What is vaginal cancer?
The vagina, referred to as the birth canal during labor and delivery, is the tubular structure leading from the cervix to the outside of the body. The most common types of vaginal cancer are squamous cell carcinomas, which start in the flat cells that line the vagina, and adenocarcinomas, which originate in the vagina’s glandular cells. Cancer of the vagina is very rare; it is diagnosed in approximately 2,300 women in the United States each year (Source: NCI).
The cause of vaginal cancer is not known, but some risk factors, such as being age 60 or older, fetal exposure to diethylstilbestrol (DES, a drug used in the 1950s to prevent miscarriage), human papilloma virus (HPV) infection, and having a history of abnormal cervical cells or cervical cancer, increase the risk of developing it.
Early vaginal cancer may have no symptoms. Problems may develop such as abnormal vaginal discharge or bleeding, pain with intercourse, pelvic pain, or a noticeable lump in the vagina. Sometimes, vaginal cancer may be found during a routine pelvic exam.
The treatment and prognosis of vaginal cancer depend on many factors, including your age, the location and size of the tumor, the type of cancer, the extent of spread, whether symptoms are present, and your overall state of health. Surgery, often followed by radiation therapy, is the most common treatment. Chemotherapy is occasionally used for surface treatment in very early cancers or used body-wide (systemically) for more advanced cancers.
The earlier vaginal cancer is identified and treated, the better its prognosis. Seek prompt medical care if you have any symptoms suggestive of vaginal cancer. Some complications of vaginal cancer can be severe or even life threatening. Seek immediate medical care (call 911)if you, or someone you are with, have symptoms such as excessive vaginal bleeding, bloody stool or urine, severe abdominal or pelvic pain, or the inability to have bowel movements or pass gas.
What are the symptoms of vaginal cancer?
Symptoms do not always occur with early vaginal cancers. As the tumors grow, they may produce a discharge or start to bleed. A lump may be present in the vagina, and there may be pain or fullness in the pelvis or lower abdomen. You may experience pain during intercourse. As the cancer continues to advance, it may interfere with your bowel or bladder function.
Although Pap smears do not screen for vaginal cancer, it may be noticed during the routine pelvic exam that accompanies Pap testing.
Common symptoms of vaginal cancer
Vaginal cancer can cause a variety of symptoms, and any of them can be severe at times. These symptoms include:
Bleeding after intercourse
Bloody or pink-colored urine (hematuria)
Frequent urination or bowel movements
Lump in the vagina
Pain during sexual intercourse (dyspareunia)
Pelvic or abdominal pain or fullness
Rectal pain or fullness
Vaginal itching or discomfort
Serious symptoms that might indicate a life-threatening condition
In some cases, vaginal cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
What causes vaginal cancer?
The cause of vaginal cancer is not known. Squamous cell carcinomas occur most commonly in women age 60 or older, while the average age at diagnosis of adenocarcinomas is 19. You may have a higher risk of vaginal cancer if you have had cervical cancer or if you have a human papilloma virus (HPV) infection. Prenatal exposure to diethylstilbestrol, a drug that was used in the 1950s to prevent miscarriage, also seems to increase the risk of vaginal cancer.
What are the risk factors for vaginal cancer?
A number of factors increase the risk of developing vaginal cancer. Not all women with risk factors will get vaginal cancer. Risk factors for vaginal cancer include:
Adolescent age (for adenocarcinomas)
Age 60 or older (for squamous cell carcinomas)
Early age of first sexual intercourse
Exposure to diethylstilbestrol (DES) while in the womb
Human papilloma virus (HPV) infection
Multiple sexual partners
Personal history of abnormal cervical cells
Personal history of cervical cancer
How is vaginal cancer treated?
The goal of vaginal cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in your body, although it may recur later.
Vaginal cancer is often treated with surgery, which may be followed by radiation therapy. Your health care professional may use topically applied chemotherapy if your vaginal cancer is very early stage. Chemotherapy may also be used systemically for advanced stage vaginal cancer. Your health care professional may also recommend that you participate in a clinical trial.
Common treatments for vaginal cancer
Common treatments for vaginal cancer include:
Chemotherapy to attack cancer cells
Participation in a clinical trial that is testing promising new therapies and targeted treatments for vaginal cancer
Radiation therapy to attack cancer cells
Surgery to remove the cancer and evaluate the extent of any spread
Supportive treatments for vaginal cancer
Other therapies may be added to help bolster your general state of health and to help offset any side effects of treatment. These include:
Blood cell growth factors to increase the number of healthy blood cells
Blood transfusions to temporarily replace blood components, such as red blood cells, that have been reduced or lost
Dietary counseling to help you maintain strength and nutritional status
Pain medications as needed
Reconstructive surgery to restore structures that have been removed
Some complementary treatments may help some women to better deal with vaginal cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.
Complementary treatments may include:
Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
In cases in which vaginal cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift from curing the disease to focusing on measures to keep you comfortable and maximize your quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support your family members.
What are the potential complications of vaginal cancer?
Complications of untreated vaginal cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by carefully following the treatment plan you and your health care professional design specifically for you. Complications of vaginal cancer include:
Adverse effects of treatment (surgery, chemotherapy, radiation)
Diminished sexual activity
Spread of cancer