Vaginal cancer


Cancer of the vagina, is a rare kind of cancer in women. In vaginal cancer, cancer (malignant) cells are found in the tissues of the vagina. The vagina is the passageway through which fluid passes out of the body during menstrual periods and through which a woman has babies. The vagina is also called the "birth canal." The vagina connects the cervix (the opening of the womb or uterus) and the vulva (the folds of skin around the opening to the vagina).


Some of the symptoms of vaginal cancer are: bleeding or discharge not related to menstrual periods, difficult or painful urination and pain during intercourse or in the pelvic area.


* Physiologic –Many women will have a consistent, slightly clear, non-odor-producing discharge, either midcycle or premenstrually, particularly if they are on oral contraceptives –A change in odor, consistency, or color of discharge may signify that evaluation is necessary –Increased discharge is associated with pregnancy * Sexually transmitted disease –Trichomonas vaginalis: “Strawberry cervix” with punctate erythema, flagellated oval organisms on wet mount –Gonorrhea/Chlamydia may be associated with pelvic pain/dysmenorrhea and dyspareunia * Bacterial vaginosis –Various organisms and changes in normal flora with a characteristic fishy odor –Not considered an STD –Increases the risk of preterm delivery in pregnant women * Alteration of normal vaginal flora and/or inflammatory response –Candida albicans overgrowth is more common with recent antibiotic use, poorly controlled diabetes, and/or pregnancy; presents with intensely pruritic, inflamed, and erythematous introitus –Doderlein's cytolysis (caused by an overgrowth of lactobacilli) * Atrophic vaginitis –Common in postmenopausal women, especially those not on HRT –Poor coital lubrication, dyspareunia –Dysuria due to atrophic urethral tissue * Foreign body vaginitis (e.g., retained tampon) * Noninfectious irritant/allergic contact vaginitis (e.g., soaps, feminine pads, perfumes) * Cervicitis (usually due to gonorrhea or Chlamydia) * Cervical dysplasia, cancer, or polyps * Vaginal or vulvar trauma or cancer


1. Pelvic Exam: The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder and rectum for any abnormalities. 2. Pap test: The doctor gently scrapes the outside of the cervix and vagina and takes sample cells for testing. 3. Colposcopy: The doctor inserts an instrument with binocular magnifying lenses into the vagina and checks the vaginal walls and cervix. 4. Biopsy: The doctor take out a small piece of vaginal tissue to send to the laboratory. At the laboratory, a pathologist will look at the tissue under a microscope to determine whether the cells are cancer.


The prognosis depends on the stage of the cancer (see Staging Cancers of the Female Reproductive System*Tables). If the cancer is limited to the vagina, about 65 to 70% of women survive at least 5 years after diagnosis. If the cancer has spread beyond the pelvis or to the bladder or rectum, only about 15 to 20% survive.


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