Cancer Of The Vagina
• What Is Vaginal Cancer?
|What Is Vaginal Cancer?
It is cancer which forms in the tissue of the vagina. The vagina is a muscular tube which connects the entrance of the body (vulva) to the the opening of the womb (cervix)(image). It is the passageway for fluids to enter the body (sperm) and to leave the body (menstrual blood). The wall of the vagina is elastic enough to expand so that a baby can pass down it during a vaginal birth.
Cancer of the vagina is very rare and accounts for less than 2 percent of all gynecologic (female) cancers in America. In 2011 there were just over 2,500 new cases and 780 deaths attributed to the disease. In the United Kingdom the figure is 250 new cases a year and about 80 deaths. If cancer is to occur in the reproductive area, it is much more likely to occur first in the cervix or vulva and only then to spread to the vagina. Sometimes cancers which start in the bladder, ovaries, uterus and rectum spread to the vagina.
Yes, there are 2 main types. Nearly 85 percent of cases are known as squamous cell carcinoma and this is more common in women over the age of 60. The squamous cells are thin flat cells which occur naturally in the lining of the vaginal wall. Cancer which starts here spreads slowly and usually stays in the vagina. When discovered early it is highly curable - if not found early, it can spread to the liver and lungs. The other type of cancer is adenocarcinoma which accounts for nearly all the remaining cases. It most often found in women under 30 and is more likely to spread to other organs. The other extremely rare types of vaginal cancer are malignant melanoma and sarcoma.
Causes of vaginal cancer: Scientists still do not know the true cause of primary vaginal cancer (cancer that starts in the vagina), specifically they do not know what causes squamous cell carcinoma. As vaginal cancer is so rare there is little information on possible risk factors. However experts believe the following factors may play a role:
Women with a past history of the following may also be prone:
What Are The Symptoms?
1. A lump which can be felt in the vagina.
The initial diagnosis will be made through a pelvic exam and Pap test. If cancer is suspected the next step is to learn about the type and location of the cancer as well how far it has progressed. This will determine the type of treatment plan put in place. Further diagnostic tests such as a biopsy and colposcopy will define the extent of the cancer. Other tests such as an intravenous pyelogram (IVP), X-ray, proctosigmoidoscopy (to view the rectum) and cystoscopy (to view the bladder) may also be ordered. Lymph nodes in the groin area will also be checked for signs of cancer by a lymphangiogram, but more frequently these days by an MRI scan. See vaginal cancer diagnosis for a further explanation.
Vaginal cancer treatment can include any of the following options:
After therapy your doctor will want to monitor you very closely. Follow up visits will include pelvic exams and pap tests. There may also be some X-rays and lab tests to check for signs of recurrences or side effects to cancer treatments. Almost all treatments, including radiation and surgery will have side effects. Some will last for a few months, others may last a lifetime. The vaginal tissue is likely to be delicate and prone to injury, scarring or tightening. This is why some women are advised to use vaginal dilators. These are smooth cylinder shaped pieces of plastic which are inserted (in the privacy of your own home) into the vagina and gradually help to stretch the vaginal muscles. Typically they are bought as a set and the woman works her way up, gradually increasing the size of cylinder she inserts. Once cancer has occurred it is very important to ensure you keep your health insurance in place. Although no one likes to think of it, a recurrence is always possible.
If cancer returns after treatment this is known as a recurrence. It may be that the cancer was resilient to the treatment or that the therapy missed some cancerous cells which remained behind. If it comes back in the same place it is known as a local recurrence. If it comes back in a distant organ such as the lungs it is known as a distant recurrence. Unfortunately the prognosis (outlook) for women with vaginal cancer recurrence is not good. According to the National Cancer Institute (NCI), studies indicate that only 10 percent of women with recurrences are saved by surgery or radiation. Most recurrences occur in the first 2 years after original treatment. If the cancer returns in the central pelvic area then radiation therapy and pelvic exenteration present the best chance of survival. Women with recurrences may be advised by their doctor to take part in NCI trials for recurrent vaginal cancer. Those trials can be listed according to location, drugs used and type of medical intervention.
Without knowing the exact cause of vaginal cancer, preventative care is aimed at spotting it early, rather than prevention (vaginal cancer prevention). The best way to do this is to have regular Pap smear tests. This still also applies to women who have had a hysterectomy. As vaginal cancer grows slowly a pap test every 2 to 3 years is considered acceptable. If you have more risk factors, such as exposure to DES or HPV then you should be screened more often. Women who are sexually active with multiple partners should consider getting the HPV Gardasil vaccine. Originally approved for women to prevent cervical cancer it has now been approved to prevent vaginal and vulva cancer as well as their precancerous conditions. Other HPV vaccines are still in development. See also: cancer prevention.
The following is a list of the 5 year survival rates for women who live at least 5 years after vaginal cancer is diagnosed. It is important to note that many go on to live much longer than 5 years and many are in fact cured. The numbers are based on the National Cancer Institute's SEER database. They take into account all types of vaginal cancer diagnosed between 1990 and 2004. They predict how a large number of people will react to a disease; they do not predict the outlook for each individual. Other factors may affect your personal prognosis such as your age, general health and reaction to individual treatments.
5 Year Survival Rates:
Benign vaginal disease is also called vaginal carcinoma in situ or vaginal intraepithelial neoplasia (VAIN). VAIN is considered a precancerous condition, rather like endometrial hyperplasia or vulva intraepithelial neoplasia. There are 3 types of VAIN: VAIN1, 2 and 3. VAIN3 indicates the furthest progression to real cancer. VAIN is more common in women who have had a hysterectomy and those that were previously treated for cervical cancer or cervical intraepithelial neoplasia (CIN), the precancerous stage.
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Recommended Health Screenings For Women: Tests for every decade.
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