Frequently Asked Questions
Some of the questions you've asked !
It is very unlikely that you will ovulate whilst your hCG levels are higher than normal. But it is still compulsory to use an effective form of barrier contraception until you are told otherwise.
If your employer does not pay you occupational (company) sick pay you could receive statutory sick pay (government). Following long periods of sick leave you may qualify for Incapacity Benefit. For further details please CLICK HERE (you will now be forwarded to another website)
If you have previously taken out critical illness insurance, it may be possible for you to claim against this for your molar pregnancy (you must be receiving treatment and not working). This could help you pay off your mortgage etc for a period of time. (Please consult with your own individual insurer)
You may also be able to have some help towards your commuting costs dependant on your income. The Cancer Support Centre in Sheffield will be able to advise you on this. Their telephone number is 0114 226 5391 and their website is www.cancersupportcentre.co.uk. In certain cases the Sheffield hospital can provide Medicar Transport. For information on support by the London treatment centre; please refer to the contacts page.
Chemotherapy is a systemic therapy; this means it affects the whole body by going through the bloodstream. The purpose of chemotherapy and other systemic treatments is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.
Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. The side effects of chemotherapy come about because cancer cells aren't the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the chemotherapy is going to affect them, too.
Still, chemotherapy is much easier to tolerate today than even a few years ago. And for many people it's an important "insurance policy" against cancer or pre-malignancy recurrence. It's also important to remember that organs in which the cells do not divide rapidly, such as the liver and kidneys, are rarely affected by chemotherapy. And doctors and nurses will keep close track of side effects and can treat most of them to improve the way you feel.
There are no strict guidelines as to how long Chemotherapy lasts, each individual is different. Depending on the risk of your molar pregnancy you will receive treatment for approximately 4-6 months if you respond well, but this can change on a weekly basis dependant on your blood count and hCG levels.
It is advised that you do not consume large amounts of alcohol whilst having treatment. Not only is it not good for health generally, chemotherapy can put your liver under strain. Any excessive use of alcohol will contribute to this. Then again, a small drink every now and then will do you no harm.
As you know smoking is not good for your health so we wouldn’t recommend this.
It is also advised not to strenuously exercise whilst having treatment for your molar pregnancy but if you are feeling well enough there is no reason why you shouldn’t. Please bare in mind leisure centres and gym's are a breeding ground for germs, so you may be more at risk of catching a cold as Chemotherapy can lower your immune system.
Your fertility should not be affected by the chemotherapy Methotrexate. Assuming your reproductive system is working well you may go on to have a healthy pregnancy/s if you wish. Other chemotherapy treatments can cause infertility and it is for you to discuss with your consultant/gynaecologist if fertility may be affected.
After a molar pregnancy many couples ask what they can do to minimise the chance of it happening again, or if there is anyway of screening for the problem earlier.
The first thing to realise is that repeated molar pregnancies are rare. The chances of having a second molar pregnancy, in any subsequent pregnancy, is in the order of 1 in 80.
In terms of early diagnosis, it is suggested that an earlier ultrasound is performed in any subsequent pregnancy. This most frequently serves to reassure women that they do in fact have a normal pregnancy. Very occasionally a complete molar pregnancy will be detected at this point, but partial molar pregnancies are difficult to detect at this early point.
It is occasionally asked if using IVF and pre-implantation genetic diagnosis is an appropriate idea to consider. Whilst theoretically pre-implantation diagnosis should be able to detect the majority of molar pregnancies in IVF pregnancies, it is not recommended in this situation. IVF is a complex, costly and complicated procedure, not without some modest health issues for the mother and only results in pregnancy in approximately 1/3rd of cycles.
With the risk of a repeat molar pregnancy being so low and the difficulties of using IVF screening in this situation being so significant, this approach is not recommended. Very occasionally, in the very rare women who have a number of repeated molar pregnancies, this can be looked at as a possibility.
It is advised that whilst receiving treatment you do not expose yourself to sun rays as chemotherapy can make your skin hyper sensitive. It would be best to not make any holiday plans as it cannot be specified how long your treatment will last. The reasons being that if you visit abroad and you encounter bleeding or other side effects from your condition/treatment you will not be able to gain the specialised treatment that your regional centre can give. It has also been known that you could be more at risk of developing DVT on long haul flights whilst receiving chemotherapy.
You may also find it difficult to gain travel insurance because trophoblastic disease is classified as a critical illness/pre malignancy as it is linked to cancer and some insurers may not cover this. (Please consult individual insurance companies to see if this is the case)
BUT, if you are coming to the end of your treatment, you feel well enough and have discussed it with your consultant there is no reason why you cannot take short breaks in between treatments.
It is also advisable to declare your illness with your individual vehicle insurer, as you may not be covered or they may class you as being at a higher risk whilst you are receiving treatment.
Sometimes it is hard to determine what type of mole you have/had if it was not diagnosed by an ultra-sound scan but usually further tests and scans (ct and x-rays) and pathology reports can determine this.
Chemotherapy can cause total hair loss or thinning (apart from Methotrexate). The normal scalp has approximately 100,000 hairs and at any one time roughly 10% of your hair is in the resting phase. The other 90% is growing and is susceptible to chemotherapy. The hair loss is not usually permanent and the hair grows back once the treatment is completed. You will start to lose you hair about 2 to 3 weeks after your first dose and this total loss is usually 4 weeks. The most likely place to lose hair is from the head, but you may also lose hair from the face, arms, legs, underarms and pubic area. (no more waxing or shaving for a while!) A Chemocap can be used but isn’t effect with all chemotherapy treatments.
Hair loss can be very discouraging and very depressing, especially for a women whose hairstyle is one of her main features. Many support groups offer advice. You will be entitled to a range of NHS wigs with a free prescription for £50-£55 or you can choose to wear a groovy scarf or hat. It is your choice.
Losing you hair may be a small price to pay to be well but do not underestimate the trauma. Try not to be too brave – it is a very real loss; therefore it is natural and understandable for you to take a while to come to terms with losing your hair, if you do come to terms with it. Try not to withdraw from social life and friends, they will want to help and support you.