Re: Methotrexate and what happens next
From: Jane (anonymous@obgyn.net)
Tue, 22 Aug 2000 09:40:48 -0500 (CDT)
Thanks you J Wang and D Ashley Hill for your answers.
I'm afraid I am a little confused after reading both your replies. Are
you saying that I don't have the type of pregnancy ie molar, which can
go up again once negative, or that ectopics can too, but rarely do. Can
the cancer situation apply to ectopics aswell as in molars?
No-one at my hospital has suggested doing any blood tests after I get to
zero; is this something I should insist upon, and how regularly should I
have them done (ie the norm in the US?)
Thank you.
Jane
At Mon, 21 Aug 2000, D. Ashley Hill, MD wrote:
>
>At Mon, 21 Aug 2000, Jane wrote:
>
>>The good news is that after a HCG reading of 268 on Day 7 after the
>>methotrexate, I've just got my results from Day 11 and it's down to 31.
>
>This is very reassuring.
>
>>What I'd like to know (and this came from a consultant who didn't want
>>to give me Methotrexate) is it true that once the HCG comes down to
>>below 10, or even zero, it can sometimes start to go up again
>
>This is possible, but thankfully uncommon. This situation is why we
>measure HCG levels every week until zero, then monthly for 6-12 months
>(depending on the clinical situation). The worst-case scenario is that
>the HCG climbs but is not being monitored appropriately (which, of
>course, would not be the case with you). In those cases, the abnormal
>placental tissue can actually become cancerous, requiring advanced
>chemotherapy and, at the extreme, hysterectomy. So, it's very important
>to keep your doctor's appointments over the next year, and obtain HCG
>levels as suggested by your doctor. Even if your HCG levels begin to
>climb again, the abnormal placental tissue can be quickly treated with a
>D&C or further chemo. Again, it's a fairly uncommon situation, so the
>odds are certainly in your favor. Good luck with everything.
>
>--
>David Ashley Hill, MD
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
>http://home.cfl.rr.com/dahmd
>
>My apologies, but due to time constraints I am unable to answer private e-mails.
>
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