Vaginal cancer

Vagina is the passage from the cervix to the outside of the body of a woman. It is also called as birth canal as the baby passes out from the body through this canal. The glandular cells of the vagina produce mucus that keeps the vagina moist. The wall consists of squamous epithelial cells. Underneath the wall, there is connective tissue, muscle tissue, nerves, and lymph vessels.

Vaginal cancer is a rare or uncommon condition. Only one out of every 1,100 women may develop vaginal cancer. It is of the following types:

  • Squamous cell carcinoma – Cancer forms in the flat, squamous cells of the vagina. It is the most common type of vaginal cancer. It spreads slowly and stays within the vagina in most cases
  • Adenocarcinoma – Cancer forms in the glandular cells. It spreads quickly when compared to the squamous cell carcinoma
  • Melanoma – Cancer forms in the pigment-forming cells (melanocytes) of the vagina
  • Sarcoma – Cancer forms in the cells of the connective tissue present in the walls of the vagina

Symptoms of vaginal cancer are not seen during initial stages. The symptoms appear as the disease progresses. The symptoms include:

  • Abnormal bleeding
  • Pelvic pain
  • Watery discharge from vagina
  • A lump or mass
  • Painful and frequent urination
  • Pain during sexual intercourse

The causes of vaginal cancer are not clear. In general, cancer occurs due to a mutation in the DNA leading to an abnormal growth of cells. These abnormal cells undergo cell division rapidly and form a mass called the tumor.

Elderly women are at more risk for vaginal cancer. Use of diethylstilbesterol during pregnancy, smoking, multiple sexual partners, human papilloma virus (HPV) infection, history of cervical cancer, history of previous radiation therapy, and hysterectomy increases the risk of vaginal cancer.

Your doctor performs a physical examination and reviews your medical history. Other tests include:

  • A pelvic exam is also performed to examine the reproductive system (vagina, uterus, fallopian tubes, ovaries, and rectum). This exam is done by inserting lubricated and gloved fingers of one hand into the vagina and the other hand on the abdomen to examine the shape and position of the uterus and ovaries.
  • A pap test is performed by collecting the cells from the surface of vagina and cervix for microscopical examination.
  • A colposcopy is performed using a colposcope to check vagina and cervix for abnormalities.
  • A biopsy is performed to examine the cells and tissues of vagina and cervix.
  • Imaging tests such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) scans are performed for staging cancer.

Your doctor chooses the treatment based on your age, physical condition, stage of cancer, and extent of spread of the disease. Treatment of vaginal cancer includes:

Surgery: Surgery involves removal of small tumors, vaginectomy, or pelvic exenteration (removal of a majority of pelvic organs) depending on the extent of your cancer. Your doctor recommends pelvic exenteration if your cancer has spread to a majority of pelvic area or cancer has recurred.

If vaginectomy is performed, you may undergo a surgery called vaginal reconstruction. In this procedure, your surgeon constructs a new vagina using the flaps of muscle or sections of intestine.

Radiation therapy: Radiation therapy involves killing cancer cells using laser beams or high-energy X-rays. Your doctor chooses either external radiation or internal radiation (brachytherapy). External radiation is performed by positioning you on a table and directing the radiation machine to the target area. Internal radiation is given by placing radioactive devices such as wires, cylinders, or other materials in your vagina and removing these devices after a certain amount of time.

Generally, internal radiation is given after external radiation. But, individuals who are in the early stages of cancer receive only internal radiation.

In few cases, chemotherapy is given the following radiation to enhance the effectiveness of the therapy.

Before initiating the treatment, talk with your doctor and clearly, explain your expectations from the therapy. Take help from your healthcare team and family members to identify and implement coping strategies. Discuss the possible side effects that you may experience during and after treatment.

Following few tips can help to prevent vaginal cancer:

  • Undergoing gynecological examination annually
  • Avoiding multiple sexual partners
  • Practicing safe sex
  • Quitting smoking