Cancer Of The Vagina
Easy Guide To: Symptoms, Causes, Treatment And Prognosis

Vaginal Cancer


Cancer Of The Vagina


What Is Vaginal Cancer?
How Common Is It?
Are There Different Types?
What Are The Causes?
What Are The Symptoms?
How Is It Diagnosed?
How Is It Treated?
What Happens After Treatment?
How Likely Is A Recurrence?
Can Vaginal Cancer Be Prevented?
What Is The Survival Rate?
What Is Benign Vaginal Disease?


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Cervical Cancer
Endometrial Cancer
Ovarian Cancer
Fallopian Tube Cancer
Vulva Cancer

In This Section:

Survival Rates
Remission And Cure
Prevention Advice
Thermography Screening

Related Articles:

Female Reproductive System

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.

How Common Is It?

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.

Are There Different Types?

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.

What Are The Causes?

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:

Fluid Collection
Collection of fluid in the upper part of the vagina irritates it, eventually leading to cancer.

Exposure to the hormone DES (diethylstilbestrol) while still in the mother's womb. The drug was given to some women in the 1950s to prevent miscarriage. One in every 1,000 women born with DES exposure will develop adenocarcinoma, usually between the age of 17 and 21.

Women with a past history of the following may also be prone:

1. Trauma to the vagina.
2. Syphilis.
3. Vaginal warts.
4. Frequent episodes of vaginitis.
5. Prolapse of the vaginal wall.
6. Human papilloma virus (HPV infection).
7. Cervical cancer or a history of abnormal cell growth in the cervix.
8. Radiotherapy to the pelvic area. This is a very rare complication of radiotherapy. See also: General cancer causes for an overview.

What Are The Symptoms?

Symptoms of vaginal cancer: Very often there are no signs and cancer may only be discovered during a regular Pap test. The following are a list of symptoms which may occur (one or more occur in 80 percent of cases), but they can also indicate other conditions:

1. A lump which can be felt in the vagina.
2. Bleeding or other discharges between menstrual periods. Discharges may be foul smelling.
3. Painful intercourse.
4. Pelvic pain.
5. The need to strain with bowel movements (tenesmus).
6. The need to urinate more frequently, particularly at night. There may also be blood in the urine and pain when passing.

How Is It Diagnosed?

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.

How Is It Treated?

Vaginal cancer treatment can include any of the following options:

• Surgery.
Radiation Treatment.
Chemotherapy Treatment.
• Participation in cancer clinical trials.

Traditionally surgery is the most common choice of treatment for women with cancer of the vagina. Choices range from minimally invasive to complicated, extensive operations. These procedures include:

Laser Surgery
This uses a laser beam instead of a knife to destroy cancer cells. This is an option for stage 0.

Wide Local Excision
This cuts out the cancer and a safe margin of healthy tissue around it. Skin grafts may be needed to repair the vagina. Vaginectomy
This surgery removes the entire vagina. It is often combined with a radical hysterectomy and is only performed when cancer has spread outside of the vagina. Pelvis lymph nodes are also likely to be removed.

Pelvic Exenteration
This is a very serious radical procedure which removes the uterus, vagina, rectum, bladder and lower colon. As 10 percent of patients die during or immediately after surgery it is usually only considered as a last resort. It may be considered in cases of recurrent vaginal cancer.

Radiation Therapy
Some women may only be offered radiation while others will be recommended surgery combined with radiation. There are 2 ways of giving radiation for vaginal cancer. The first is external radiation where the beam is aimed directly as the affected spot. Internal radiation (brachytherapy) involves inserting radioactive device into the vagina for a set number of days. Brachytherapy can be given to women with very early stages of the disease or it may also be given as a follow-up treatment to external radiation.

If surgery or radiation cannot control the cancer, chemotherapy drugs may be offered. As it is not clear whether chemo has much affect on vaginal cancer, it is rarely given as a treatment on its own. It may be used in combination with radiation to enhance the overall effect.

Clinical Trials
Cancer clinical trials experiment with new methods of treatment which are not yet standard or available to non-participating patients. To see which trials are open for vaginal cancer near you, contact the American Cancer Society or the National Cancer Institute.

What Happens After Treatment?

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.

How Likely Is A Recurrence?

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.

Can Vaginal Cancer Be Prevented?

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.

What Is The Survival Rate?

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:
Stage 1
: 84 percent
Stage 2: 75 percent
Stage 3 and 4: 57 percent

For more information see: vaginal cancer survival rates as well as vaginal cancer stages.

What Is Benign Vaginal Disease?

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.

Most of the time women with VAIN experience no symptoms except light spotting after sexual intercourse. It is usually discovered through a routine Pap test. A vaginal colposcopy and biopsy will establish a definite diagnosis. The standard treatment is surgical removal. If only a minor area is affected the biopsy might also be considered a cure. If several areas are affected part or the entire vagina may need to be removed. Laser surgery has become accepted as another form of treatment and is usually carried out under general anesthesia. One treatment is all that is usually necessary and recovery takes about 4 to 6 weeks.

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