In a world of cruel diseases, none perhaps is as cruel as choriocarcinoma. Due to an unusually spiteful turn of nature, this rapidly growing cancer arises from a zygote, a mass of recently fertilized cells that attaches to the womb as an early step in pregnancy.
But instead of developing into a functioning placenta, the lifeline for any growing fetus, something goes haywire and an aggressive tumor grows instead. Even crueler, the cells technically are not the cells of Mom but rather the cells of the forming embryo. The growing cells of the fertilized egg produce a potentially lethal tumor that actually will kill the mother unless treated.
And most bitterly ironic of all, because the cancerous tissue is genetically programmed to form the placenta, the “pregnancy hormone” beta-HCG is made so that home and formal lab pregnancy tests read positive.
In other words, up to the point that the sonogram touches the expectant mom’s abdomen looking for the little beating heart, everything is happy. A young woman feels a little discomfort, fatigue, and nausea, chalking it up to morning sickness. But she is discovered instead to have no fetus at all, but rather a form of cancer.
A recent article from the U.K. retells this sad turn of events in heartbreaking fashion. Demi Wright, her delighted family, and a caring boyfriend all went to see the doctor for the good news but instead, they were told of an advanced cancer already spread to the liver.
The 22-year-old woman died from the disease within weeks of diagnosis.
Unlike the fatal story described above, though, up to 95 percent of choriocarcinomas are curable with timely diagnosis and appropriate treatment. In fact, choriocarcinoma was one of the very first cancers shown to respond to chemotherapy, as Siddhartha Murhurjee described in his memorable book, The Emperor of All Maladies: A Biography of Cancer.
Lest any pregnant readers think that their upcoming little bundle of joy is instead a cancer, your doctor likely has already excluded the possibility. The levels of beta-HCG in choriocarcinoma are sky-high, which provides a clue to trouble. In addition, the odds are against it: This is a very unusual cancer.
And finally, there is a preventative strategy for many but not all cases. There is something called a “molar pregnancy,” which is a condition that predisposes to this cancer. Here, a chromosome-less egg is nevertheless fertilized; a placental is formed that makes the beta-HCG but unlike choriocarcinoma, the tumor is benign. Importantly, non-emergent removal of the mole (a medical term deriving from the Latin, “mola,” for false) prevents deterioration into cancer.
Thankfully stories like that from Britain are extremely rare. And more thankfully 21st-century medicine has a very effective way to treat choriocarcinoma, that most vicious of all masqueraders.