What is Vaginal Cancer?
Vaginal cancer is not common. When found in early stages, it can often be cured. There are two main types of vaginal cancer:
Squamous Cell Carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the vagina. This cancer spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer and is found most often in women aged 60 or older.
Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the vagina make and release fluids such as mucus. Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes and is found most often in women aged 30 or younger.
Research is increasing regarding what we know about vaginal cancer. Scientists are learning more about its causes. Following are common risk factors for the disease:
Age and exposure to the drug DES (Diethylstilbestrol) before birth affect a woman’s risk of developing vaginal cancer.
Additional risk factors for vaginal cancer include the following:
- Age - Being aged 60 or older
- Human Papillomavirus - Being infected with HPV
- Personal history of cervical pre cancer or cancer changes - Having a history of abnormal cells in the cervix or cervical cancer.
Signs and Symptoms
Vaginal cancer often does not cause early symptoms and may be found during a routine Pap Test. When symptoms occur they may be caused by vaginal cancer or by other conditions. A doctor should be consulted if any of the following problems occur:
- Pain or abnormal vaginal bleeding
- Bleeding or discharge not related to menstrual periods
- Pain during sexual intercourse
- Pain in the pelvic area
- A lump in the vagina
If a patient has symptoms that could be vaginal cancer, the doctor will test for fever and high blood pressure and check general signs of health. The patient will likely have one or more of the following tests:
A biopsy may be done to find out if cancer has spread to the cervix. A sample of tissue is cut from the cervix and viewed under a microscope. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office. A woman may need to go to a hospital for a cone biopsy (removal of a larger, cone-shaped piece of tissue from the cervix and cervical canal). A biopsy of the vulva may also be done to see if cancer has spread there.
An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are then checked under a microscope for signs of cancer.
A procedure to look inside the ureters to check for abnormal areas. A ureteroscope is inserted through the bladder and into the ureters. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. A ureteroscopy and cystoscopy may be done during the same procedure.
A procedure to look inside the rectum to check for abnormal areas. A proctoscope is inserted through the rectum. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. CT Scan (CAT Scan) - A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
An imaging study that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). A dye may be injected into the veins to help organs or tissues show up more clearly.
A procedure used to x-ray the lymph system. A dye is injected into the lymph vessels in the feet. The dye travels upward through the lymph nodes and lymph vessels and x-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes.
CT Scan (CAT Scan)
An imaging study that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Treatment will depend on the size, location and how deep the tumor is in the skin, as well as if it has spread elsewhere.
In the majority of cases, early-stage (when the cancer is small and it has not spread outside of the vagina) vaginal cancer is treated using local surgery and/or medications applied to the skin (called topical therapies). More advanced-stage vaginal cancers require treatment with radiation therapy and/or chemotherapy.
Treatments usually include:
SCC can invade nearby tissue. If this happens, surgery to remove the cancer is not enough to keep the cancer from returning. Treatment for SCC that has spread usually involves radiation and chemotherapy and not surgery.
Early-stage vaginal cancer (when the tumor is small and it has not spread outside of the vagina) can be treated with surgery. This surgery includes a radical hysterectomy (removal of the uterus, cervix, at least part of the vagina, and pelvic lymph nodes.
Radiation therapy uses high-energy x-rays to target and kill cancer cells. Radiation therapy is used when the vaginal cancer has spread outside the vagina to nearby organs or the cancer cannot be removed in its entirety with surgery alone.
For SCC that has spread (metastasized), systemic therapy can be considered which includes chemotherapy, targeted therapy, and clinical trials. For organ transplant patients who have many SCCs, transplant physicians can consider adjusting the immunosuppressive treatment if appropriate.
Medications that kill the cancer and are given through the vein. This treatment is used when the cancer has spread outside the vagina.