Vaginal cancer

VAGINAL CANCER

Vaginal cancer is a rare form of cancer that develops in the vagina (the muscular canal connecting the cervix to the vulva). Vaginal cancer usually begins in the cells that line the vaginal canal, an area often called the birth canal.

Risk factors

Aging: The risk of vaginal cancer increases with age. The majority of women diagnosed with this form of cancer are over 60 years old.
Diagnosis of vaginal intraepithelial neoplasia (VAIN): Being diagnosed with VAIN increases the risk of vaginal cancer. The cells affected by VAIN are abnormal but not cancerous. However, even with a diagnosis of VAIN, the risk of developing vaginal cancer remains low. VAIN is frequently associated with exposure to the human papillomavirus (HPV), which can also cause vulvar and cervical cancers. It is recommended that you discuss with your doctor the vaccines available against certain strains of HPV.
Fetal exposure to diethylstilbestrol (DES): If your mother took DES, a drug used in the 1950s to prevent miscarriages, your risk of developing clear cell adenocarcinoma, a form of vaginal cancer, may be higher.

Screening

Vaginal cancer can be identified during a routine pelvic exam even before symptoms appear. During the exam, the doctor inspects the inside of the vagina while pressing on the lower abdomen to feel for pelvic organs. A Pap test, commonly used to detect cervical cancer, can also detect vaginal cancer. The frequency of screening depends on your risk factors and history of abnormal Pap tests.

Diagnosis

After screening tests, including a pelvic exam and Pap test, your doctor may perform the following procedures to diagnose vaginal cancer:

Thorough vaginal inspection: Using a colposcope, an instrument that magnifies and illuminates, the doctor closely examines the surface of your vagina to detect abnormal cells.
Biopsy: A sample of suspicious tissue is taken for laboratory analysis. This biopsy may be performed during colposcopy.

Treatment

Developing a treatment plan for vaginal cancer takes into account several factors, such as the stage of the cancer, other health problems you may have, and your personal preferences. Common treatment options include surgery and radiation therapy, which can be used alone or in combination. Additionally, other treatment approaches may be incorporated into your treatment plan based on specific needs.

Surgery

Different surgical procedures are used to treat vaginal cancer, such as:

Removal of small tumors or lesions: For early-stage cancer located on the surface of the vagina, the affected tissue along with a margin of healthy tissue may be surgically removed to ensure that no cancer cells remain.
Vaginectomy: In more advanced stages, part (partial vaginectomy) or all (radical vaginectomy) of the vagina may need to be removed. This procedure may also include removal of the uterus, ovaries (hysterectomy), and nearby lymph nodes.
Pelvic exenteration: For extensive disease in the pelvic area or recurrent vaginal cancer, this radical surgery may be necessary. It involves the removal of the bladder, ovaries, uterus, vagina, rectum, and part of the colon. This surgery usually requires the use of ostomy bags to collect waste after the operation. Reconstructive surgery may also be performed to create a new vagina, allowing sexual intercourse.

Radiotherapy

Radiation therapy uses high-intensity energy beams to target and kill cancer cells, and can be administered externally or internally:

External beam radiation therapy: Directs high-intensity energy beams to the pelvis or entire abdomen, often used to treat vaginal cancer.
Internal radiation therapy (brachytherapy): Involves the placement of radioactive materials directly inside the vagina or into adjacent tissues. This method is particularly suited to early-stage cancers, although it can also follow external radiation therapy in some treatment plans.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. The effectiveness of chemotherapy for vaginal cancer remains under study, so it is often used in conjunction with other treatments to increase effectiveness.

Supportive (palliative) care

Supportive or palliative care plays a crucial role in the overall treatment regimen, focusing on pain relief and providing support from a multidisciplinary team of healthcare professionals. Palliative care specialists collaborate closely with other healthcare providers to optimize quality of life and treatment outcomes for patients.

VAGINAL CANCER

Risk factors

Screening

Symptoms and signs

Diagnosis

Staging

Treatment