Saturday, November 23, 2019
Choriocarcinoma Essays
Choriocarcinoma Essays Choriocarcinoma Paper Choriocarcinoma Paper Choriocarcinoma Introduction            Choriocarcinoma, also called gestational trophoblastic disease, is a form of cancer with relatively low epidemiological occurrence. It is known to typically originate from trophoblastic cells, as this cancer is generally developed from germ cells with placental tissue origin. Trophoblastic cells are known to assist in the attachment of an embryo to the uterus and help placental formation. These mentioned cells normally transform into tissues functioning for the process of reproduction. It is a rare type of tumor, as it has an incidence rate of 1 in every 2,000 pregnancies, which is both anaplastic and invasive. It is highly metastatic. However, it is curable even in conditions of rapid and widespread uncontrolled cellular proliferation (Ajufo 83; Spickler, paragraph 1; Hamada et al. 4873; Ghaemmaghami 937).            This cancer is usually observed after pregnancy, â€Å"which may be partial or complete hydatidiform mole, or even an apparently normal pregnancy†(Ajufo 83). Since this disease is due to complications in an individuals trophoblastic tissues, chorionic gonadotrophin (hCG) is synthesized and released in large quantities (see Figure 1). Therefore, part of the indicators of the presence of the disease is this abnormal level of hCG. This is constantly monitored during treatment, as its quantity is directly related to the size of the tumor. If detected during its earlier stages, there is a high probability that the patient will survive the disease (Ajufo 83).            Alternative names given to this disease include â€Å"chorioblastoma, trophoblastic tumor, chorioepithelioma, invasive/malignant mole, and gestational trophoblastic neoplasia†(Nanda, paragraph 1). Choriocarcinomas can metastasize through the blood and reach other parts of the body including the lungs. They frequently form inside the uterus after the process of fertilization (National Cancer Institute, paragraph 1). Etiology and Symptoms            Choriocarcinoma (see Figure 2) is typically derived from germ cells that normally differentiate into sperm or egg cells. Morphologically similar to uterine cells surrounding an embryo, Choriocarcinomas are commonly found in reproductive organs. More often observed in cases of young adults, this cancer generally develops from the testes or ovaries. Most cases demonstrate that this disease usually forms in the uterus. It characteristically develops after the appearance of a mole during after pregnancy or miscarriage. In addition, this form of cancer is also found in organs other than the reproductive ones. These are called extragonadal tumors that are typically acquired by male young adults (Spickler, paragraph 2; Nanda, paragraphs 1-3).            Choriocarcinoma is frequently acquired through the damage in the genetic material of the cell. There is higher tendency for those afflicted with Klinefelter syndrome to develop this disease due to the existence of an extra Barr body in their sex chromosome, therefore increasing the occurrence of â€Å"extragonadal germ cell tumors†(Spickler, paragraph 3; Nanda, paragraph 4).            Most symptoms of this disease depend on the tumor location in the body. If the origin and concentration is in the uterus, patients typically manifest bleeding. Female patients suffer from constant vaginal bleeding after recently having hydatidiform mole, abortion and even pregnancy. If this occurs in the ovary, increased waistline and pain in this area are some of the subtle manifestations of the disease. Patients are also found to have ovarian cysts and their hCG levels are extremely maintained at high levels. In male testes, these usually occur as lumps without inducing pain. Choriocarcinomas have high rates of spreading to different tissues and organs, which gives bleeding symptoms (Spickler, paragraph 5; Nanda, paragraph 7). Pulmonary presentations of this disease include â€Å"haemoptysis, dyspnoea, pleuritic pain, and cough without haemoptysis†(Magrath et al. 633). When this cancer reaches the brain, the patient usually suffe rs from a stroke (Spickler, paragraph 5) due to intracranial pressure, accompanied by papilloedema and repeated unconsciousness (Magrath et al. 634). Epidemiology            Most incidences of choriocarcinoma are preceeded by the formation of a hyadatidiform mole. It is the main precursor in the development of a highly malignant disease of trophoblastic cells. Its has relative occurrences among populations from different parts of the world. In Europe and North American continents, there is one choriocarcinoma patient for every 30,000-40,000 pregnant women. It also has an incidence rate of 1 in every 40 molar pregnancies. In the Southeast Asian region, for every 500-3000 pregnancies, at least one individual is afflicted. When scientists assessed the relative incidences of the disease among races, including whites, blacks, and other races, it was found that black women are most susceptible to choriocarcinoma (Wells 984). Diagnosis and Treatment            Oncologists conduct several procedures in order to accurately diagnose a patient for choriocarcinoma. This includes physical examinations and organ tests aided by findings from x-rays and ultrasound instruments. Medical professionals instruct patients to undergo pelvic examinations in order to test for the presence of uterine tumor, while others are ordered to subject themselves to quantitative serum hCG test. This hormone is also monitored in order to assess the effectiveness of the treatment given to a patient. Computed Tomography (CT) scans and magnetic resonance imaging (MRI) scans are also used in detecting metastases in the brain (Spickler, paragraphs 6-7; Nanda, paragraph 10).            