Stages

If vaginal cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

The Spreading of Cancer

There are three ways that cancer spreads in the body:

Through tissue.
Cancer invades the surrounding normal tissue.

Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.

Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, another, or secondary tumor, may form. This process is called metastasis. The secondary, or metastatic, tumor is the same type of cancer as the primary tumor. For example, if vaginal cancer spreads to the bones, the cancer cells in the bones are actually vaginal cancer cells. The disease is metastatic vaginal cancer, not bone cancer. 

Stages of Vaginal Cancer 

Stage 0 (Carcinoma in Situ):
In stage 0, abnormal cells are found in tissue lining the inside of the vagina. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I - In this stage, cancer has formed and is found in the vagina only.

Stage II - In this stage, cancer has spread from the vagina to the tissue around the vagina.

Stage III - In this stage, cancer has spread from the vagina to the lymph nodes in the pelvis or groin, or to the pelvis, or to both.

Stage IV - This stage is divided into stage IVA and stage IVB:

Stage IVA: Cancer may have spread to lymph nodes in the pelvis or groin and has spread to one or both of the lining of the bladder or rectum, or, beyond the pelvis.

Stage IVB: Cancer has spread to parts of the body that are not near the vagina, such as the lungs. Cancer may also have spread to the lymph nodes.

Knowing the stage assists the doctor in determining a prognosis. It also better helps you understand the care and treatment that will be required. Generally, treatment for the different stages are as follows:

Stage 0 (Carcinoma in Situ) - Treatment of stage 0 may be one of the following:
Wide Local Excision (with or without a skin graft)
Partial or total vaginectomy ( with or without a skin graft)
Topical Chemotherapy
Laser Surgery
Internal Radiation Therapy

Stage I - Treatment of stage I squamous cell vaginal cancer may include the following:

Internal Radiation Therapy (with or without external radiation therapy to lymph nodes or large tumors
Wide local excision or vaginectomy with vaginal reconstruction. Radiation therapy may be given after surgery.
Vaginectomy and lymph node dissection (with or without vaginal reconstruction) Radiation therapy may be given after the surgery.

Treatment of stage I vaginal adenocarcinoma may include the following:

Vaginectomy, hysterectomy and lymph node dissection. This may be followed by vaginal reconstruction and/or radiation therapy
Internal Radiation Therapy (with or without external radiation therapy to lymph nodes)
A combination of therapies that may include wide local excision (with or without lymph node dissection and internal radiation therapy)

Stage II - Treatment of stage II vaginal cancer is the same for squamous cell cancer and adenocarcinoma. Treatment may include the following:

Both internal and external radiation therapy to the vagina (with or without external radiation therapy to lymph nodes)
Vaginectomy or pelvic exenteration (with or without radiation therapy)

Stage III - Treatment of stage III vaginal cancer is the same for squamous cell cancer and adenocarcinoma. Treatment may include both internal and external radiation therapy (with or without surgery.)

Stage IV - Treatments may be divided into stage IVA and IVB:

Stage IVA: Treatment of stage IVA vaginal cancer is the same for squamous cell cancer and adenocarcinoma. Treatment may include both internal and external radiation therapy (with or without surgery.)

Stage IVB: Treatment of stage IVB vaginal cancer is the same for squamous cell cancer and adenocarcinoma. Treatment may include the following:

Radiation Therapy as palliative therapy to relive symptoms and improve quality of life. Chemotherapy may also be given.

In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique.

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