Diagnosis and treatment for a rare complication of pregnancy may soon be improved through new testing methods being developed at the University of Sheffield.
Speciality Obstetrics and Gynaecology Registrar, Dr Victoria Parker, was inspired to put her career on hold and embark upon her PhD research at the University of Sheffield after caring for patients experiencing a molar pregnancy – where abnormal cells grow in the womb instead of a healthy foetus and placenta.
Her goal is to improve the way in which doctors manage the condition and help to ease the mental health impact of the current diagnosis and treatment process.
There are several types of molar pregnancy – or Gestational Trophoblastic Disease (GTD) – which usually result in the loss of a pregnancy. If GTD is suspected, the abnormal tissue is removed, followed by regular monitoring of pregnancy hormone levels for up to six months to ensure the condition has resolved.
However one in ten women will go on to develop a more serious form, Gestational Trophoblastic Neoplasia (GTN), which is cancerous and requires chemotherapy or further surgery to treat it successfully. One-in-three patients will not respond to the initial chemotherapy and need further, more intensive treatments to achieve a cure.
Dr Parker aims to identify these patients earlier, and more reliably from the outset, ideally at the time of their first visit to healthcare professionals. Dr Parker said: “GTD can take several weeks to diagnose, while it can take months to diagnose GTN. I aim to find a blood test which could help to confidently diagnose the condition at the time of the patient’s first ultrasound scan.
“This would allow doctors to inform patients not only if they have GTD, but also see if they are likely to develop the cancerous form and whether they will respond to initial chemotherapy treatments.”
In addition to a blood test, Dr Parker is investigating one of the largest databases of GTN patients in the world to help improve the decision-making process for giving different chemotherapy drugs. This would mean that women can be counselled more effectively and given tailored treatment options.
During her research, Dr Parker has worked with two women to set up patient support groups to increase the awareness of this condition. “Even though GTN has an excellent prognosis, with a 99 per cent cure rate, many patients find this diagnosis very isolating, having not heard of it before, and are very anxious to meet other women who can offer them support through the diagnostic, monitoring or treatment process,” she added.
Donna Ricketts, 35 from Rotherham, is setting up one of the support groups. She was diagnosed with GTD two months after having a miscarriage in December 2018.
“I was already grieving for my miscarriage when I found out my pregnancy was molar, and the possibility that I could be diagnosed with cancer. Having to keep explaining to people what was happening was really upsetting,” she said.
“Speaking to other women and hearing about their outcomes and recovery was tremendously helpful, it really helped me find my voice and come to terms with what had happened. Even though Dr Parker’s research won’t help what I’ve been through, something good has already come out of this. If she can also help improve diagnosis and treatment times in the future, that would be amazing.”
Dr Parker also helped Danielle Jones, 28, from North Wales, who found out she had GTN just two weeks after giving birth to her daughter, Averly. She said:
“Two weeks after giving birth I was in a lot of pain, and my hospital in North Wales found out I had cancer. A doctor there suspected it could be related to my pregnancy so I was blue-lighted up to the Weston Park Cancer Centre in Sheffield. My local hospital hadn’t seen a molar pregnancy before, so the initial confusion and diagnosis were really difficult times.
“I had found support groups online in America, but they treat the disease very differently, so it was difficult to make sense of what I was going through. I wanted to do whatever I could to help in any way to raise awareness and, through that, I have been able to find others to talk to who know what I’m going through, which is invaluable.”
Dr Parker added: “Danielle and Donna founded these groups during incredibly vulnerable moments in their lives, yet admirably wanting to make a difference and help others, and I was delighted to have them involved with my research.
“The medical and nursing team at the Sheffield Trophoblastic Centre at Weston Park Cancer Centre offer a tremendous support network for patients and the support groups will complement this perfectly.”
Speaking of the research, which is mainly funded by Weston Park Cancer Charity, CEO Samantha Dixon commented: “We are extremely proud to support Dr Parker’s research efforts. This pioneering study has the potential to change the lives of women and the way this cancer is understood, detected and treated across the world.
“Enabling and funding research is just one of the ways we’re here, at every step, to support people with and beyond cancer.”