What's to know about vaginal cancer?
There are two primary types: squamous cell carcinoma and adenocarcinoma. Vaginal squamous cell carcinoma arises from the squamous cells that line the vagina. It is the most common type of vaginal cancer, and is found most often in women aged 60 years or older.
Vaginal adenocarcinoma arises from the glandular cells in the lining of the vagina that produce some of the vaginal fluids. Adenocarcinoma is more likely to spread than squamous cell cancer.
- Vaginal cancer is not a common form of cancer and affects around 2,000 Americans per year.
- According to the Centers for Disease Control and Prevention (CDC), 75 percent of vaginal cancers are associated with HPV.
- Black American and Hispanic women more commonly get HPV-related vaginal cancer than women of other races and ethnicities.
- One of the first noticeable symptoms of vaginal cancer is bleeding after sex.
One symptom of vaginal cancer is pelvic pain.
Early stage cancer and precancerous lesions often don't cause symptoms but are found during a routine exam. Later stage vaginal cancers are more likely to be associated with symptoms.
One of the most common symptoms is abnormal vaginal bleeding after sexual intercourse. It is often one of the first symptoms to be noticed. Vaginal bleeding in women after menopause is abnormal and should always be evaluated.
Other symptoms might include:
- abnormal vaginal discharge
- vaginal mass
- difficulty or pain when urinating
- pain during sex
- pelvic pain
- pain in the back of the legs or leg swelling
If an individual displays any of these symptoms, they should make an appointment with their doctor right away.
Unfortunately, researchers do not yet know the exact causes of vaginal cancer. They have, however, identified several risk factors for developing vaginal cancer. These risk factors include:
- Age - those aged over 60 are at most risk.
- HPV infection - contracting the human papilloma virus 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 cells can develop into cancer.
Many types of cancer caused by HPV, including vaginal and cervical cancer, are associated with precancerous lesions. These develop before the cancer and can be picked up on a Pap smear test.
Exposure to the synthetic hormone Diethylstilbestrol (DES) while in the womb can increase risk. This drug was taken by mothers from the 1940s until 1971. As a result, the cases attributed to DES are on the decline as children born from those pregnancies are now in their late 40s or older.
Radiation therapy is one of the treatment options for vaginal cancer.
Cancer treatment can involve one of several different treatments.
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.
The more educated an individual is about cancer treatment, the better they can communicate with the medical team and participate in their treatment decisions and overall care.
Surgery is sometimes used to remove the cancer, but most patients are treated with radiation. If the tumor is cervical cancer that has spread to the vagina, or if it is at an advanced stage, radiation and chemotherapy are often given.
The first doctor's visit will include a history and physical exam. They will ask about any symptoms or concerns the individual might be having, including:
- sexual practices and family history will also be discussed
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 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 anesthetic is used to ease discomfort and pain.
If vaginal cancer is confirmed, several more tests will be completed to determine the stage of the cancer and to help plan treatment.
Finding out that you have cancer is often very distressing. Coping with a new diagnosis can be difficult, but getting support early on may help an individual to cope during treatment and beyond.
The best way a woman can reduce her risk factor for developing vaginal cancer is to try to avoid being infected with HPV, an extremely common sexually transmitted virus. In fact, about 80 percent of sexually active men and women are infected with HPV at some point in their life.
HPV can cause many types of cancer, including cervical cancer. Researchers believe there may be a link between vaginal cancer and HPV.
Other factors that can help prevent vaginal cancer include:
- Not having sexual intercourse until late teens or older.
- Avoiding sexual intercourse with multiple partners.
- Avoiding sexual intercourse with anyone who has had multiple partners.
- Practicing safe sex (although condoms cannot fully protect against HPV).
- Having regular Pap tests to find and treat precancerous conditions.
- Stopping smoking, or not starting in the first place.
Researchers are still investigating the causes of vaginal cancer and ways to prevent it. There is no way to completely prevent the disease, but by following the advice above, risks can be minimized.