Vaginal cancer, a rare type of cancer, accounts for around 1 % of female genital cancers. Read about the symptoms, causes, diagnosis, and treatment options here.
Rare cancer that originates in the vagina, the tube made of muscles that connect the uterus with the outer genitals, is called vaginal cancer. Healthy cells in the vaginal wall change and start multiplying out of control, forming a tumor, which can be cancerous or benign. Cancerous tumors grow and spread to other parts of the body, while benign tumors can grow but will not spread. It is rare to see cancer that begins from the vaginal cells (primary vaginal cancer), and almost 85% of cancer found in the vagina actually spread from other body parts, and 50 % of such cancer spreads from the cervix or uterus. An early diagnosis of vaginal cancer is essential to cure it because if it extends beyond the vagina, it becomes more challenging to treat.
The following are the five main types of cancer that begin in the vagina:
Vaginal Squamous Cell Carcinoma - This is the most commonly seen vaginal cancer, and almost 80 % of all vaginal cancer cases are squamous cell carcinoma. It can develop in the cells that line the vagina and most often present closer to the cervix. This cancer develops slowly from vaginal intraepithelial neoplasia (VaIN), which is a precancerous condition.
Vaginal Adenocarcinoma - This cancer originates in the glandular cells in the lining of the vagina or the gland tissue that secrete mucus and other fluids. This type is more likely to spread to other areas like the lymph nodes and lungs. Around 5 to 10 % of vaginal cancers are adenocarcinomas.
Vaginal Clear Cell Adenocarcinoma - It is a rare subtype of adenocarcinoma. It is usually seen in women whose mothers took Diethylstilbestrol (DES), a hormone, during the early months of pregnancy. This medicine was frequently prescribed between the 1940s and 1970s to prevent miscarriage and other problems. In every 1000 women exposed to DES, at least one woman will develop vaginal cancer.
Vaginal Melanoma - This cancer is commonly seen in the parts of the body exposed to the sun. But rarely (9%), melanoma, a cancer that originates from the cells that give the skin color, can also grow in the vagina. It generally occurs in the outer portion of the vagina.
Vaginal Sarcomas - Various types of sarcomas, cancers that originate from the connective tissue, can be found in the vagina. This cancer makes up around 4% of cases. The most commonly found vaginal cancer in children is rhabdomyosarcoma, and leiomyosarcoma occurs commonly in women over the age of 50.
Vaginal cancer usually does not produce any noticeable symptoms, so by the time it gets diagnosed, cancer would have spread. In the later stages, vaginal cancer can result in:
Abnormal vaginal bleeding that is not related to menstruation, such as -
Bleeding after sex.
Pain during sex.
Abnormal discharge from the vagina.
A palpable mass in the vagina.
Pain during urination.
The causes of vaginal cancer include:
Human Papillomavirus (HPV) - This virus is transmitted sexually and is the most common cause of vaginal cancer. Some strains of HPV are linked more strongly with certain types of vaginal cancers.
Herpes Simplex Virus (HSV) - Women infected with this virus also are at risk of developing vaginal cancer.
History of Cervical Cancer - As cervical cancer is also usually due to infection with HPV, women with a history of cervical cancer are at risk for vaginal cancer.
Exposure to Diethylstilbestrol (DES) - As mentioned above, women exposed to this hormone in-vitro are at risk. As this medicine is no longer prescribed to prevent miscarriage in early pregnancy, vaginal cancer due to DES is very rare.
Factors that increase a woman’s chance of developing vaginal cancer are:
This cancer is more common in women who are 60 years or older. Almost 50% of cases occur in women older than 70 years, and just 15% of the affected women are younger than 40 years.
Women who smoke are at risk.
Previous treatment with radiation in the vaginal area increases the risk.
HIV (human immunodeficiency virus) infected women.
Usually, vaginal cancer is found during a routine pelvic exam. During the pelvic examination, the doctor inspects the outer genitals, after which he or she inserts two fingers into the vagina and simultaneously applies pressure on the abdomen. If needed, a speculum is also used to open the vaginal canal to inspect the vagina and cervix properly.
The doctor might also perform a Pap smear test, where cells are collected from the cervix and vagina for testing. Sometimes, a colposcopy is performed. Here, a lighted magnifying tube called a colposcope is inserted into the vagina to look for any abnormalities. If any abnormal growth is seen, the doctor might collect some tissue to test for cancer cells.
