Treatment of Gestational Trophoblastic Disease in the 2020s
    J Clark and others
    Current Opinions in Obstetrics and Gynecology, 2021. Volume 33. Pages 7-12 

  • Charing Cross Hospital (CXH) Trophoblast Disease Clinic Guide
    Accessed June 2019

Last reviewed: 
20 Jun 2023
Next review due: 
19 Jun 2026

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