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Vaginal Cancer

Vaginal Cancer

Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina.

 

The vagina is the canal leading from the cervix (the opening of uterus) to the outside of the body. At birth, a baby passes out of the body through the vagina (also called the birth canal).

 

Vaginal cancer is not common. When found in early stages, it can often be cured.

 

There are two main types of vaginal cancer:

 

  • Squamous cell carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the vagina. Squamous cell vaginal cancer spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer. It is found most often in women aged 60 or older.

 

  • Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the vagina make and release fluids such as mucus. Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes. It is found most often in women aged 30 or younger.

Symptoms

Possible signs of vaginal cancer include pain or abnormal vaginal bleeding.

 

Vaginal cancer often does not cause early symptoms and may be found during a routine Pap test. When symptoms occur they may be caused by vaginal cancer or by other conditions.

 

A doctor should be consulted if any of the following problems occur:

  • Bleeding or discharge not related to menstrual periods,
  • Pain during sexual intercourse,
  • Pain in the pelvic area,
  • A lump in the vagina.

Causes

Age and exposure to the drug DES (Diethylstilbestrol, a synthetic form of the hormone estrogen) before birth affect a woman's risk of developing vaginal cancer.

 

Anything that increases your risk of getting a disease is called a risk factor.

 

Risk factors for vaginal cancer include the following:

  • Being aged 60 or older.
  • Being exposed to DES  while in the mother's womb. In the 1950s, the drug DES was given to some pregnant women to prevent miscarriage (premature birth of a fetus that cannot survive). Women who were exposed to DES before birth have an increased risk of developing vaginal cancer. Some of these women develop a rare form of cancer called clear cell adenocarcinoma.
  • Having human papilloma virus (HPV) infection.
  • Having a history of abnormal cells in the cervix or cervical cancer.

Treatment

There are different types of treatment for patients with vaginal cancer.

 

Different types of treatments are available for patients with vaginal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial.

 

A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

 

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

 

Three types of standard treatment are used:

 

Surgery

 

Surgery is the most common treatment of vaginal cancer. The following surgical procedures may be used:

 

  • Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
  • Wide local excision: A surgical procedure that takes out the cancer and some of the healthy tissue around it.
  • Vaginectomy: Surgery to remove all or part of the vagina.
  • Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
  • Lymphadenectomy: A surgical procedure in which lymph nodes are removed and checked under a microscope for signs of cancer. This procedure is also called lymph node dissection. If the cancer is in the upper vagina, the pelvic lymph nodes may be removed. If the cancer is in the lower vagina, lymph nodes in the groin may be removed.
  • Pelvic exenteration: Surgery to remove the lower colon, rectum, and bladder. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.

 

Skin grafting may follow surgery, to repair or reconstruct the vagina. Skin grafting is a surgical procedure in which skin is moved from one part of the body to another. A piece of healthy skin is taken from a part of the body that is usually hidden, such as the buttock or thigh, and used to repair or rebuild the area treated with surgery.

 

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

 

Radiation therapy

 

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

 

Chemotherapy

 

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can affect cancer cells throughout the body (systemic chemotherapy).

 

When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

 

Topical chemotherapy for squamous cell vaginal cancer may be applied to the vagina in a cream or lotion.

 

New types of treatment are being tested in clinical trials.

 

These include the following:

 

Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

 

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

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