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Vaginal Cancer

Vaginal cancer is a type of gynecologic cancer in which malignant cells develop in the vagina. It's a rare form of cancer that commonly found in women over 50 years old. The survival rate varies depending on multiple factors, including the disease stage at the time of diagnosis. As with most types of cancer, it's advisable to keep an eye for physical symptoms and do regular gynecologic exams every year to detect any anomalies as early as possible. 

In the sections below, you can learn more about vaginal cancer, including:

Signs & Symptoms of Vaginal Cancer

Vaginal cancer doesn't usually display early symptoms. Most people find out about it during a pelvic exam or Pap test. Symptoms accompanying vaginal cancer are often confused with those of other conditions. Having said that, if you experience one of the below symptoms, consider seeking advice from a doctor:

  • Vaginal bleeding not during menstruation
  • Pain while urinating
  • Unexplained pain in the pelvic area
  • Pain during sexual intercourse
  • A lump in the vaginal area

Risk Factors & Prevention of Vaginal Cancer

Most vaginal cancers are caused by certain types of human papillomavirus (HPV). However, studies have shown that your risk for vaginal cancer increases depending on a combination of factors. This doesn't mean that not having any risk factors doesn't mean it won't happen to you. Research has shown that regular gynecologic exams can help vaginal cancer, along with other types of gynecologic cancers, to be detected early.

People are placed in a high-risk group for vaginal cancer if they have the following characteristics:

  • They have human papillomavirus (HPV) infection.
  • They are over 50 years old. 80% of all vaginal cancer patients are over 50 years old.
  • They were exposed to the Diethylstilbestrol drug while in their mother's womb. DES drug was used to prevent miscarriage in the 1950s.
  • They smoke or have a history of smoking.
  • They have previous radiation exposure to the pelvic area.

The FDA approves the HPV vaccine Gardasil for vaginal cancer prevention. 

Apart from the Gardasil vaccine, there are certain habits you can follow to lower the risk of getting vaginal cancer:

  • Practice safe sex and delay sexual intercourse until late teens or older.
  • Get regular Pap tests
  • Avoid smoking
  • Avoid having sex with multiple partners

Detecting & Diagnosing Vaginal Cancer

Your doctor may use many tests to detect or diagnose vaginal cancer. The most common way vaginal cancer is detected is through a Pap test, or pap swear. During a pap smear, a piece of cotton or a small wooden stick is used to collect cells in the vagina and cervix area. These cells are then analyzed under a microscope for abnormality. 

Before a Pap test, your doctor will collect information about your health history and carry out a pelvic exam. During a pelvic exam, your doctor or nurse will inspect your uterus, vagina, rectum, ovaries, and cervix to check for abnormalities such as lumps.

In addition to Pap tests and pelvic exams, your doctors may also use the following tests for diagnosis:

  • Human papillomavirus (HPV) test: This test can be done using the cells collected during a Pap test. The cervical cells are collected, and their DNA structures are analyzed to determine if an HPV infection is present.
  • Colposcopy: A diagnostic procedure in which a device called a colposcope is used to carefully examine the vagina, vulva, and cervix for signs of cancer. Your oncologist may recommend this procedure if your Pap test shows abnormal results.  
  • Biopsy: If the Pap test result shows anything suspicious, a biopsy can be carried out during a colposcopy to collect tissues from the cervix and vagina for later analysis under a microscope. If the gynecologist suspects cancer, they may request further images to be done, such as an MRI or a PET scan to find out if cancer has spread beyond the vagina.

Vaginal Cancer Staging 

Staging is the process to find out if cancer has spread within the vagina or to other parts of the body. From the information gathered, the gynecologic oncologist can determine the current stage of the disease and come up with an appropriate cancer treatment plan. The following is one way of determining the stage and, therefore, the types of treatment needed.

  • Stage I: This is the initial stage in which cancer is found within the vaginal wall.
  • Stage II: In this stage, cancer has spread through the vaginal wall to the tissues around the vagina.
  • Stage III: Cancer has spread to the wall of the pelvis.
  • Stage IV: This stage is further divided into two sub-stages:
    • Stage IVA: Cancer has spread to one or more of the surrounding areas: the uterus, ovaries, cervix, bladder, or the lining of the rectum.
    • Stage IVB: Cancer has spread to other parts of the body, such as the bone or lung. 

Types of Treatment for Vaginal Cancer

Your choice of treatment options may depend on the stage and type of cancer, your current health condition, and your care goals. Currently, three standard treatment methods are being used to treat vaginal cancer patients:

Surgery

Surgery is used to remove all cancer that can be seen from the vagina. Depending on the severity of the condition, patients may undergo surgeries that remove only the affected tissues or have their uterus, ovaries, and vagina removed entirely.

Radiation Therapy

During radiation therapy, high energy x-rays are used to kill cancerous cells or prevent them from growing. If needed, the gynecologic oncologist will usually recommend a combination of external beam radiation and brachytherapy.

  • External radiation therapy: A machine is used outside the body to send radiation to the intended area.
  • Internal radiation therapy involves placing hollow tubes in the vagina next to the tumor so that a precise dose of radiation can be inserted into the tubes and directly applied to the cancer. The radioactive substance is left in place in the vagina for several minutes, and patients must stay in bed during this time. These are most often done as outpatient procedures.

Chemotherapy

In chemotherapy, drugs are used to stop the growth of cancer. Chemo is often given to vaginal cancer patients, along with radiation after surgery is complete. Depending on the type and stage of cancer, either systemic or regional chemotherapy, will be administered. Regional chemotherapy affects only the infected areas. Systemic chemotherapy is often injected into the muscle or taken orally. This way, the drug enters the bloodstream and works its effect on cancer cells throughout the body. 

Vaginal cancer can come back to the vagina or other parts of the body after it has been treated; therefore, it's important to carry out regular follow-up tests after cancer treatments conclude.