Overview of vaginal cancer
If malignant cells originate from the vagina then this diseased condition is called vaginal cancer. The vagina is the canal leading from the cervix (the opening of uterus) to the outside of the body, through which a baby passes out of the body at birth. Therefore vagina is also called the birth canal. Its very uncommon to have vaginal cancer but if found in early stages it may be cured. There are two main types of vaginal cancer:
Squamous cell carcinoma
Adenocarcinoma
Causes/risk factors of vaginal cancer
Following are the possible risk factors for vaginal cancer:
Age: Being aged 60 or older is one of the risk factors
Exposure to certain drugs e.g. DES (diethylstilbestrol) before birth affect a woman's risk of developing vaginal cancer.
Infected by human papilloma virus (HPV)
Cervical cancer
Symptoms of vaginal cancer
There are little or no symptoms at the early stages of vaginal cancer. At an early stage it may be found during a routine Pap test. If any of the symptoms mentioned below do occur, they may be caused by vaginal cancer or by other conditions. In any situation its advisable to consult a doctor. The symptoms may include:
Presence of a lump in the vagina
Experiencing pain during sexual intercourse
Pain in the pelvic region
Bleeding or discharge not related to menstrual periods.
Diagnosis of vaginal cancer
In order to diagnose vaginal cancer a doctor may ask for tests that examine the vagina and other organs in the pelvis. The following tests and procedures may be used for diagnosis:
Physical exam and history: General signs of health are checked in a physical exam. It also includes checking for signs of disease, such as lumps or anything else that seems unusual. Patient's health habits and past illnesses and treatments are of utmost importance to know whether there is a chance for vaginal cancer to occur.
Pelvic exam: A doctor checks the reproductive organs of a female which includes examining the vagina, cervix, uterus, fallopian tubes, ovaries, and he/she also checks the rectum. To feel the regularity in size, shape and position of uterus and ovaries the doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease.
Pap smear/test
Biopsy
Colposcopy
In addition to all these tests a doctor may also advice for the following tests to be sure if there are any signs of cancer or to decide the stage the cancer may be at:
Chest x-ray
Cystoscopy
Ureteroscopy
Proctoscopy
CT scan (CAT scan)
MRI (magnetic resonance imaging)
Lymphangiogram
Stages of vaginal cancer
Staging of a cancer implies the extent to which it has spread from the organ of its origin. Generally at higher stages cancerous cells have also affected other body organs in addition to the organ of origin. Once a doctor is sure that vaginal cancer has occurred, tests are done to find out if cancer cells have spread within the vagina or to other parts of the body. Following are the stages of a vaginal cancer:
The following stages are used for vaginal cancer:
Stage 0 (carcinoma in situ): Carcinoma in situ means cancer in its place of origin. In stage 0, squamous cell cancer is found in tissue lining the inside of the vagina.
Stage I: In this stage cancer is concentrated only in the vagina.
Stage II: In stage II, cancer cells have invaded the region around the vagina and it has spread from the vagina to the tissue around the vagina.
Stage III: In stage III, lymph nodes in the pelvis or groin (or both) are also affected and cancer has spread from the vagina to them.
Stage IV is divided into stage IVA and stage IVB:
Stage IVA: Cancer may have spread to lymph nodes in the pelvis or groin and has spread to one or both of the following areas:
The lining of the bladder or rectum.
Beyond the pelvis.
Stage IVB: Cancer has spread to parts of the body that are not near the vagina, such as the lungs. Cancer may also have spread to the lymph nodes.
Recurrent vaginal cancer
Recurrent vaginal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the vagina or in other parts of the body.
Treatment of vaginal cancer
There are different types of treatment for patients with vaginal cancer. But to decide which treatment method or a combination of treatment methods will be best suited, depends on following:
The stage, size, and location of the cancer
Whether the tumor cells are squamous cell or adenocarcinoma
Whether the patient has a uterus or has had a hysterectomy.
Whether the patient has had past radiation treatment to the pelvis
Three types of standard treatment are used:
Surgery
Surgery is the most common treatment of vaginal cancer. The following surgical procedures may be used:
Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
Wide local excision: A surgical procedure that takes out the cancer and some of the healthy tissue around it.
Vaginectomy
Total hysterectomy
Lymphadenectomy
Pelvic exenteration
Skin grafting
Radiation therapy
Chemotherapy
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