What is vaginal cancer?
The vagina is the canal that leads from the uterus to the external genitals.
Vaginal cancer is one of the rarest types of cancer affecting the female reproductive system. It is more common in women 60 and older, and the prognosis for recovery is usually good when the cancer is detected early.
Vaginal cancer, however, can start in other parts of the body and spread to the vagina. This most commonly occurs with other gynecologic cancers like cervical and vulvar cancers.
Normally, healthy cells grow, multiply, and die at a set rate. Cancer cells grow and multiply out of control and don’t die. The accumulating abnormal cells form a mass (tumor).
What are the symptoms of vaginal cancer?
Vaginal cancer has many of the same symptoms as other reproductive diseases and infections, which is why it’s important to see our OB/GYN at the first sign of symptoms.
Early-stage cancer and precancerous lesions often don’t cause symptoms but are found during a routine pelvic exam. Later-stage vaginal cancers are more likely to cause 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 can include:
- Pelvic pain
- Painful sexual intercourse
- Abnormal vaginal bleeding (not related to menstruation)
- Abnormal vaginal discharge
- Vaginal mass
- Painful urination
- Constipation
- Pain in the back of the legs or leg swelling
Seeing a doctor early can rule out other gynecological conditions and catch cancer early — greatly improving your prognosis.
How can you prevent vaginal cancer?
To reduce the risk of vaginal cancer, it is recommended to have regular pelvic exams and Pap tests. These can help detect early signs of anomalies, which in turn might lead to the discovery of signs indicative of vaginal cancer.
Additionally, getting the human papillomavirus (HPV) vaccine can help reduce your cancer risk. HPV is linked to several forms of cancer, including vaginal cancer and cervical cancer. The vaccine can significantly decrease the likelihood of contracting HPV, thereby potentially lowering the risk of developing HPV-related cancers.
What are the types of vaginal cancer?
Not all vaginal cancer is the same. The risk and outlook of vaginal cancer can vary based on where the cancer forms. Some types of vaginal cancer include:
Squamous cell carcinoma
Squamous cell carcinoma (also squamous cell cancer) is by far the most common vaginal cancer type, comprising about 70% of cases. Carcinomas of the squamous cells affect the flat cells that make up the surface layer of the vagina. They most often occur in the upper third of the vagina (the part nearest to the cervix), but they can occur in the lower portion as well.
Squamous cell carcinomas have been known to develop slowly over many years. They typically start as pre-cancerous changes called vaginal intraepithelial neoplasia (VAIN). Mild cases of VAIN, called VAIN 1, sometimes develop and then disappear before the problem becomes cancerous. However, it can progress to more severe stages, such as VAIN 2 and VAIN 3, before becoming cancer. If you develop VAIN 1, Dr. Aliabadi will monitor its progression.
Adenocarcinoma
The second most common type of vaginal cancer is clear cell adenocarcinoma, which makes up about 15% of cases. Adenocarcinomas originate in the glandular cells in the vaginal lining. Glandular cells are responsible for secreting fluids, which make it more likely for adenocarcinomas to spread to the lungs and lymph nodes.
Sarcoma
A sarcoma is a very rare type of cancer that originates in the bone, muscular, or connective tissue cells deep in the walls of the vagina.
Melanoma
Melanomas are most commonly found on sun-exposed areas of the body. They don’t commonly affect the vagina, but it can happen. Melanomas are carcinomas of the pigment-producing cells in the skin. Most cases of vaginal melanomas occur on the vulva or the lower portion of the vagina.
What are the causes of vaginal cancer?
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 – people over age 60 are at most risk.
- HPV infection – 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 Pap smear.
- Hysterectomy
- A history of cervical cancer
- Previous radiation treatment – this can sometimes cause an increased likelihood of vaginal cancer.
- Use of a vaginal pessary – use of pessaries, such as during pelvic organ prolapse, is associated with an increase in risk.
- Vaginal intraepithelial neoplasia – Sometimes these cells are considered precancerous and can develop into cancer.
- Exposure to the synthetic hormone diethylstilbestrol (DES) while in the womb can increase risk. This drug was given to pregnant women 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.
How is vaginal cancer diagnosed?
Your appointment with Dr. Aliabadi will include a review of your medical history and an exam. She will also go over any symptoms or concerns you might be having. The examination might include:
- Pelvic exam – looking and feeling for abnormalities.
- Pap smear – a sample of cervical cells is taken and examined for any abnormal cells.
- Colposcopy — an examination of the vaginal walls and cervix with a special lighted magnifying tool (colposcope).
- Biopsy — cell samples may be taken from the cervix, vaginal walls, or any discovered masses. These cells are then analyzed in a lab to check for abnormalities and determine the type and stage of cancer.
Determining vaginal cancer stages
If you’re diagnosed with vaginal cancer, the next step is a referral to a gynecologic oncologist — a specialist in gynecological cancers. This specialist may recommend several tests to determine the stage of the cancer. The stage describes the size of the cancer and whether it has spread, which helps predict the likelihood of a cure and guides the treatment plan.
Tests used to stage vaginal cancer include:
- Imaging Tests: These may include X-rays, CT scans, MRI scans, or positron emission tomography (PET) scans. More advanced imaging allows your healthcare team to look for masses and determine if the cancer has spread.
- Endoscopic procedures: Examination using tiny cameras can help assess whether the cancer has spread to specific areas. A cystoscopy looks inside the bladder, while a proctoscopy examines the rectum.
If vaginal cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called symptom management, palliative care, or supportive care.
What is vaginal cancer treatment?
Vaginal cancer treatment options can involve one of several different treatments, most commonly radiation therapy and/or chemotherapy.
While these are standard methods of treatment in many types of cancer, your gynecologic oncology care team will go over all your treatment options, possible side effects, and the risks and benefits of each treatment.
Surgery is sometimes used to remove cancer, but most patients are treated with radiation. Your doctor may use a laser to cut out affected tissue or growths. In some cases, removal of all or part of the vagina (vaginectomy) or uterus (hysterectomy) will be performed.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When you’re treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Sources
Stages and grades for vaginal cancer. Cancer Research UK. (2022, November 7). https://www.cancerresearchuk.org/about-cancer/vaginal-cancer/staging
Vaginal cancer treatment (PDQ) – patient version. National Cancer Institute. https://www.cancer.gov/types/vaginal/patient/vaginal-treatment-pdq.
Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.