Examinations are done on individuals in order to ensure the presence or absence of metastatic activities. Once a patient is tested positive in the appropriate tests administered by his physician, he is usually subjected to several treatment options. These include surgery, chemotherapy, and radiation. Several occasions require for hysterectomy (see Figure 3). Uterine removal through surgery, to be conducted (Spickler, paragraph 8; Nanda, paragraphs 13-14).            There are other treatments that patients may choose to undergo in managing their disease. But most of them are only complementary to the mentioned available treatment for choriocarcinoma, as they give optimal results through concerted effects. Exercises such as yoga and meditation or prayer are proven helpful in reducing stress levels and cancer treatment side effects. Massage and music therapy are also claimed to produce positive results (Spickler, paragraph 9). Prognosis            Patients with choriocarcinoma often manifest excellent prognosis. Although there is a rapid rate of metastasis, this form of cancer is highly curable. Statistics reveal that approximately 90% are able to maintain normal functioning of their reproductive systems even after treatment, while almost 66% women with initial pessimism successfully achieve remission (Nanda, paragraph 16). Chemotherapy is also proven reliable and effective; as it results in 80-90% remission rate in cases it is applied. Even after having the disease and having been successfully treated, women are still able to undergo normal pregnancies and deliveries (Spickler, paragraph 10).            There are, however, several cases when patients encounter poor prognosis. Such conditions are due to rapid uncontrolled metastatic activities throughout the human body. Individuals do not manifest optimal response to the chemotherapy sessions, and even if the treatment seems effective the final result highly depends on the extent of cancer dispersal. In general, poorer prognosis is observed in patients where the cancer has metastasized all the way to the liver or brain, if the patient has extremely high hCG levels, and if the cancer is extragonadal in nature (Spickler, paragraph 11). Conclusion            Choriocarcinoma is a rare type of cancer that demonstrates positive prognosis relative to other types. Although scientists are still to determine prevention methods against this disease, patients afflicted are more likely to survive the illness. With all the technological advances that the medical field is currently exploiting, many can hope to find the proper cure and treatment for this cancer that has invaded their systems. Ajufo, I. I., S. W. Lindow, and S. H. Canty. â€Å"Choriocarcinoma with markedly elevated serum     hCG levels and negative urin hCG levels.†Journal of Obstetrics and Gynaecology,    26(2006):83-85. â€Å"Choriocarcinoma.†National Cancer Institute. 18 February 2008            cancer.gov/Templates/db_alpha.aspx?CdrID=46753. Ghaemmaghami, F., N. Behtash, H. Ayatollahi, and P. Hanjani. â€Å"Successful treatment of two      patients with gestational trophoblastic neoplasm presenting with emergent neurologic    symptoms.†International Journal of Gynecological Cancer, 16 (2006): 884-943. Hamada, Anna Lissa, Koji Nakabayashi, Asomi Sato, Kenji Kiyoshi, Yukou Takamatsu, Jovelle B. Laoag-Fernandez, Noriyuki Ohara, and Takeshi Maruo. â€Å"Transfection of Antisense Chorionic Gonadotropin B Gene into Choriocarcinoma Cells Suppresses        the Cell Proliferation and Induces Apoptosis.†The Journal of Clinical Endocrinology         and Metabolism. 90(2005):4873-4879. Magrath, I. T., P. R. Golding, K. D. Bagshawe. â€Å"Medical Presentations of Choriocarcinoma.†    British Medical Journal, 2(1971):633-637. Nanda, Rita. â€Å"Gestational Trophoblastic Disease.†11 September 2006. Medline Plus. 18 February 2008 nlm.nih.gov/medlineplus/ency/article/001496.htm. Spickler, Anna Rovid. â€Å"Choriocarcinoma.†14 August 2006. Health A to Z. 18 February 2008            healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?           requestURI=/healthatoz/Atoz/ency/choriocarcinoma.jsp. Tran, Huy A. â€Å"Biochemical tests for abnormalities in pregnancy.†Australian Precriber,    29(2006):48-52. Well, Michael. â€Å"The pathology of gestational trophoblastic disease: recent advances.†Pathology 39(2007):88-96.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.