Gestational Trophoblastic Disease (GTD) Treatment in India

Gestational Trophoblastic Disease (GTD) is a rare pregnancy-related tumor that responds well to early and complete treatment. India offers advanced diagnostics, chemotherapy, and surgical care at a significantly reduced cost compared to Western countries. Treatment in India ranges from $2,500 to $6,000, while the same care may cost $25,000–$40,000 in the U.S. and $10,000–$18,000 in Thailand. This makes India a preferred destination for safe, high-quality, and affordable GTD care.

What Is Gestational Trophoblastic Disease (GTD)?

Gestational Trophoblastic Disease (GTD) refers to a group of rare tumors that involve abnormal growth of cells inside a woman’s uterus, specifically the trophoblasts, which are the cells that normally develop into the placenta during pregnancy.

What are the Types of Gestational Trophoblastic Disease (GTD)?

Types of Gestational Trophoblastic Disease (GTD):

50. Hydatidiform Mole (Complete and Partial Molar Pregnancy)
50. Invasive Mole
50. Choriocarcinoma (a highly malignant type)
50. Placental Site Trophoblastic Tumor (PSTT)

GTD can develop after any type of pregnancy, including miscarriage, normal delivery, or abortion.

Who Is Affected by GTD?

GTD primarily affects women of childbearing age, especially:

50. Women under 20 or over 40
50. Those with a previous molar pregnancy
50. Women in Asia, Africa, and Latin America show slightly higher incidence rates

What Are the Symptoms and Risk Factors?

Common Symptoms:

50. Irregular or heavy vaginal bleeding after pregnancy
50. High levels of HCG (Human Chorionic Gonadotropin)
50. Nausea, vomiting (hyperemesis gravidarum)
50. Rapid uterine enlargement
50. Abdominal pain or pelvic pressure

Risk Factors:

50. Age <20 or >40
50. Previous molar pregnancy
50. Nutritional deficiencies
50. Genetic predisposition

How Is GTD Diagnosed in India?

India offers swift and comprehensive diagnosis using international protocols.

Diagnostic Steps:

50. Blood tests: HCG level measurement
50. Ultrasound: Transvaginal scan to detect molar growth
50. Pelvic exam: Uterine enlargement or unusual bleeding
50. Imaging: Chest X-ray or CT scan to detect metastasis
50. Biopsy: In suspected choriocarcinoma or PSTT cases

Diagnosis is often completed within 48–72 hours after patient arrival in India.

What Is the Detailed Treatment Protocol for GTD in India?

The treatment for GTD in India follows global guidelines and varies based on the type and stage of the disease. The protocol is divided into several stages to ensure accurate diagnosis, effective intervention, and ongoing follow-up.

1. Initial Evaluation and Diagnosis (Days 1–3)

What happens during the first 72 hours?

Consultation with an oncologist and/or gynecologist

Blood tests to measure β-hCG levels (a key GTD marker)

Transvaginal ultrasound to evaluate uterine contents and abnormalities

Imaging tests like Chest X-ray or CT scan to check for metastasis (especially in suspected choriocarcinoma)

Biopsy or D&C analysis if previous surgery was incomplete or diagnosis is unclear

Timeline: 1–3 days
Available in most Indian metro hospitals with rapid reporting

2. Suction Evacuation or Surgical Removal (If Molar Pregnancy)

How is a molar pregnancy treated?

Suction Curettage (D&C): First-line surgical procedure to remove abnormal tissue

Hysterectomy: Recommended in rare or resistant cases, or for women not planning future pregnancies

Important: Fertility-sparing surgery is prioritized in India unless there is aggressive malignancy.

Timeline: 1-day hospital stay, 3–5 days recovery

3. hCG Monitoring Post-Surgery (Days 4 Onward)

Why is hCG monitoring crucial?

50. To confirm complete removal of molar tissue
50. To detect persistent GTD or choriocarcinoma early
50. β-hCG levels are measured weekly until they return to normal, then monthly for 6–12 months

Normal decline: 10–15% drop weekly is expected

4. Chemotherapy for Persistent GTD or Choriocarcinoma

Who needs chemotherapy?

Persistent GTD (hCG does not normalize or rises)

Choriocarcinoma, Invasive mole, or Metastasis detected

Which chemotherapy drugs are used?

Low-risk cases:

Methotrexate (MTX) with or without folinic acid

Actinomycin D

High-risk or metastatic cases:

EMA-CO Regimen (Etoposide, Methotrexate, Actinomycin D + Cyclophosphamide, Vincristine)

How many cycles are given?

• Typically 1–6 cycles, depending on HCG levels and response

50. Each cycle lasts about 1 week, repeated every 7–14 days

5. Supportive & Fertility Preservation Care

What supportive care is provided?

• Antiemetics, nutritional support, and psychological counseling
• Fertility preservation consultation for patients undergoing multi-agent chemotherapy

Pregnancy is advised only after 12 months of normal hCG levels

6. Long-Term Follow-Up

Why is long-term follow-up required?

• Even after cure, recurrence can occur in 1–3% of cases
• Patients undergo monthly hCG testing for up to 1 year
• Annual gynecological check-ups advised

Follow-up duration: 1–2 years

What Are the Treatment Options in India?

Treatment depends on the type and severity of GTD:

1. Suction Curettage

Primary treatment for molar pregnancy. Removes abnormal tissue from the uterus.

2. Chemotherapy

Used for persistent GTD or malignant types like choriocarcinoma. Regimens include:

• Methotrexate (MTX)
• Actinomycin D
• Multi-drug chemotherapy for high-risk or metastatic disease

3. Hysterectomy

Considered for women who do not desire future pregnancies or in resistant cases.

4. HCG Monitoring

Essential for tracking recovery. Weekly or monthly until normal levels are sustained.

Why Choose India for GTD Treatment?

• Affordable care with globally comparable outcomes
• Internationally trained gynecologic oncologists
• JCI and NABH-accredited hospitals
• Quick access to diagnosis and treatment
• Multidisciplinary teams including gynecologists, oncologists, pathologists

Why Choose Dr. Ankur Bahl?

• Renowned oncologist with specialization in GTD and gynecological cancers
• 20+ years of experience treating international patients
• Practices at leading accredited cancer hospitals in India
• Offers personalized treatment plans and teleconsultation services
• Focus on fertility preservation and long-term care

What Medical Technologies Are Used in India for GTD?

• High-resolution transvaginal ultrasound machines
• HCG quantitative testing labs
• Laparoscopic surgical tools
• Chemotherapy infusion pumps and safety systems
• CT & MRI for staging and metastasis detection

Cost Breakdown for GTD Treatment in India

Cost Comparison: India vs Other Countries

India offers a 60–80% savings without compromising on medical quality.

Step-by-Step Procedure for Foreign Patients

• Online Consultation with Dr. Ankur Bahl
• Visa Invitation & Travel Support
• On-Arrival Diagnosis (HCG, Ultrasound, CT)
• Surgical or Chemotherapy Treatment
• Regular HCG Monitoring until remission
• Follow-Up Care (on-site or via telemedicine)

Gestational Trophoblastic Disease is highly treatable, and early intervention ensures complete recovery in most patients. India stands out as a leading destination for GTD treatment due to:

• Advanced medical infrastructure
• Affordable, evidence-based care
• Compassionate support for international patients

Dr. Ankur Bahl is a trusted name in gynecologic oncology and has successfully treated hundreds of international patients.