Vaginal cancer
Vaginal cancer is an abnormal growth of cells that starts in the vagina, also called the birth canal. Most of the time, cancer will form on the inner wall of the vagina, but it can form in or spread to other areas as well.
Understanding vaginal cancer
What are the types of vaginal cancer ?
Squamous cell carcinoma is the most common type of vaginal cancer, comprising 9 out of 10 cases of vaginal cancer. It starts in the cells that line your vagina and spreads slowly.
Adenocarcinoma is a rarer type of vaginal cancer. It starts in the glandular cells that make vaginal mucus. A rare form of adenocarcinoma is linked to women being exposed to the drug DES before birth.
Other rare types of vaginal cancer include melanoma and sarcomas. Sarcomas most commonly occur in children.
What causes vaginal cancer ?
The risk factors for vaginal cancer include:
-
Older age
- History of abnormal, precancerous cells lining the inside of vagina (vaginal intraepithelial neoplasia, or VAIN)
- Exposure to the drug DES while in the mother’s womb in the 1950s
- Human papillomavirus (HPV) infection
- History of abnormal PAP smears
- Smoking and tobacco use
- History of cervical cancer
- History of HIV (human immunodeficiency virus)
What are the symptoms of vaginal cancer ?
You can have vaginal cancer with no symptoms. Some women do have symptoms. Common symptoms of vaginal cancer may include:
- Bleeding not related to your menstrual period
- Bleeding after sex
- Pelvic pain
- Pain or bleeding when urinating or having bowel movements
- Lump in your vagina
- Watery or bad smelling discharge
- Constipation
Diagnosisng vaginal cancer
The most common way to find vaginal cancer is unusual bleeding that causes a woman to see a doctor. The doctor will do a pelvic exam. A colposcopy may be done. A biopsy is the only way to know if a lump or change is cancer. Small pieces of tissue are taken out and checked for cancer cells.
What should I do if I am diagnosed with vaginal cancer?
If the biopsy shows vaginal cancer, the next step is to visit a Certified Gynaecological Oncologist. Seeking specialist care is crucial, as Gynaecological Oncologists have the knowledge, training, and experience to provide the best vaginal cancer care.
Will I need other tests ?
After a diagnosis of vaginal cancer, you’ll likely need other tests in order to determine the stage of the cancer. The stage is how much and how far the cancer has spread in your body. It’s one of the most important things to know when deciding how to treat the cancer. The following exams may be used to ascerain the satge of the diasease:
- Examination under anaesthesia
- Magnetic Resonance Imaging (MRI) of the lower abdomen with intravenous contrast agent
- PET/CT or alternatively chest CT and upper abdomen CT or MRI with intravenous contrast agent
- Rarely, cystoscopy and/ or orthoscopy
Treating vaginal cancer
Your treatment choices depend on the type of vaginal cancer you have, test results, and the stage of the cancer. Treatment for vulvar cancer usually involves surgery or combined chemotherapy and radiotherapy.
Surgical management
For stage I surgical excision may be an option. Surgery may include:
- Radical vaginectomy with radical vulvectomy
- Radical vaginectomy with radical hysterectomy
- Groin lymph node dissection
- Pelvic lymph node dissection
Excellence in surgical care
Dr. Tranoulis is highly experienced in the treatment of gynecological cancers and a recognised leader in his field. International studies have demostrated that surgeons performing higher volumes of particular procedures can often offer patients better outcomes, such as shorter hospital stays and fewer complications. Studies also confirm that vaginal cancer patients initially treated by Gynaecological Oncologists have improved survival rates compared to those treated by general gynaecologists or general surgeons.
Depending on the location and stage of your cancer, Dr Tranoulis may recommend:
- Radical vaginectomy
- Radical vulvectomy
- Robotic radical hysterectomy for vaginal cancer
- Comprehensive lymphadenectomy (groin or pelvic)
- Plastic reconstruction
Surveillance
Once you’re finished with treatment, you’ll enter a period of surveillance to make sure the cancer doesn’t return, and if it does, to catch it early. Dr Tranoulis will create an individualised follow-up plan for you which includes:
- Periodic clinical examination, including gynecological examination (every 3-6 months)
- Periodic screening tests. The available options include computed tomography or magnetic resonance imaging and PET/CT, so the relevant decisions are made based on the doctor’s judgment and the symptoms that the patient may have.
Coping with fear
Being told you have vaginal cancer can be scary, and you may have many questions. We are here to help you. Learning about your cancer and about the treatment options available to you can make you feel less afraid.