Choriocarcinoma, Treatment of Molar Pregnancy, Cure of Cancer

By Larry Puls  @larrypulsauthor

Choriocarcinoma; Cancer from Pregnancy

Standing outside the door, I collect my thoughts. Walking into her hospital room, I see the young lady who is struggling to breathe. Oxygen is flowing to her. At her rate of decline, she will be on the ventilator soon. And this will not change unless therapy is started quickly. Time becomes a key element. Her breathing is increasingly labored. Her diet is pure oxygen. It is the relative calm before the storm.

Treatment is defined by the word aggressive. A five-drug regimen going by the acronym EMACO. Etoposide. Methotrexate. Actinomycin-D. Cytoxan. Oncovin. Each of those successive letters standing for the listed drugs. But each represents different side effects. All with the potential to eradicate those rapidly growing cells--the little parasites taking over her body. And although they will all be administered through an IV, one is also given directly into her spine. A needle into the back. A drug that will bathe the nervous system with cancer poison. We have to hit the tumor where it lives and breathes--in her brain.

She is young and otherwise strong and will need that youth to tolerate so great a burden. Five simultaneous medicines. It is not like taking Tylenol. Hair loss, nausea, drop in her immune system, a blow to her kidneys, neuropathy (numbness in the hands and feet), all mixed in with just a touch of chemo-brain. But those are the burdens that come with the treatment—that hopefully come with a cure. I am cautiously optimistic.

Cycle one goes in. Tough but doable. Within days, we see improvement in her breathing. This suggests an early response. An encouraging sign. The oxygen requirement drops, and in fact drops quickly. In a mere two weeks, she is living on the same amount of air as the world. It is too early to repeat her x rays, but my optimism grows. Another favorable finding is that the blood test that was over a million, tumbles down into the low thousands within a matter of days. That test reflects the cancer. And the lower the test, the smaller the cancer, the more cells we have killed.

She leaves the hospital and moves into the outpatient world. The child finally comes in and I am elated with the introduction. It was that pregnancy, with that child, that caused all of this mess. But the child is resting peacefully and remains clueless. I think it is better that way.

Five months of chemo and even a youth begins to wear down. Her bone marrow responds more sluggishly. The neuropathy slows her down and makes walking a bit tougher. Sleeping is more of an ordeal. But her pregnancy test goes to normal, her tumor marker reflecting the cancer says promising. That test tells us that the young woman nearly on hospice probably has a chance to raise her child.

She achieves, according to her scans and exams and blood-testing, a total remission. In all of this, she never loses her smile, her sense of humor. And in the end, she is cured. The side effects slowly all disappear—thank goodness the human body is so fearfully and wonderfully made. She never looks back.

She had choriocarcinoma, a one in 40,000-pregnancy event. Before the advent of chemotherapy, this was essentially a uniformly lethal diagnosis, and today it is rarely that way. This disease has an important place in the history of cancer as the first disease process purely cured with chemotherapy alone, made possible by the drug called methotrexate (The M of EMACO). It remains as one of the most responsive cancers to chemotherapy and is highly, though not uniformly, curable.

 (https://www.cancer.gov/research/progress/discovery/methotrexate)  

In my career spanning almost thirty years, I have had one death from this disease (secondary to a brain metastasis). It is one of the most beatable malignancies--even when the initial presentations looks scary.   

Treatment of Choriocarcinoma, Larry Puls, (Click to Tweet)

If you would like to read part I; Choriocarcinoma, Cancer from Pregnancy