Vaginal cancer

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.