Vaginal cancer is a malignancy of
the vagina (birth canal) and is considered rare, it makes up about 3% of all
gynecological cancers. There are two types of vaginal cancer, adenocarcinoma
(DES related) and squamous cell, squamous cell being the most common.
Vaginal cancer is usually slow growing and preceded by Vaginal Intraepithelial
Neoplasia (VAIN), which is pre-cancerous and easily treated if found early.
There are many risk factors for VAIN/vaginal cancer:
- Human Papilloma Virus (HPV) infection
- Smoking
- Age: over half of the women diagnosed are over the age of 60
- DES: a hormonal drug prescribed from 1940-1971 for potential miscarriages. If your mother took DES you are at risk.
- Radiation therapy in the vaginal area
- cervical dysplasia or cancer
- hysterectomy
If you fall into one of these categories it does not mean that you will
automatically get cancer. It means that the potential could be there, so it is very
important that you always keep your yearly check-ups and watch your body for any
changes. In fact, you could perform a monthly vaginal self-exam just like you would
your breasts.
Women with invasive vaginal cancer may experience one or more of the
following symptoms:
- Abnormal bleeding…the most common symptom
- Bleeding with intercourse
- Foul discharge
- Pelvic pain
- Back or leg pain
- Swelling of the legs
Women with VAIN may experience no symptoms, but many on our group
have experienced burning and chronic itching.
It is vital that you see a physician for a check-up if you experience
any of these symptoms. Keep in mind many benign vaginal conditions can cause these
symptoms too, so the only true way to know what is going on with your body is to
have a check-up.
A pap smear is a wonderful tool to detect vaginal dysplasia and cancer early.
The doctor gently scrapes cell samples from your cervix and vagina; you may feel a
slight pressure, but it usually is not painful. If the pap test reveals abnormal cells your
doctor will probably want to perform a colposcopy. The colposcopy allows the doctor
to view your cervix and vagina with a microscope for any abnormalities.
Anything unusual would then be removed and sent to pathology.
Once you receive your pathology report, you and your doctor can discuss the
findings and any future treatment if needed.
There are three stages of VAIN or vaginal dysplasia.
- VAIN I: mild dysplasia, abnormal cells found through 1/3 of tissue
- VAIN II: moderate dysplasia, abnormal cells found through 2/3 of tissue
- VAIN III: severe dysplasia, carcinoma in-situ, stage 0, abnormal cells found
through the full thickness of the tissue, but it has not broken through the bottom
membrane
If your pathology report shows that you have VAIN I or II,
you may need no treatment. Most doctors usually monitor these grades
closely because some cases can regress on their own. On the other hand,
some doctors may prescribe a topical treatment such as the Aldara or 5FU cream.
VAIN III is not considered to be invasive cancer, however, it usually does
require treatment to prevent progression. Treatment may consist of a wide local excision, laser ablation, or a topical cream.
To read about the different stages of invasive vaginal cancer
please go to The American Cancer Society.
Treatment for invasive vaginal cancer may be one or a combination of the
following:
- Laser surgery: a beam of light is used to destroy early cancer cells
- Wide local excision: removal of the cancer and some of the surrounding healthy tissue
- Vaginectomy: removal of the vagina and possibly lymph nodes
- Radical Hysterectomy, if the cancer has spread outside of the vagina
- Radiation
- Chemotherapy
