Diagnosing invasive mole and choriocarcinoma

Invasive mole and choriocarcinoma are cancers that develop from placental cells. They are types of gestational trophoblastic disease (GTD). An invasive mole happens after an abnormal type of pregnancy called a molar pregnancy. Choriocarcinoma can also occur after a miscarriage, abortion or healthy pregnancy.

After a molar pregnancy

If you have had a molar pregnancy, you will be under the care of a specialist hospital. These are based at:

• Charing Cross Hospital in London
• Weston Park Hospital in Sheffield
• Ninewells Hospital in Dundee

You have regular urine and blood tests to measure the levels of a hormone called human chorionic gonadotrophin (hCG). 

If you develop an invasive mole or choriocarcinoma it usually shows up on these tests before you notice any symptoms. Your specialist team will then ask you to go in to see them.

When to see your GP

Even if you haven’t had a molar pregnancy, you should see your doctor if you have any symptoms. This might be a change that isn't normal for you, feeling sick, abnormal vaginal bleeding or a swollen abdomen (tummy).

If you have very heavy vaginal bleeding that is dark red or brown go to your local Accident and Emergency (A&E) department straight away.

Getting the most out of your GP appointment

You may have your appointment in person, over the telephone or as a video call. However you speak to your GP it can be difficult to remember everything you want to say. These tips will help you get the most out of your appointment.

Tips

• Write down your symptoms including when they started, when they happen and how often you have them.
• Write down anything that makes them worse or better.
• If you would like to see a male doctor, or would prefer a female doctor, ask when you book the appointment - the receptionist will tell you if it is possible.
• Tell your GP if you are worried about cancer.
• Tell them if you have any family history of cancer.
• Have a friend or relative with you for support - they could also ask questions and take notes to help you remember what the GP says.
• Ask the GP to explain anything you don’t understand.
• Ask the GP to write things down for you if you think it might help - if you are having a telephone or video appointment ask for the information to be left at reception for you to pick up.

What happens during your GP appointment?

Your doctor needs to build up a picture of what's going on. So they will ask you some questions. These include:

• what symptoms you have

• when you get them

• whether anything makes them better or worse

They will ask you about your general health and any other medical conditions you have. 

During the appointment your doctor may want to examine you. You can ask for someone else to be in the room with you if you want, to act as a chaperone. A chaperone is a trained health professional such as a nurse. A friend or relative can also stay with you for support. They can be with you during the examination or throughout the appointment.

Tests your GP might do

Depending on your symptoms your GP might do a general examination. They will feel for any areas that might be swollen or might not feel normal. And if you have any pain they will feel those areas. It might feel tender, or it might be possible to feel a lump. 

After your examination, your doctor might need to refer you to hospital for tests. Or they might refer you directly to a specialist. 

What happens next?

Make sure you know what happens next. Make another appointment if your symptoms don’t clear up, or if they change or get worse.

Tests

The tests you have might include:

• blood and urine tests
• ultrasound scan
• chest x-ray
• scans such as a CT scan or MRI scan