Vaginal Cancer

What is Vaginal Cancer ?

Vaginal cancer is one of the rare kind of cancer in women, accounting for around two per cent of cases. Women aged over 50 years are most commonly affected. The vagina is part of the female reproductive system. This muscular canal is around 7.5cm long and extends from the neck of the uterus (cervix) to the external genitals (vulva).

Many cancers involving the vagina have actually spread from adjacent tissues, usually from the uterus (womb) or cervix (neck of the womb).

There are many different types of cancer of the vagina: squamous cell cancer (squamous carcinoma), adenocarcinoma, malignant melanomas, and sarcomas.

About 95 per cent of cancers that start in the vagina are squamous cell carcinomas, which means the cancer originated from the skin cells.

Causes of Vaginal Cancer

It is not known exactly what causes primary vaginal cancer. However, women whose mothers took the hormonal drug diethylstilbestrol (DES) during pregnancy to boost oestrogen levels (to prevent miscarriage) are at higher risk of developing a rare type of vaginal cancer called clear cell carcinoma. Only 1 in 1000 women whose mothers took DES go on to develop cancer of the vagina.

There may also be a link between human papilloma viruses (HPV) and all cancers of the reproductive organs, including the vagina. HPV can be transmitted through sexual contact.

Signs & Symptoms of Vaginal Cancer

Some vaginal cancers have no symptoms in their early stages, and only cause symptoms once they have invaded other parts of the body. They may be found through an abnormal pap smear. Some of the symptoms of vaginal cancer can include:

• Painless vaginal bleeding that’s not associated with menstruation
• Bleeding after sexual intercourse
• Constipation
• Smelly vaginal discharge
• Pain or difficult urination
• Constant pelvic pain.
• Mass that can be felt

Please keep in mind that these symptoms are also symptoms of many other illnesses. Please see a healthcare provider if you are experiencing any of these symptoms or anything that is abnormal for you.

Diagnostic Tests

Your doctor will ask about your symptoms and medical history, and perform a physical exam, including a pelvic exam. You may be referred to a doctor who specializes in women’s health (a gynecologist).

Tests may include:

• Biopsy — removal of a sample of vaginal tissue for testing
• Pap test (also called Pap smear) - test that involves microscopic examination of cells collected from the cervix, used to detect changes that may be cancer or may lead to cancer, and to show noncancerous conditions, such as infection or inflammation.
• Colposcopy: The doctor inserts an instrument with binocular magnifying lenses into the vagina and checks the vaginal walls and cervix.

Treatment

• Surgery to remove a part or the whole of the vagina is usually necessary. Technically, it can be a complicated operation for the surgeon because the vagina lies so close to the bladder at the front, and the bowel at the back.
• Internal radiation therapy (brachytherapy) - radioactive material is surgically implanted into the tumour or nearby.
• Chemotherapy is the use of drugs to kill cancer cells.

Prevention Tips

No certain preventative measures are known.

While a Pap smear is an effective screening tool for cervical cancer, it cannot be relied upon to detect vaginal cancer. However, regular gynecologic examinations may reduce the mortality from vaginal cancer by providing your physician with the opportunity to detect it earlier rather than later. Moreover, informing your physician that you may have been exposed to DES in the womb should induce him or her to provide even closer surveillance.