One in a Million

Yesterday was A DAY. Morning doctor's appointment and test turned into an unexpected afternoon of doctor's appointments and tests. At least now we have some answers, and a plan. 

So let me back up. If you've been following, you know that I've been going for weekly blood work to watch my HCG levels. The actual draws have been going a lot better. The results, not so much. for two weeks in a row, my beta levels have gone up: 33 to 38, 38 to 44. So it was time for some tests. 

What we knew going in was that a rise in HCG levels most likely meant that there were cells left over from the d&c. Those cells are trophoblasts, which, in a successful fertilization, provide the baby with nourishment and form the placenta. After a molar pregnancy, if these cells persist, it is known as Gestational Trophoblastic Disease (GTD). This can occasionally progress into Gestational Trophoblastic Neoplasia (GTN).

Let me break it down for you. 

1 in 1,000 women will experience a molar pregnancy. 

1 in 7 of those pregnancies will develop into GTN that requires chemo. 

By comparison, only 1 in 700 pregnancies that end with a live birth will have a GTD.

I've always been a one in a million kind of gal. But now I'm 1 in 7. One in a million is preferable; right now I'd settle for being one of the other 6.

Neoplasia is the growth of abnormal cells. Neoplasms are only considered cancer if they are malignant. (Yes, I've been learning quite a bit.)So there's good news and bad news.My blood work confirms that there are abnormal cells growing, which we know by my HCG level. A rise of <10% is nothing to worry about, but my increase was 25%. The good news is that there were no masses found on my pelvic ultrasound, nor my pelvic/abdominal CT scan. So it fits half the definition of cancer. 

We talked to the gynecological oncologist (had no idea that was a thing until yesterday) about the possible treatments: another d&c to try and get the cells, and/or chemo to wipe them out completely. With a 99% cure rate, the hardest part of this conversation was hearing that we'd have to wait at least 12 months after treatment to try again. By our estimation, this meant nearly 2 more years until we would have a baby.

Around hour 8 of being at the hospital, we did get some good news: the beta level that was collected earlier in the morning (around hour 2) came back and showed that my HCG had dropped--back to 39. This (along with a thin and healthy uterine lining) took another d&c off the table. We were given two options:

1) Wait a few weeks, continue to watch my HCG. If it went back up, we come back and figure out a plan. If it continued to go down, keep waiting for it to go down to zero. Ugh. More waiting.

(Remember, we are looking for 3 weeks of 0's, followed by 3-6 months of 0's)

2) Proceed with the chemo--just wipe the cells out. Get to zero faster, get back on track.

Both options were favorable, as neither affects fertility, and it was completely up to us. The better news: whether it went down on its own or we chose to do chemo, once we are at zero, we proceed with the original 3 week, 3-6 month plan. 

We chose option 2. The short end to a long story is that the doctor prescribed an oral chemo med, to be taken for 5 days, at 15mg a day. I will go Friday for my next beta level.

Yesterday was A DAY. But some days are like that. And today has been a better one.