Vaginal cancer, a rare form of cancer, begins in your vagina (the muscular tract connecting your cervix and uterus with your vulva). The birth canal, a population of cells lining the vaginal tract, is where vaginal cancer most commonly starts.
Risk factors for Vaginal Cancer
The main risk factors for vaginal cancer are:
Aging: As you get older, your risk of developing vaginal cancer rises. Most women diagnosed with this cancer form are at least 60 years old.
Being diagnosed with vaginal intraepithelial neoplasia: Vaginal intraepithelial neoplasia (VAIN) diagnosis increases your likelihood of developing vaginal cancer. Cells affected by VAIN are abnormal in appearance yet not considered cancerous cells. Even when diagnosed with VAIN, however, the risk of vaginal cancer remains small. VAIN often occurs in those exposed to the sexually transmitted human papillomavirus (HPV), which also causes vulvar and cervical cancers. Ask your doctor for vaccines to protect yourself against certain strains of HPV.
Fetal exposure to a miscarriage prevention drug: You may have a higher risk of developing clear cell adenocarcinoma (a form of vaginal cancer) if your mother was pregnant in the 1950s and took the drug, diethylstilbestrol (DES).
Signs & Symptoms of Vaginal Cancer
In the early stages of vaginal cancer, you may not experience any symptoms. As the cancer advances, you may experience some of the following:
- Abnormal vaginal bleeding, such as after intercourse or after menopause
- Watery vaginal discharge
- A lump or mass in your vagina
- Pain while urinating
- Frequent urination
- Pelvic pain
Screening for Vaginal Cancer
Vaginal cancer may be determined during a routine pelvic exam before the signs and symptoms begin. In the pelvic exam, your doctor examines the inside of your vagina and simultaneously presses the lower part of your belly to feel your pelvic organs. You may also undergo a Pap test which is often used to detect cervical cancer but can also be used to find vaginal cancer. The frequency of screenings depends on your risk factors and if your previous Pap tests have been abnormal.
Diagnosis of Vaginal Cancer
After your doctor performs the screening tests (pelvic exam and Pap test), the following tests and procedures can be done by your doctor to diagnose vaginal cancer:
Inspecting the vagina more closely: With a colposcope, light enhanced magnifying instrument, your doctor examines your vagina surface by magnifying the area. This close-up view can reveal the areas with abnormal appearing cells.
Removing some vaginal tissue for testing: This biopsy procedure removes a part of irregular tissue for laboratory testing. Your doctor can perform the biopsy during a colposcopy exam.
If found to have vaginal cancer, the doctor will determine your cancer stage by performing more tests. Your stage remains a crucial factor in planning the course of your treatment. Some tests used to determine your cancer’s stage include a chest X-ray, a computerized tomography (CT) scan, positron emission tomography (PET) scan, and blood tests. Vaginal cancer ranges from I to IV. In stage I, cancer has not spread past your uterus. By stage IV, vaginal cancer has grown to distant body parts.
Treatment and side effects
Developing a treatment plan for vaginal cancer depends on different factors such as the cancer stage, additional health problems you may have, and your preferences. Treatment often involves surgery or radiotherapy, but you can also combine the two. In some cases, your treatment plan can comprise other treatment therapies.
Types of surgery used to treat vaginal cancer include:
- Small tumors or lesion removal. Low-stage cancer restricted to the vaginal surface can be cut away. The doctor will also remove some healthy surrounding tissue to ensure the complete removal of cancer cells.
- Vagina removal (vaginectomy). Advanced stage cancer can result in the removal of either a portion of your vagina (partial vaginectomy) or your whole vagina (radical vaginectomy). The doctor may also suggest removing your uterus, ovaries (hysterectomy), and nearby lymph nodes.
- Pelvic organ removal (pelvic exenteration). If vaginal cancer has spread throughout your pelvic area or vaginal cancer has reappeared, this extensive procedure could provide treatment. The surgeon could remove your bladder, ovaries, uterus, vagina, rectum, and the lower part of your colon. Most notably, this surgical procedure would require you to have ostomy bags that collect body wastes. Your surgeon can also reconstruct a new vagina so that you can participate in vaginal intercourse.
Radiation therapy uses high-powered energy beams to destroy cancer cells. Radiation therapy is delivered either externally or internally.
- External radiation involves the high power beam positioned at your pelvis or entire abdomen. This form is most common in women with vaginal cancer.
- Internal radiation, also called brachytherapy, involves inserting radioactive devices (seeds, wires, cylinders, or other items) into the vagina or neighboring tissue. Early-stage vaginal cancer patients may only receive this treatment type. However, some patients may receive this after receiving external radiation treatment.
Chemotherapy involves the use of chemicals to destroy cancer cells. Researchers are unclear about the usefulness of chemotherapy in treating vaginal cancer; therefore, doctors generally pair chemotherapy with other treatment options.
Supportive (palliative) care
Supportive or palliative care aids in the medical care used in disease treatment. Palliative care provides pain relief and other support forms from a team of doctors, nurses, and other health professionals. In this therapy, palliative specialists work with you and other healthcare providers to ensure healthier patient outcomes.