CONDITIONS
Vaginal Cancer
Vaginal Cancer
Growth of cancerous cells in the vagina is know as vaginal cancer. The vagina, also known as the birth canal, is a a muscular tube that connects the uterus with the outer genitals.
Vaginal cancer is a rare form of cancer making up less than 2% of gynecological cancers worldwide with a death of about 44.7% in developing countries like India compared to 15.4% percent in developed countries.
What are the symptoms of Vaginal Cancer?
Vaginal cancer often doesn’t cause symptoms because of which most vaginal cancers are detected at a late stage and it may be detected in a routine exam or Pap test.
Few symptoms may include:
- Unusual bleeding from your vagina
- Watery or bad-smelling discharge from your vagina
- Pain in your pelvis
- Pain when having sex
- Pain when peeing
- Peeing more than usual
- Constipation
- A lump in your vagina
The presence of these symptoms is not sure shot indication of vaginal cancer; it could be an infection. It is important to consult a doctor in any case.
What are the causes of Vaginal Cancer?
Vaginal cancer begins when cells in the vagina develop changes in their DNA (fundamental cells giving instructions to grow). In rare cases, this change in the DNA is said to occur owing to a virus known as human papillomavirus (HPV) leading to cancer of the vagina.
The other factors that may increase the risk of vaginal cancer are:
- Increasing age: Generally vaginal cancer occurs in older adults.
- Exposure to human papillomavirus (HPV): A virus often passed through sexual contact, HPV may cause many types of cancer, including vaginal cancer.
- Smoking
- Ingestion of certain medicines: Exposure to miscarriage prevention medicine such as diethylstilbestrol (DES), especially in pregnancy may increase the risk of vaginal cancer. might be increased. Diethylstilbestrol is linked to a type of vaginal cancer called clear cell adenocarcinoma.
Can vaginal cancer be prevented?
- Getting regular pelvic exams and PAP tests generally conducted for cervical cancer
- Getting the HPV vaccine may protect against the strains of the virus that are thought to cause most cases of vaginal cancer. There are vaccines available to protect against most common types of HPV and is usually meant for people ages 9 to 45.
- Certain lifestyle changes may also reduce vaginal cancer risk:
- Withholding sex until late teen years or beyond.
- Not having sex with more than one partner.
- Not having sex with someone who has multiple partners.
- Using condoms during sex.
- Quit smoking. If a person doesn’t smoke, then they should not start.
How is vaginal cancer diagnosed?
A pelvic exam or a Pap test is usually conducted by the doctor and if the results of these show signs of problem, the doctor suggests for a colposcopy. Colposcopy is a procedure that is done by using a lighted magnifying tool to check the vagina and cervix for anything unusual.
Taking out a tissue from the vagina (biopsy) and sending it to the lab to confirm cancer is also done to confirm the cancer.
What are the stages of vaginal cancer?
If the tests detect signs of cancer, the doctor will check the size of the tumour and if it has spread (staging). Staging indicates the likelihood of cancer cure and helps the doctors to create a treatment regimen.
Stage I: Cancer is present only in the vaginal wall
Stage II: Cancer moved to nearby tissues around the vagina.
Stage III: Cancer has spread to the wall of the pelvis.
Stage IVa: Cancer has spread to the lining of bladder, rectum, or another area of the pelvis.
Stage IVb: Cancer has spread to farther parts of your body like your lungs or bones.
Imagine tests like MRI, X-rays, CT, or positron emission tomography, also called PET are conducted to confirm the stages of cancer. Alternatively, tiny cameras are inserted inside the body to determine the spread of cancer to certain areas.
What are the treatment options for vaginal cancer?
Treatment options are based on multiple things such as the closeness of cancer to other organs, its stage, previous radiation treatment in the pelvic area, and if a person has undergone hysterectomy (removal of the uterus).
One or more the following treatment are recommended:
Radiation therapy: The main treatment in vaginal cancer is radiation therapy. Killing cancer cells by using high-powered energy beams, such as X-rays and protons is known as radiation therapy. A machine beaming rays into the body may be used. Radiotherapy for vaginal cancer can either be given from outside the body or inside (brachytherapy).
Most vaginal cancers are treated with a combination of radiation therapy and low-dose chemotherapy medicines.
Surgery: This treatment is only used on vaginal cancers that detected early or if radiation therapy is unsuccessful. The types of surgery are:
- Removal of the vagina (Vaginectomy) – for small vaginal cancers that are not around important parts.
- Removal of multiple pelvic organs – in case of cancer recurrence
- A doctor may remove the bladder, ovaries, uterus, vagina and rectum.
Vaginal reconstruction: In case the vagina is completely removed, vaginal reconstruction surgery is an option where a new vagina is created by using that person’s skin and muscles. Consult the doctor and understand.
Other treatment options
Chemotherapy: A drug treatment typically using chemicals to kill cancer cells, usually administered vias a vein in your arm or by mouth. Generally used in combination for treatment in vaginal cancers.
References
- Vali M, Maleki Z, Jahani MA, Hajizade-Valokolaee M, Hashemi SN, Sedighi S, Ghelichi-Ghojogh M, Hassanipour S, Solati A, Javanian M, Nikbakht HA. Survival rate of vaginal cancer in Asian countries: a systematic review and meta-analysis. Ann Med Surg (Lond). 2023 Oct 2;85(11):5577-5583.
- Martin L. Vaginal Cancer. December 2023. WebMD. https://www.webmd.com/cancer/what-is-vaginal-cancer
- Vaginal cancer. Mayo Clinic. December 2023. https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20352447
- Vaginal Cancer. December 2023. NHS UK. https://www.nhs.uk/conditions/vaginal-cancer/
