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Vaginal cancer develops in the muscular tube that connects your uterus with your outer genitalia, or vagina. It most frequently develops in the cells that line your vagina.
While many different cancers can migrate from other parts of your body to your vagina, primary vaginal cancer, which starts in your vagina, is uncommon.
The likelihood of a cure is highest when vaginal cancer is discovered in its early stages. Treatment for vaginal cancer that has spread outside of the vagina is more challenging.
Symptoms
Early vaginal cancer may not cause any signs and symptoms. As it progresses, vaginal cancer may cause signs and symptoms such as:
- Abnormal vaginal bleeding, such as after intercourse or after menopause
- Vaginal discharge that is watery
- Vaginal lump or mass
- Painful urination
- Urinary frequency
- Pelvic pain
- Constipation
If you experience any indications of vaginal cancer, such as unusual vaginal bleeding, consult your doctor.
Causes
The exact cause of vaginal cancer is unknown. Cancer typically starts when normal cells undergo a genetic mutation that transforms them into abnormal cells.
Healthy cells develop and proliferate at a specific rate before dying at a specific period. Cancer cells do not die; instead, they proliferate and reproduce uncontrollably. A tumor which is a mass of abnormal cells develop as they accumulate.
The tissues surrounding can be invaded by cancer cells after breaking off from the primary tumor and therefore causing a spread in the body to other organs (metastasize).
Risk factors
Vaginal cancer risk factors include the following:
- Increasing age. As you become older, your chance of vaginal cancer rises. The majority of vaginal cancer patients are over 60 years old.
- Having Vaginal Intraepithelial Neoplasia (VAIN). Your chance of developing vaginal cancer rises if you are given a diagnosis of vaginal intraepithelial neoplasia (VAIN).
Vaginal cells with VAIN resemble abnormal cells, but not abnormally enough to be classified as cancer. Vaginal cancer can occur in a tiny percentage of VAIN patients, while it’s unclear why some cases progress to malignancy while others remain benign.
The sexually transmitted human papillomavirus (HPV), which among other things can lead to cervical, vaginal, and vulvar malignancies, is a common cause of VAIN.
- Taking medication for prevent miscarriage. If your mother used the drug diethylstilbestrol (DES) while she was pregnant in the 1950s, you may be at a higher risk of developing clear cell adenocarcinoma, a specific type of vaginal cancer.
The following risk elements have also been connected to a higher risk of vaginal cancer:
- Smoking
- HIV infection
- Multiple sexual partners
- Sexual intercourse at an early age
Diagnosis
Screening for vaginal cancer
Sometimes vaginal cancer is discovered during a normal pelvic exam before symptoms and indications show up.
Your doctor will carefully examine your outer genitalia during the pelvic exam, put two fingers of one hand into your vagina, and push the other hand on your abdomen to feel your uterus and ovaries. Additionally, your doctor places a speculum inside of your vagina and examine your vagina and cervix for anomalies using the speculum, which opens your vaginal canal.
Your doctor may also do a pap smear test which is used to screen for cervical cancer but can also detect vaginal cancer.
The frequency of these screenings depends on your cancer risk factors and whether you’ve ever had an abnormal pap test.
Tests to diagnose vaginal cancer
To screen for anomalies that could be signs of vaginal cancer, your doctor might perform a pelvic examination and pap test. Your doctor may perform additional tests to see if you have vaginal cancer based on those findings, such as:
- Colposcopy. A colposcope, a specialized lighted magnifying device, is used during a colposcopy to examine your vagina, by magnifying the vaginal surface and check for any abnormal cell growth.
- Biopsy. The removal of a sample of questionable tissue for a biopsy is done to check for cancer cells. A tissue biopsy may be performed by your doctor during a colposcopy examination. The tissue sample is sent to a lab by your doctor for analysis.
Staging
Staging is the method used to identify the cancer’s extent when your doctor detects vaginal cancer to choose the best course of treatment and may suggest the following methods to ascertain the stage of your cancer:
- Imaging tests. To detect whether cancer has spread, your doctor could prescribe imaging tests. X-rays, Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) are examples of imaging examinations.
- Cystoscopy or proctoscopy Your doctor may be able to tell whether cancer has spread to specific places of your body through procedures that make use of tiny cameras to view inside your body. The bladder (cystoscopy) and rectum (proctoscopy) can be seen by the doctor through the cameras.
Treatment
Your vaginal cancer treatment depends on the type and stage of your disease. Based on your treatment objectives and your willingness to put up with side effects, you and your doctor decide together which treatments are best for you. Radiation and surgery are usually used as vaginal cancer treatments.
Surgery
The following surgical procedures could be used to treat vaginal cancer:
- Removal of small tumors or lesions. In order to ensure that all cancer cells have been eliminated, cancer that is localized to the surface of your vagina may be taken away along with a thin margin of surrounding healthy tissue.
- Vaginectomy. It might be necessary to remove your entire vagina or only a portion of it in order to completely remove the cancer. Depending on the severity of your cancer, your doctor may advise combining a vaginectomy with a hysterectomy to remove your uterus and ovaries, and with a lymphadenectomy to remove adjacent lymph nodes.
- Pelvic exenteration. If the disease has progressed to your pelvic region or if your vaginal cancer has recurred, this substantial surgery can be an option.
Many of the organs in your pelvic region, including your bladder, ovaries, uterus, vagina, rectum, and lower part of your colon, may be removed by the surgeon during pelvic exenteration. In order to allow urine (urostomy) and waste (colostomy) to leave the body and to be collected in ostomy bags, openings are made in the abdomen.
If the vagina is entirely removed, you may decide to have surgery to create a new vagina from scraps of skin, intestine, or muscle from other parts of your body. You can engage in vaginal sex with a reconstructed vagina with a few modifications. A recreated vagina, however, is not the same as your natural vagina. For instance, due to alterations in the surrounding nerves, a reconstructed vagina lacks natural lubrication and has a distinct sensation when touched.
Radiation therapy
High-powered energy beams, like X-rays, are used in radiation therapy to kill cancer cells. There are two ways to administer radiation:
- External radiation. Depending on the extent of your cancer, external beam radiation may target your entire abdomen or only your pelvis. You will lie down on a table during external beam radiotherapy, and a sizable radiation machine is moved around you to focus on the treatment area. External beam radiation is given to the majority of vaginal cancer patients.
- Internal radiation. Radioactive seeds, wires, cylinders, or other objects are inserted into your vagina or the tissue around it during internal radiation therapy (brachytherapy). The devices may be taken out after a specified amount of time. Very early-stage vaginal cancer patients might only get internal radiation. After receiving external radiation, others could absorb internal radiation.
Radiation therapy destroys cancer cells that are dividing quickly, but it also has the potential to cause side effects by damaging neighboring healthy cells. The intensity and direction of the radiation affect its side effects.
Chemotherapy
If radiation and surgery are unable to control your cancer, chemotherapy may be an option. Chemotherapy kills cancer cells by using chemicals and may or may not be effective in the treatment of vaginal cancer and it is typically not used alone to treat vaginal cancer due to this. To increase the effectiveness of radiation therapy, chemotherapy may be administered concurrently.
