Methotrexate for trophoblastic cancer

Examples

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Brand Name	Chemical Name
Rheumatrex	methotrexate

How It Works

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

Why It Is Used

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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

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Methotrexate has been shown to cure about 94% 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

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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

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The possibility of experiencing severe side effects increases if you combine methotrexate with alcohol or certain medications. 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) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Markusen TE, O'Quinn AG (2003). Gestational trophoplastic diseases. In AH DeCherney, L Nathan, eds., Current Obstetric and Gynecologic Diagnosis and Treatment, 9th ed., pp. 947–958. New York: McGraw-Hill.

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

Credits

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Author	Colleen Cronin
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Associate Editor	Lisa Shaw
Primary Medical Reviewer	Joy Melnikow, MD, MPH - Family Medicine
Specialist Medical Reviewer	Kirtly Jones, MD - Obstetrics and Gynecology
Last Updated	November 3, 2005