Vaginal Cancer

The vagina or the birth canal is the canal leading from the cervix (opening of the uterus) to the outside of the body. Vaginal Cancer can be defined as a disease in which cancer cells form in the vagina. This cancer is not very common and recovery chances are high if treated early.

Vaginal-CancerTypes:

Vaginal cancer can be broadly classified as

1)      Squamous Cell Carcinoma:  This type of cancer spreads slowly and is usually confined to the vagina but may spread to lungs and liver.  It is the most common type of vaginal cancer and is predominant in women above 60 years.

2)      Adenocarcinoma: This type of cancer spreads rapidly to the lungs and lymph nodes. It is more prevalent in women aged 30 or younger.

Causes:

You may possess a risk of getting Vaginal Cancer if one or more of these conditions hold true

  • Being infected with HPV (Human Papilloma Virus)
  • Age above 60 years
  • Having a history of cervical cancer
  • Being exposed to the drug DES (which was given to prevent miscarriages during the 1950s) while in the mother’s womb.

Symptoms

Early stages of Vaginal Cancer is not symptomatic and can be detected using Pap smear test (refer cervical cancer section). Common symptoms include

  • Abnormal bleeding or discharge
  • Pain during sex
  • Pain in the pelvis region
  • Lump in the vagina

Diagnosis

Vaginal cancer can be detected using one or a combination of these procedures:

Pelvic Examination: A thorough examination of the female reproductive organs (vagina, cervix, uterus, fallopian tubes, ovaries) and rectum is done to check for abnormalities.

Pap Smear: The cells from the surface of the cervix and vagina are scraped and tested for abnormalities. If this test shows abnormal results then biopsy can be done.

Biopsy: A small sample of tissue or cells are collected from the vagina and cervix and tested for signs of cancer. Colposcopy is a similar procedure in which tissue samples are tested and an instrument called colposcope is used to check the vagina and cervix.

Staging

Vaginal cancer can be divided into the following stages depending on the extent to which the cancer has spread

Stage 0

In this stage, the squamous cell cancer affects the tissue lining the inside of the vagina. Stage 0 cancer is also termed carcinoma in situ.

Stage I

In this stage, only the vagina is affected

Stage II

In this stage, tissue around the vagina is also affected along with the vagina.

Stage III

In this stage, cancerous cells have spread from the vagina to the pelvis or to the lymph nodes in the pelvis or groin, or both.

Stage IV

In this stage cancerous cells may have spread the lining of the bladder or rectum or beyond the pelvis. It could also body parts (like the lungs) which are not near the vagina.

Recurrent vaginal cancer

 Vaginal cancer may recur even after treatment. The cancer may come back in the vagina or in other parts of the body.

Treatment

Depending on the stage, size and location of cancer, treatment options may vary. These standard procedures are used either alone or in combination.

1)      Surgery

Various types of Surgical procedures may be used such as

  • Laser Surgery: this surgery involves the usage of laser beam to remove a surface lesion such as cancer. 
  • Wide local excision: this surgical method is used to remove the cancer and some healthy tissue around it.
  • Vaginectomy: This surgical procedure involves removal of all parts of the vagina
  • Hysterectomy: Uterus along with the cervix is removed surgically in this procedure.
  • Lymphadenectomy: Surgical procedure involving removal of lymph nodes from pelvis or groin to check for cancerous growth.
  • Pelvic exenteration includes removal of lower colon, rectum and bladder along with ovaries, cervix, vagina and nearby lymph nodes.

To reconstruct the vagina post surgery, a technique called as Skin Grafting is done. In this case healthy skin from a unseen part of the body like buttocks or thighs are taken to repair the area treated by surgery.

2)      Radiation

Radiation is a process in which cancerous cells are destroyed using high energy x-rays or other types of radiation. Radiation therapy may follow a surgery in order to kill any cancer cells that may be left after surgery.

3)      Chemotherapy

Chemotherapy is a process in which drugs are used to stop the growth of cancerous cells. This is achieved either by killing the cells or by not allowing them to divide.

4)      Radiosensitizers

 A new type of treatment involving the use of radiosensitizers is being tested. In this process, drugs are administered that make the tumor cells more sensitive to radiation therapy. Combining this with radiation therapy may yield satisfactory results.

Prevention

Like all other cancers, vaginal cancer cannot be prevented completely but by avoiding risk factors you can reduce your risk of getting it.

  • Avoid HPV infection

HPV is spread through unprotected sexual contact. Hence practicing safe sex (using condoms and limiting number of sex partners) greatly reduces your risk.

HPV Vaccination is available that provides protection against two strains of the virus.

  • Don’t Smoke

Women who don’t smoke are at less risk than those who do

  • Diagnose and treat pre cancerous conditions

Regular screening like the HPV test and Pap smear test (discussed in cervical cancer section) can detect cancerous cells before symptoms occur.

 

Not everyone with these risk factors gets vaginal cancer but in case you experience any of the symptoms please consult your gynecologist. 

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