Gynecological Cancers

Gynecological cancer occurs when certain cells within the female reproductive organs grow in an uncontrolled, abnormal, manner. These organs include the cervix, ovaries and uterus.

Cervical Cancer

Cervical cancer forms in the tissues of the cervix, the organ that connects the uterus and vagina. Cervical cancer growth often has no symptoms, however, it can be detected with a Pap test. The American Cancer Society estimates that more than 88,000 new cases of cervical cancer will be diagnosed in the United States and nearly 30,000 will die from the disease in 2011. 

Ovarian Cancer

Ovarian cancer is a rare cancer that begins in the ovaries, the egg-producing female reproductive organs. There are two types of ovarian cancer — germ cell and stromal cell. Germ cell cancer starts in the cells that form eggs in the ovary and stromal cell cancer begins in the cells that produce female hormones and hold the ovarian tissues together. The National Cancer Institute estimated that there would be 21,880 new cases of ovarian cancer in the United States in 2010 and 13,850 deaths from the disease. 

Uterine (Endometrial) Cancer

Uterine or endometrial cancer forms in the tissue lining of the uterus, the pear-shaped organ where a fetus develops. In the most common type of uterine cancer, called endometrial adenocarcinoma, cancer begins in the cells that make and release mucus and other fluids. In uterine sarcomas, malignant cells form in the muscle of the uterus or in the uterine lining. Uterine sarcomas are much less common than endometrial cancer, accounting for fewer than five percent of all uterine cancers. However, they are much more aggressive and can spread quickly to other sites. For 2010, the National Cancer Institute estimated 43,470 new cases of uterine cancer and 7,950 deaths from the disease.

What molecular imaging technologies are used for gynecological cancers?

The molecular imaging technologies currently being used for gynecological cancers are positron emission tomography (PET) scanning and PET in conjunction with computer-aided tomography (CT) scanning (PET-CT).

How is PET used for gynecological cancers?

Physicians use PET and PET-CT studies to:

• diagnose and stage: by determining the exact location of a tumor, the extent or stage of the disease and whether the cancer has spread in the body, especially the lymph nodes.
• plan treatment: by selecting the most effective therapy based on the unique molecular properties of the disease and of the patient’s genetic makeup and to determine a site that is appropriate for biopsy, if necessary
• evaluate the effectiveness of treatment: by determining the patient’s response to specific drugs and ongoing therapy. Based on changes in cellular activity observed on PET-CT images, treatment plans can be quickly altered
• manage ongoing care: by detecting the recurrence of cancer

What are the advantages of PET studies for gynecological cancer patients?

PET-CT:

• often results in a change in patient management
• may determine the effectiveness of therapy after just one cycle of treatment
• is highly accurate at detecting recurrent ovarian cancer and more accurate than CT imaging alone
• in combination with CT or MRI may improve imaging of vaginal cancer, sparing some patients unnecessary surgical procedures and allowing others to receive radiation treatment to a smaller area
• is highly accurate in detecting cervical cancer when it has spread outside of the pelvis, especially to the lymph nodes
• allows more accurate and targeted planning of the boundaries for radiation treatment for cervical cancer, which minimizes effects of radiation on normal tissues
• is particularly useful in detecting a recurrence of cervical cancer before symptoms appear and in accurately monitoring how cervical cancer is responding to radiation treatment
• may eliminate unnecessary surgeries after treatment by differentiating between tumors and benign residual masses.

What is the future of molecular imaging and gynecological cancers?

There are many new and emerging molecular imaging technologies that may benefit people with ovarian cancer, including:

• hybrid imaging systems, such as combined PET-MR, which may improve accuracy and allow physicians to see how cancer is affecting other systems in the body
• the use of new technologies for ovarian cancer, such as optical imaging for detection and targeted ultrasound for differential diagnosis
• new PET radiotracers to image critical cancer processes, such as fluorothymidine (FLT) to show tumor proliferation.