What is vaginal cancer?

What is vaginal cancer?

The vagina is the birth canal that leads from a woman’s external genitals (the vulva) to the bottom of the uterus (the cervix). The flat, thin skin cells that comprise the surface of the vaginal walls are squamous cells. Squamous cells are one of three types of epithelial cells – the cells that make up the tissue that line the body’s cavities, blood vessels, and organs.

Beneath the epithelial layer, the vaginal walls are composed of muscles, connective tissues, lymph vessels, and nerves. The vagina also contains a series of glands, which secrete fluids, keeping it moist and elastic.

Vaginal cancer is a rare type of cancer. It is more common in women 60 and older, and the prognosis for recovery is usually good when the cancer is detected early. Some cancers, however, can start elsewhere and spread to the vagina, such as cervical or vulvar cancers. Vaginal cancer happens when malignant (cancerous) cells form in the vagina.

Normally healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Sometimes cancer that begins in other parts of the body spreads (metastasizes) to the vagina. When this happens, the cancer is named for the part of the body where it started.

Symptoms of vaginal cancer

You should always make an appointment with your gynaecologist if you’re experiencing any abnormal symptoms, including:

• Pelvic pain
• Painful sexual intercourse
• Abnormal vaginal bleeding (not related to menstruation)
• Abnormal Vaginal discharge
• Vaginal mass
• Difficulty or pain when urinating.
• Constipation
• Pain in the back of the legs or leg swelling

Causes of vaginal cancer

It is not yet known the exact causes of vaginal cancer. However, identified several cancer risk factors for developing vaginal cancer. These risk factors include:

• Age – those aged over 60 are at most risk.
• HPV infection – contracting the human papillomavirus increases risk.
• Hysterectomy – women who have had a hysterectomy are statistically more likely to get vaginal cancer.
• A history of cervical cancer – cervical cancer diagnosis is a risk factor for vaginal cancer.
• Previous radiation treatment – this can sometimes cause an increased likelihood of vaginal cancer.
• Use of a vaginal pessary – use of these, such as during pelvic organ prolapse, is associated with an increase in risk.
• Vaginal intraepithelial neoplasia (VAIN) – these cells are different from normal cells, but not different enough to be classed as cancer cells. Sometimes, these are considered precancerous cells that can develop into cancer.

Many types of cancer caused by HPV, including vaginal and cervical cancer, are associated with precancerous lesions. These develop before cancer and can be picked up on a smear test.

Diagnosis of vaginal cancer

Your appointment will include a review of your medical history and physical, pelvic exam (an exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum), and pap test. They will ask about any symptoms or concerns you might be having. The examination will include:

• Pelvic exam – the doctor will look and feel for abnormalities.
• Pap smear – a test for cervical cancer.
• Colposcopy (examination of the cervix) – may be carried out if the Pap test was abnormal or if the doctor saw anything unusual or suspicious during the pelvic exam.

To make a definitive diagnosis to confirm that you are at risk of vaginal cancer, a biopsy is required. During a biopsy, small tissue samples are taken and examined by a pathologist. Biopsies are commonly carried out during a colposcopy. A local anaesthetic is used to ease discomfort and pain.

Treatment for vaginal cancer

Treatment options can involve one of several different treatments.

• Radiation therapy
• Chemotherapy

While these are standard methods of treatment in many types of cancer, before any treatment regimen, a patient should understand what to expect, possible side effects, and the risks and benefits of treatment.