Patients treated in the Radiation Oncology Department for gynecologic malignancies are seen mainly by Dr. P. Grigsby, Chief of Service, and Dr. I. Zoberi.
The department radiation oncologists work closely with the gynecologic oncologists from the Department of Obstetrics and Gynecology, and physicians from the Nuclear Medicine Division of the Mallinckrodt Institute of Radiology (MIR).
Radiation therapy is the most common form of treatment for patients with advanced stages of cervical, endometrial or vaginal cancer.
This treatment therapy destroys the ability of cells to grow and divide. Both normal and diseased cells are affected, but most normal cells are able to recover. With radiation therapy, the side effects depend largely on the treatment dose and the part of the body that is treated. Treatment for all sites is administered using external beam irradiation, 3-D conformal and, most recently, intensity modulated (IMRT), sometimes in combination with brachytherapy (intracavitary irradiation).
Recently we incorporated the use of Positron Emission Tomography (PET) in detecting lymph node involvement in patients with cervical cancer, which has been shown to be more sensitive than Computed Tomography (CT) imaging in staging the tumor.
The current clinical program in brachytherapy at the Radiation Oncology Department is one of the largest, not only in St. Louis and Missouri, but also in the United States, utilizing high dose rate and low dose rate. These advanced technologies allow more precise irradiation of the tumor, while sparing pelvic normal tissues, resulting in better tumor control and less treatment morbidity (side effects).
With this treatment, rod-shaped applicators containing radioactivity are placed close to cancerous tissue. Brachytherapy is used successfully to treat women who have cervical cancer that has not spread far beyond the cervix.
To improve survival, MIR researchers are developing ways to image a woman's pelvic anatomy during brachytherapy treatment. These images, combined with those taken at other times during treatment, will allow radiation oncologists to assess the total doses of radioactivity reaching healthy and cancerous tissue.
We have incorporated the use of Positron Emission Tomography (PET) in detecting lymph node involvement in patients with cervical cancer, which has been shown to be more sensitive than Computed Tomography (CT) imaging in staging the tumor.
Positron emission tomography, which MIR researchers developed in 1972, captures tumor cells in action. It accurately gauges the severity and spread of cancer by revealing the metabolic activity of tissues using small amounts of a radioactive compound.
In some cases, PET imaging gives radiologists a way to detect various types of cancer in early, more treatable stages - sometimes months before a tumor becomes evident through other forms of imaging.