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Vaginal Cancer

What is the Vagina?

The vagina is a 3 to 4 inch (7 1/2 -10 cm) tube that at one end joins the cervix, the lower part of the uterus (womb), and at the other end opens onto the vulva, the external genitalia. The vagina is also called the birth canal. The vagina is usually in a collapsed state with its walls touching each other. The vaginal walls have many folds that help the vagina to open and expand during sexual intercourse or birth of a baby. Glands in the cervix secrete mucus to keep the vaginal lining moist.

What is 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).

There are many different types of cancer of the vagina: squamous cell cancer (squamous carcinoma), adenocarcinoma, malignant melanomas, and sarcomas.

About 90% of vaginal cancers are squamous cell carcinomas that begin in the epithelial lining of the vagina. These kinds of cancers tend to occur in the upper area of the vagina near the cervix. Vaginal squamous cell carcinomas do not appear suddenly, they develop over a period of many years from precancerous changes called vaginal intraepithelial neoplasia (abbreviated as VAIN). Squamous carcinomas are usually found in women between the ages of 60 and 80.

About 5% of vaginal cancers are adenocarcinomas. The most common type of vaginal adenocarcinoma usually develops in women over age 50. Another type called clear cell adenocarcinoma usually occurs in young women who were exposed to Diethhystilbestrol while they were in their mother's womb. Diethylstilbestrol is a hormonal drug that was prescribed between 1940 to 1971 for some women thought to be at increased risk for miscarriages. Adenocarcinomas are often found in women between the ages of 12 and 30.

Malignant melanoma is a cancer that develops from pigment-producing cells called melanocytes. Malignant melanomas are usually found on sun-exposed areas of the skin but occasionally form on the vagina or other internal organs. They account for about 2% to 3% of all vaginal cancers. Malignant melanoma usually affects the lower or outer portion of the vagina.

About 2% to 3% of vaginal cancers are sarcomas. These cancers form deep in the wall of the vagina, not on its surface epithelium. There are several types of vaginal sarcomas. Some of the types are: leiomyosarcomas and rhabdomyosarcoma. Leiomyosarcomas resemble the involuntary muscle cells of the vaginal wall. Rhabdomyosarcoma is a childhood cancer, usually found before the age of 3. This type of cancer has cells that resemble voluntary muscle cells. Voluntary muscle tissue is not normally found in the vaginal wall.

Symptoms of Vaginal Cancer?

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.

Vaginal Cancer Statistics

Vaginal cancer accounts for about 3% of cancers of the female reproductive system.

Cancers found in the vagina are less common than cancers that start in other organs and then spread vagina.

Risk Factors for Vaginal Cancer?

Some of the risk factors for developing vaginal cancer are: age, prescription of diethylstilbestrol, and already being diagnosed with cervical cancer, and Age.

Age is a risk factor for squamous cell carcinoma. Most of the women who are diagnosed with squamous cell carcinoma are diagnosed while the women are between the ages of 50 and 70.

Diethylstilbestrol is a hormonal drug that was prescribed between 1940 to 1971 for some women thought to be at increased risk for miscarriages.

A person who has cervical cancer has a high risk of developing vaginal squamous cell cancer. This is because cervical and vaginal cancer have similar risk factors.

Methods of Treatment

Surgery, radiation therapy and chemotherapy are the most common treatments.

Surgery may be performed to remove tissue that has become cancerous. It is the primary method of treatment for vaginal cancer.

Surgery options include:

  1. Laser surgery. A narrow beam of light is used to kill very early stage cancer cells
  2. Wide local excision. The surgeon takes out the cancer and some of the surrounding tissue.
  3. Vaginectomy. The surgeon removes the vagina and maybe lymph nodes from the pelvic area.
  4. Radical hysterectomy. If cancer has spread outside of the vagina, the uterus, ovaries and fallopian tubes, as well as lymph nodes may be removed.

Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill cancer cells.

Chemotherapy is the use of drugs to kill cancer cells.

Effects of Treatment

How is Vaginal Cancer Diagnosed?

A variety of tools are used to diagnose vaginal cancer. The most often used tools are:

  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.

 

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