Generally, cancer is a dreaded disease condition where cells divide and spread across other surrounding tissues in an uncontrollable manner. Be that as it may, in the case of vaginal cancer these uncontrollable cells give rise to malignant tumors in the vagina tissues. These malignant tumors formed in the vaginal tissues are medically termed Vaginal Cancer.
This type of cancer (also known as carcinoma of the vagina) is a rare type found in less than 2 percent of females with malignant pelvic tumors. The most common type is the squamous-cell carcinoma. Vaginal cancers are strongly linked to human papillomavirus (HPV) - sexually transmitted disease (STD).
Signs and Symptoms
Although most vaginal cancers like STDs are without notable signs and symptoms, there are a few others that do present obvious symptoms such as:
- Excruciating pain during sex
- Abnormal vaginal bleeding during sex, after sex, post-menopause, and in-between menstruation
- Vaginal discharge
- Urine and stool mixed with blood
- Frequent urge to urinate
- Lumps that can be felt in the vagina
- Fistula (in advance stages)
Types of Vaginal Cancer
The two basic types of vaginal cancers and the others are as follows:
- Squamous-cell carcinoma is the most common type of cancer found in women aged 60 upward. It originates from the vaginal lining (squamous-cells) and slowly spread across the vagina.
- Adenocarcinoma of the vagina originates from the glandular cells within the linings of the vagina wall.
- Melanoma is a type of cancer that begins in the vagina’s pigmentation cells
- Endodermal sinus and teratoma tumors are rare types of cancer generally manifested as the germ cell tumors mostly found in female children including infants.
- Sarcoma botryoides is a rhabdomyosarcoma originating from the vaginal wall of children as well as infants.
Although the severity of vaginal cancer can be visualized and surveyed through the use of a PET scan, CT scan, or MRI, the real diagnostics tests include the following:
- HPV test in high-risk type. This can also be done with the HPV rapid test kit
- Physical exam and personal history
- Pelvic exam
- Pap smear
Stages of Vaginal Cancer
With the aid of the PET scan, CT scan, or MRI, the stages of vaginal cancers can be investigated. The stages include:
- The pre-cancer stage also known as vaginal intraepithelial neoplasia (VAIN) is not cancer. But at this stage, the vaginal lining already has abnormal cells that are yet to grow and spread.
- Stage I – the tumor is limited to the vaginal wall
- Stage II – the tumor has spread beyond the vaginal wall unto the next tissue but yet to reach the pelvic wall.
- Stage III – the tumor is fully spread across the pelvis (as well as the lymph nodes in some cases).
- Stage IV – this has 2 sub-stages:
- Stage IV (A) – the tumor has reached both rectum and bladder, or either of both.
- Stage IV (B) – the tumor has advanced to further regions of the body including organs such as distant lymph nodes, lungs, and liver.
Treatment and Management
Vaginal cancer at stage I can be removed through surgery; several statistics already show its curative power. But this method of treatment is less effective in the advanced stages, and in some cases can pose a great risk to the bowel, bladder, and vagina.
The survival rates for the advanced stages are generally low but the newer treatment option which involves the simultaneous use of paclitaxel and carboplatin, external-beam radiation therapy (EBRT), and high-dose-rate interstitial brachytherapy (HDR-ISBT) provides very good results with the 5-year survival rates soaring above 80 percent for tumor less than 4cm.
Generally, tumors at Stage IV (B) currently have no known cure but medical palliatives can help manage symptoms. In these cases, physicians may recommend chemotherapy or radiotherapy.
There are several steps that can help reduce the risk of cancer to the barest minimum. These include:
- Quit tobacco. Smoking tobacco is a major factor that greatly increases the risk of vaginal cancer as well as other cancers
- Abstinence from sex or the use of condoms when having sex to reduce the risk of contracting HPV
- HPV vaccination
- Moderate consumption of alcohol
- Routine Pap smear and pelvic exams to timely find pre-cancer signs
Risk Factors and likely Causes
- Constant vulvar itching
- Human Immunodeficiency virus (HIV) infection
- Human papillomavirus infection
- Use of tobacco
- Exposure to Diethylstilbestrol prenatally
- History of vagina carcinoma
One major study in the United States reveals that vaginal cancer is one of the most common types of cancer found among women. According to a WHO report, nearly all cervical cancers are directly linked to the notorious STD – HPV. Also, the lifetime risk of contracting this is estimated between 75 – 95 percent. Other diseases related to this virus include subclinical dysplasia and genital warts.
Despite the fact that most HPV infections spontaneously resolve on their own, the risk of the infection progressing to a full-blown vaginal cancer is extremely high. In women with weakened immunity such as those with unmanaged HIV infection, it takes cervical cancers between 5 and 10 years to develop. While in those with regular immunity, it may take about 15 to 20 years for vaginal cancers to manifest
Proper adherence to the established preventive measures alongside routine screening and treatment can greatly curtail the mortality factor linked with the virus.