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Methotrexate for trophoblastic cancer

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By Kathe Gallagher, MSW

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How It Works

Methotrexate stops the growth of rapidly reproducing cells, such as cancer cells or fetal cells.

Why It Is Used

Methotrexate is the drug of choice for treating trophoblastic cancer that affects the uterus only, which accounts for the vast majority of cancer caused by molar pregnancy.

Methotrexate can be used to prevent trophoblastic cancer in women who are considered high risk for developing cancer after removal of a molar pregnancy.

How Well It Works

Methotrexate cures about 90% of trophoblastic cancer that is confined to the uterus.1 Cure rates are as high as 99% in women with early diagnosis and minimal cancerous growth.2

Side Effects

Methotrexate side effects are most likely to develop with long-term use. Common temporary side effects include:

  • Nausea, vomiting, and loss of appetite.
  • Fatigue and sleep disturbances.
  • Reduced white blood cell count.

Less common side effects include:

  • Sun sensitivity, easy sunburn.
  • Diarrhea or blood in the stool.
  • Mouth sores.
  • Easy bruising and bleeding.
  • Skin rash or sores.
  • Headaches.
  • Chills and fever.
  • Lightheadedness.

Long-term side effects can include:

  • Liver inflammation or damage. The risk of liver damage is increased in people with diabetes, people with a history of liver disease, and those with a history of alcohol abuse.
  • Inflammation of the lungs (pneumonitis).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

The possibility of experiencing severe side effects increases if you combine methotrexate with alcohol or certain other medicines. You will be advised to completely avoid the following until your treatment has finished:

  • Alcohol
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
  • Penicillin

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Berkowitz RS, Goldstein DP (2007). Gestational trophoblastic disease. In JS Berek, ed., Berek and Novak's Gynecology, 14th ed., pp. 1581–1603. Philadelphia: Lippincott Williams and Wilkins.

  2. Berkowitz RS, etal. (1998). Recent advances in gestational trophoblastic disease. Current Opinion in Obstetrics and Gynecology, 10: 61–64.

Credits

Author Kathe Gallagher, MSW
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Joy Melnikow, MD, MPH - Family Medicine
Specialist Medical Reviewer Kirtly Jones, MD - Obstetrics and Gynecology
Last Updated October 29, 2007
Last Updated: 10/29/2007

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