Imaging tests, like X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET), are used to determine if cancer has spread.
Vaginal cancer is staged based on where it has spread. The stages are:
Stage I - The cancer cells are only in the vagina.
Stage II - The cancer cells have spread but not to the walls of the pelvis.
Stage III - The cancer cells have spread to the lymph nodes or the pelvic wall.
Stage IVA - The cancer cells have spread to the rectum, bladder, or far from the pelvis.
Stage IVB - Here, cancer cells have spread to a distant body part.
Based on the type of vaginal cancer and the stage, the oncologist will suggest treatment. The various treatment options include:
Surgical removal of the tumor or lesion is done when the cancer is limited to the surface of the vagina. A small margin of healthy surrounding tissue is also removed to ensure cancer cells are not left behind. If the cancer is more aggressive, then the vagina has to be removed surgically (vaginectomy). When part of the vagina is removed, it is called partial vaginectomy, and when the entire vagina is removed, it is called radical vaginectomy. After complete removal of the vagina, surgery can be done to reconstruct a new vagina. If cancer has spread to the uterus, then a hysterectomy (removal of the uterus) along with the ovaries and nearby lymph nodes is done. And if cancer has spread to the pelvic region, organs from the pelvis, such as the bladder, rectum, and lower part of the colon, might have to be removed.
2) Radiation Therapy
The use of high-energy beams, like X-rays, are used to destroy cancer cells.
Prognosis is good for the early stages of vaginal cancer, and the 5-year survival rate is 80 to 90%.
For more information on vaginal cancer, consult a doctor online now.
The cause of vaginal cancer is unknown. However, in most cases, it occurs following an infection with the human papillomavirus (HPV), which is the most common sexually transmitted disease. It usually subsides on its own, but if it persists, it may lead to vaginal cancer.
- Abnormal bleeding form the vagina after menopause, between menstruation, during or after sex.
- Pain during sex.
- Pelvic pain.
- Foul-smelling watery discharge from the vagina.
- Pain during urination.
- Frequent urination.
Vaginal cancers are not so common and account for about one to two percent of the female genital tract cancers, whereas in general, it occupies a minuscule fraction of all cancers.
Treatment of vaginal cancers includes surgery like hysterectomy, radiation therapy, and chemotherapy. They are used alone or in combination. Surgery is the recommended treatment for stage 1 cancer, which is followed by radiotherapy. Radiotherapy is used to treat all stages of vaginal cancer.
Women who have the habit of smoking develop an increased risk for vaginal cancer. In particular, the risk of developing vaginal cancer is doubled in smoking women.
In general, the five-year survival rate of vaginal cancer is 49%. It is about 69% in women who are diagnosed at the early stages. In contrast, the percentage reduces to 55% if cancer has already spread to regional lymph nodes and surrounding tissue and organs before it has been diagnosed.
In vaginal cancers, vaginal bleeding is commonly seen during or after sexual intercourse, after menopause, or in between menstruation. It can sometimes be associated with sores, which may bleed and also acquire an infection.
Women who are above the age of 60 years have an increased predisposal to vaginal cancer. Appropriately, more than 50% of cases are reported in women above 70 years, and only less than 15% of women below 40 years are affected.
VAIN stands for vaginal intraepithelial neoplasia, a condition characterized by the presence of precancerous cells on the innermost layer of the vagina. These cells do not typically resemble cancer cells, but they have some abnormalities and can transfer into cancer cells at any time.
Even after a complete hysterectomy, the chances of developing vaginal cancer are common.
The prognosis of vaginal cancer depends on several factors like the general health of the patient, stage of cancer, age, and if the tumor is a recurrent one or not.
Squamous cell vaginal carcinoma is the most predominant histological variant of vaginal cancer, which accounts for about 90% of all vaginal cancers. The next being adenocarcinoma, which estimates to be about 8 to 10%.
- Postponing sex till the teenage.
- Avoiding sex with multiple partners.
- Using a condom to prevent human papillomavirus (HPV) infection.
- Avoiding smoking.
- Getting vaccinated for the HPV virus.
- Regular Pap test to diagnose any cancerous lesions.
Last reviewed at:
26 Apr 2022 - 5 min read
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