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Living with cancer· Appointment prep

Appointment sheet: Gestational trophoblastic neoplasia

One page to bring and write on: your details, the questions for Gestational trophoblastic neoplasia plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Gestational trophoblastic neoplasia

Prepared with OnCo (onco.cc/prep/gestational-trophoblastic/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

17 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Serum hCG, FIGO 2000 prognostic score, Hyperglycosylated hCG / hCG-free beta, Genotyping to confirm gestational origin, PD-L1), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Low-risk GTN (FIGO score 0-6)
  1. 5.For my situation (low-risk gtn (figo score 0-6)), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Methotrexate, Dactinomycin (actinomycin D), and what side effects should I expect?
High-risk GTN (score ≥7)
  1. 7.For my situation (high-risk gtn (score ≥7)), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Etoposide, Methotrexate, Dactinomycin (actinomycin D) or related drugs, and what side effects should I expect?
Chemotherapy-resistant GTN
  1. 9.For my situation (chemotherapy-resistant gtn), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Pembrolizumab, Avelumab, and what side effects should I expect?
PSTT / ETT
  1. 11.For my situation (pstt / ett), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Cisplatin, Etoposide, and what side effects should I expect?
Any stage
  1. 13.Are there clinical trials I could join, for example of Pembrolizumab, Avelumab?
  2. 14.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 15.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 16.I read that “Late diagnosis where hCG surveillance after molar pregnancy is absent (much of the world)”. How does that affect my plan?
  5. 17.I read that “Fertility and psychological burden of a pregnancy-related cancer”. How does that affect my plan?

The words I may hear

  • Cancer during pregnancy: About 1 in 1,000 pregnancies is complicated by cancer, most often breast, cervical, lymphoma, melanoma or leukaemia.
  • Rare cancers: Rare cancers are those with fewer than about 6 new cases per 100,000 people per year.

Tests and results to bring

Biomarker results to ask for: Serum hCG (diagnosis, staging, response, surveillance), FIGO 2000 prognostic score (low ≤6, high ≥7, ultra-high ≥13), Hyperglycosylated hCG / hCG-free beta (PSTT), Genotyping to confirm gestational origin, PD-L1 (expressed in nearly all GTN).

Scans and tests linked to this cancer: AFP, hCG and LDH in germ cell tumours (IGCCCG risk groups), Serum tumour markers: proper use and misuse, Ultrasound.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call