Vaginal Cancer

Vaginal cancer is when cancerous cells grow in the vagina.  Vaginal cancer can be difficult to diagnose sometimes that’s because cancer can originate in other organs and then it spreads to cancer mimicking as vaginal cancer. When cancer arises primarily from the vagina it is known as primary vaginal cancer and if cancer has spread to the vagina from other organs then it is known as metastatic vaginal cancer.

Where is vagina situated?

A woman’s vagina is sometimes called a birth canal, this canal is a tubular structure that goes from the opening of her uterus to the outside of her body. 

What are the causes?

In some cases of vaginal cancer, the cause is not clear. But most of the vaginal cancers are linked to infection with the human papillomavirus (HPV). There are many strains of HPV viruses but in particular HPV 16 and HPV 18, are found in over 99 percent of vaginal cancers. This is a common infection seen in most sexually active women. This infection gets cleared on its own and doesn’t require any treatment. Sometimes this virus doesn’t clear from your body and can stay for a long duration of time and causes changes in the vagina and can eventually lead to vaginal cancer. This HPV virus also causes cervical, vulval, anal, and head & neck cancers.

You are at risk of getting vaginal cancer if you:

  • Are 60 years or older

  • If you have been exposed to DES while you were still in your mother's womb

  • Drink alcohol  

  • Have a past history of cervical cancer or precancerous lesions   

  • Have sexually transmitted infections such as HIV  

  • Smoke 

  • Have precancerous cells in your vagina called vaginal intraepithelial neoplasia

What are the symptoms?

Early-stage vaginal cancer may not manifest itself with any symptoms. However, as it develops further, there may be signs and symptoms like:

  • Bleeding between periods

  • Bleeding after intercourse or after menopause

  • The watery discharge could be foul-smelling

  • Pelvic pain

  • A lump in the vagina

  • Frequent and painful urination

What test will be required for diagnosis?

1.  To confirm the diagnosis

The doctor will usually do a vaginal examination (internal examination) if you have symptoms that may possibly be like cancer.

2.  Assessing the extent and spread

Further tests may be advised to assess if cancer has spread to other organs such as an ultrasound scan, a CT scan, PET CT an MRI scan, a chest X-ray, and blood tests.

What are the treatment options?

Surgery:

Surgery will be offered depending on your stage.

  • Partial vaginectomy – removing only the part of the vagina

  • Radical vaginectomy – removing the whole vagina and pelvic lymph nodes, with or without reconstruction of the vagina

  • Radical vaginectomy and radical hysterectomy – removing the whole of the vagina, womb, neck of the womb, ovaries, fallopian tubes, and pelvic lymph nodes

  • Pelvic exenteration – removing the whole of the vagina and surrounding tissue, including the bladder and/or rectum (motion passing passage).

In some cases, radiation and or chemotherapy may be required, depending on your stage.

Chemotherapy:

  • In chemotherapy, treatment drugs are used to kill or slow the growth of cancerous cells. It’s usually given through an IV injection.

  • You will be told that you need chemo with radiation; this type of treatment is called chemoradiation.

       Adding chemo during radiation makes the radiation to be more effective. You might also get only chemotherapy treatment if your cancer has spread to other organs.

Radiation Therapy:

Radiation is a machine, which uses high-energy X-rays to kill cancer cells and stop their growth.

There are two ways of having radiation treatments:

  • Brachytherapy: Radiation is given through your vagina.

  • External beam radiation therapy: Radiation is given from above your tummy.

Follow-up after treatment
  • You should strictly go for follow-up with your doctor as per their advice.

  • In addition to receiving treatment for vaginal cancer, your success in treatment will depend only on when you have a regular follow-up.

Prevention of vaginal cancer

Since vaginal cancer is also caused by Human Papillomavirus (HPV) protection from this infection is important, including HPV vaccination, to reduce the risk of vaginal cancer. During your annual visit, an examination of the vagina for any changes can lead to the detection of preinvasive disease or early vaginal cancer.

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