Manila Fitness

It’s my last day of my chemotherapy. No, I don’t have the big C but did you know that there are other diseases and illnesses that chemo can cure? My doctor said that small dosages of a chemo medication can even be used for arthritis. But, I also don’t have arthritis either. I have a complexity which I found after my miscarriage. I’m still not sure though if it’s Gestational Trophoblastic Disease (GTD) or Placenta Accreta. My doctors are more inclined though to believe that it is the latter.

For those who have been diagnosed as such, here are some explanations that you might need to know. I had a hard time absorbing information about these two diseases, so i’m hoping this helps you.

Gestational Trophoblastic Disease (GTD)
GTD is a group of rare tumors that involve abnormal growth of cells inside a woman’s uterus. Unlike cervical cancer or endometrial cancer (uterine lining) this diseases does not develop from cells of the uterus. These tumors start in the cells that would normally develop into the placenta during pregnancy. *The term “gestational” refers to pregnancy. This disease begins in the layer of cells called the trophoblast that normally surrounds an embryo. *Tropho- means “nutrition,” and -blast means “bud” or “early developmental cell.” Early in normal development, the cells of this layer form tiny, finger-like projections known as villi. These villi grow into the lining of the uterus. In time, the trophoblast layer develops into the placenta, the organ that protects and nourishes the growing fetus.

Most GTDs are benign (non cancerous) and they don’t invade deeply into body tissues or spread to other parts of the body. But some are cancerous. All forms of GTDs can be treated and in most cases the treatment produces a complete cure. My doctor said that it’s the only form of cancer reacts almost 100% to chemotherapy, and thus, can be completely cured. When we hear of molar pregnancy or hydatidiform mole (H-mole), this is actually a type of GTD. But then again, it’s curable. For GTDs, there is only a 10% chance that it happens again in your next pregnancy. Of course, for malignant GTDs, if chemo is not able to cure it, then surgery may have to be the next option.

For more information, a good site is the Amercian Cancer Society

Placenta Accreta
In my personal blog, I had an entry there regarding placenta accreta and placenta praevia. Last August 2009, according to the news, the 29 year old wife of Junjun Binay, Kennely Binay died of placenta praevia. This is a disorder where the placenta is attached to the uterine wall close to the cervix. When I asked my doctor about it, the next day, she said that it could not have been praevia but more of accreta that was not detected earlier on.

Placenta accreta is when the placenta is deeply attached to the muscles of the uterus. It may be attached to any portion just as long as this is the portion with with highest supply of oxygen. Placenta praevia is where the accreta happens near the cervix. It is easier to detect Placenta Praevia and the worst thing that could happen is that the baby is premature. Most though who have placenta praevia survive so there is nothing to be worried about. Placenta accreta is more undetectable.

*Image from http://www.philstar.com/article.aspx?articleid=497555

Why isn’t placenta accreta detected early? To be able to detect this disease that happens rarely, a doppler ultrasound should be used, which is not normally done during transvaginal ultrasound. When I knew I was pregnant, they said I had a blighted ovum and the doctors did not suspect anything else. The gestational sac was clearly there, but with no baby. I had a d&c procedure done. I was then cleared, but to our surprise, I bled again and I bled profusely (when the bleeding should have stopped). I had a second d&c, but much to my new doctor’s surprise, when she did a transvaginal ultrasound, some placenta remains were still seen. She referred me to a doctor who was a trophoblastic specialist and given all the ultrasound scans and the histopath results, she said that I probably had placenta accreta and not GTD.

How will you know or what are the indications to check if it’s either GTD or Placenta Accreta?
1. Normally for GTDs, the doctors would already see it during a transvaginal ultrasound. So ask for your doctors if you can have a doppler ultrasound if you want to be sure.
2. There are three things to check if it’s GTD: if fetal tissues are present, if villis are present or if there is trophoblastic proliferation (but the third also can be indication of Placenta accreta)
3. Have a beta HCG test. If your HCG levels go up even if you have had a dilation and curettage procedure, the HCG levels should go down.

When you search on the internet for cures for placenta accreta, all of these searches would say that one would need histerectomy right away.

Check out this sample video:

Here’s a video on placenta praevia and other pregnancy difficulties:

I had a Beta-HCG reading of 3800 when I started. The week after, I had 3,000. I asked my doctor if we could wait one more week. After a week it was at 1800. My doctor did not agree to wait for another week, because if we go by the book, after two weeks of beta hcg being that high, the doctor has to act on it, either by histerectomy or in the case of conservative doctors in the Philippines, they do try chemo medication.

I just had my first course of chemo (5 days with a low dosage). The side effects would be oral ulcers that are really bad, but I was lucky enough to have none. The doctor said I had a strong immune system. I will have my blood tested next week to check my beta hcg levels and of course, to have a complete blood count. It is important to have iron during the course of medication.

I’m still hoping for the best. The doctor says that hopefully, a year after my hcg levels go back to zero, I can have a baby, but they have to do histerectomy right away after the procedure.

I still believe in miracles though. Who knows?

I am writing this post for other women out there so you may know about these things. I have bought baby books and I haven’t seen one yet that discusses this in detail. Just some tips, they say that the probable cause may be lack of red meat or high levels of mercury (but then again, it’s still not proven). Also, try to take vitamins already during the time you are still planning to get pregnant. Eat a balanced diet so you are sure that you give yourself and your baby-to-be enough nutrients.

Also, if you have questions on where to contact my OB, kindly message me and I will give you her contact details.

I hope this helps! Again, all these are what I experienced. It’s still best to ask your own OB for guidance.

Please do purchase my eBook. It is entitled Complexities in Pregnancy.” Please click on this link:
http://www.smashwords.com/books/view/21180