Treatment

Different types of treatment are available for patients with vaginal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. (A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer)

Your treatment options depend on the stage of cancer, your overall health and your preferences about treatment. In metastatic disease, the location and extent of the vaginal cancer is also an important consideration. In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique.

You do not have to rush to make a decision, so consider the options carefully. Ask questions if you do not understand any aspect of treatment or the terms your doctors are using. Research shows that cancer survivors of all educational levels and backgrounds can have a hard time communicating with their health care team. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.

A treatment plan is a way to deal with both the short and long term goals of managing your cancer. There are several treatment options for vaginal cancer, depending on the cancer stage and the patient’s age and general health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.

Standard Treatments for Vaginal Cancer

Surgery
Surgery is the most common treatment of vaginal cancer. There are several types of surgery available. Following are most commonly used:

Laser Surgery - A surgical procedure that uses a laser beam(a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor. However, this is not a treatment for invasive cancer. For laser surgery to be an option, the doctor must be certain that the worst lesion was biopsied and that invasive cancer is not a concern.

Wide Local Excision - A procedure that takes out the cancer and some of the healthy tissue around it.

Vaginectomy - Surgery to remove all or part of the vagina.

Total Hysterectomy - Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.

Lymph Node Dissection - A surgical procedure in which lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy. If the cancer is in the upper vagina, the pelvic lymph nodes may be removed. If the cancer is in the lower vagina, lymph nodes in the groin may be removed.

Pelvic Exenteration - Surgery to remove the lower colon, rectum and bladder. In women, the cervix, vagina, ovaries and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.

Radiation Therapy
Radiation Therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Topical chemotherapy for squamous cell vaginal cancer may be applied to the vagina in a cream or lotion.

New types of treatment are being tested in clinical trials, such as radiosensitizers. These are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. 

Social networking and online support groups are important tools. Reaching out to others who have or have had similar experiences can provide you with valuable insights. Check out Cancer Support Community's The Living Room for more information on clinically facilitated support online. 

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