Vaginal cancer is a rare cancer that develops in the cells of your vagina. Vagina, also called birth canal, is a muscular tube that connects your uterus with your outer genitals.
Many other cancers can spread to your vagina from other body parts but cancer that begins in your vagina (primary vaginal cancer) is rare. If detected at early stage, there is a higher chance for cure. Advanced cancer that has spread to other parts, is difficult to treat.
Early stage vaginal cancer may not cause any apparent signs and symptoms. As it progresses, vaginal cancer may cause signs and symptoms such as:
Visit your doctor if you experience any signs and symptoms of vaginal cancer, such as abnormal vaginal bleeding. You may not always notice the signs and symptoms of vaginal cancer, therefore it is better if you have regular pelvic exams under consultation from your doctor.
The exact cause of vaginal cancer has not been identified yet. Normal cells in vagina turn into cancer cells due to changes in the DNA (DNA mutations). DNA mutations cause an “out-of-control” cell growth and multiplication leading to accumulation of abnormal cells (tumor). These cancer cells can affect surrounding tissues or dislodge from site of origin and spread to other body parts (metastasis). Vaginal cancer is divided into following types according to the type of cells where the cancer originated:
Vaginal squamous cell carcinoma: It is the most common type that affects squamous cells (thin, flat cells) that line the surface of the vagina.
Vaginal adenocarcinoma: It starts in the secretory cells lining the vagina.
Vaginal melanoma: It starts in pigment-producing cells (melanocytes) of vagina.
Vaginal sarcoma: It starts in the connective tissue that form the walls of vagina.
4 Making a Diagnosis
Visit your doctor or a gynecologist if you any signs or symptoms of vaginal cancer that bother you. If signs and symptoms indicate possibility of vaginal cancer, your doctor can refer you to a doctor who specializes in female reproductive cancers (gynecologic oncologist).
How to prepare yourself for the visit?
Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.
List out all the symptoms.
Write down your key medical information.
Write down the names of all your medications, vitamins or supplements.
Ask a friend or a family member to accompany you during the visit.
Make a list of the questions to ask your doctor. Some typical questions can be:
What could be possible causes of my symptoms?
What are the tests that I need?
What are my treatment options and side effects of each option?
Can treatments affect my sexuality?
Do I need to follow any restrictions?
Has my cancer spread to other parts?
What is the stage of my cancer?
What are my chances of recovery?
Should I see a specialist?
What your doctor wants to know?
A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor. Your doctor might ask you typical questions like:
When did the symptoms start appearing and how severe are they?
Have your symptoms been continuous or occasional?
Does anything improve or worsen your symptoms?
Do you have any idea of your mother taking diethylstilbestrol (DES) during pregnancy?
Have you ever been diagnosed with other cancers or human papillomavirus (HPV)?
Has your Pap test shown any abnormalities?
Screening tests for healthy women
Pelvic examination: This begins with examination of the outer part of your genital followed by insertion of two gloved fingers into the vagina and at the same time pressing a hand on your abdomen to feel your uterus and ovaries. A speculum (device to inspect cervix and vagina) is inserted into the vagina to investigate whether there is any abnormality.
Pap test: Pap test, a common screening test for cervical cancer, can also detect vaginal cancer cells. Consult your doctor to know how often you need these screening tests.
Tests to diagnose vaginal cancer
After a pelvic exam and Pap test, you may need following tests to confirm the diagnosis of vaginal cancer:
Colposcopy: A special magnifying instrument (colposcope) is used to inspect vagina.
Biopsy: A sample of tissue is removed from the affected site and is sent for laboratory analysis.
Staging a cancer is based on the extent of cancer. Staging is important to determine appropriate treatment and hence its outcome. Staging may be done by:
Imaging tests: Tests like X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) or positron emission tomography (PET) may be recommended to determine if your cancer has spread.
Visual examination by using cameras: It involves using tiny cameras to view interior of your body to determine if cancer has spread. Procedure called cystoscopy helps to view inside your bladder (cystoscopy) whereas proctoscopy helps to view rectum.
The stages of vaginal cancer are:
Stage I: Cancer is restricted to the vaginal wall.
Stage II: Cancer has spread to tissue near your vagina.
Stage III: Cancer has spread to the pelvis.
Stage IVA: Cancer has spread to surrounding areas, such as your bladder or rectum.
Stage IVB: Cancer has spread to distant parts of body, such as your liver.
Choice of a treatment option depends on the type and stage of vaginal cancer. Together with your doctor, you can chose a treatment that best suits you. Surgery and radiation form the mainstay of vaginal cancer treatment.
Surgery: There are various types of surgery for vaginal cancer which include:
Removal of small tumors or lesions: If cancer has affected only the surface of vagina, it may be surgically removed.
Vaginectomy: It involves surgeries to remove either a part of vagina (partial vaginectomy) or entire vagina (radical vaginectomy). Along with vaginectomy, surgeries may be carried out to remove uterus and ovaries (hysterectomy) and nearby lymph nodes (lymphadenectomy).
Pelvic exenteration: It is a major surgery that removes a number of organs in the pelvic area such as bladder, ovaries, uterus, vagina, rectum and the lower portion of colon.
Radiation therapy: It uses ionizing radiations like X-rays to destroy cancer cells. The source of radiation may be outside your body (external radiation) or in vagina (brachytherapy). External radiation is more commonly used technique for vaginal cancer. Internal radiation may be used for very early-stage vaginal cancer.
Chemotherapy: It uses chemical drugs to kill cancer cells. The benefit of using chemotherapy in women with vaginal cancer is not well defined. It may be used along with radiation.
Clinical trials: These are the experiments performed to demonstrate the benefits of new treatment methods. Clinical trials do not guarantee a cure. Discuss with your doctor before participating in a clinical trial. You may also contact the National Cancer Institute or the American Cancer Society to find if any clinical trial is available.
No one knows the actual preventive measures for vaginal cancer but there are ways to reduce your risk:
Regular pelvic exams and Pap tests: Talk to your doctor to know about these screening tests.
HPV vaccine: Getting vaccinated for HPV infection may keep your risk lower.
Don't smoke: Smoking increases the risk of vaginal cancer.
7 Lifestyle and Coping
Lifestyle modifications are necessary in order to cope with vaginal cancer.
Diagnosis of vaginal cancer cause a heap of stress. It may make you anxious and rob happiness off your life. Here are some tips to help you cope:
Expand your knowledge on your cancer. A broad and updated knowledge of your condition can help you make better decisions about your treatment.
Stay close to your partner: Sexual intimacy during cancer therapy is painful or temporarily impossible. Discover some news ways to keep your romance alive.
Create a support network: Keep in touch with friends and family that helps to gain support during hard times. You may also share your condition with social workers and psychologists.
Join a support group in your community or online. To get more information, contact the American Cancer Society.
8 Risks and Complications
There are several risks and complications associated with vaginal cancer. Risks include:
Age: Risk of vaginal cancer increases with your age.
Vaginal intraepithelial neoplasia: Vaginal intraepithelial neoplasia (VAIN) increases your risk vaginal cancer. VAIN is a condition in which atypical cells are present in the vagina. VAIN is caused by the sexually transmitted human papillomavirus (HPV). Consider vaccines against HPV infection.
Exposure to diethylstilbestrol (DES): DES is a drug used to prevent miscarriage. If your mother took a DES while pregnant, you are more likely to have adenocarcinoma.
Multiple sexual partners
Starting intercourse early
Vaginal cancer may spread (metastasize) to other parts of your body, such as your lungs, liver and bones.
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