The vagina is an approximately 3- to 4-inches long canal also known as the birth canal, seen in the lowest part of the female reproductive tract.It connects the cervix (that is the lower part of the uterus) on the inside of the body to the vulva on the outside of the body (or the external female genitals).The unborn baby grows in the upper part or the body of the uterus, travels down the cervix and finally passes through the vagina lower down, in the process of labour. The vagina has a vaginal wall, made up of epithelium, underlying connective tissue, muscle tissue (that helps it to contract and expand), lymph vessels, blood vessels and nerves. There is also glandular tissue present that helps to moisten the vagina.
What are vaginal cancers ?
Vaginal Cancers are basically tumours of the VAGINA.
How is a vaginal cancer caused ?
- Diethylstilbestrol (DES) : DES is a drug that was earlier given to particular pregnant women to avert miscarriage in the years 1940’s to 1970’s. The women born to mothers, who had taken DES in their pregnancy, got vaginal adenocarcinoma at a higher rate.
- Cervical cancer : Having either cervical cancer or cervical pre-cancer ups the risk of vaginal squamous cell cancer. It could be more so as cervical and vaginal cancers have comparable risk factors, like smoking & HIV infection.
- HIV infection : As in many lower-tract gynaecological tumours, high risk type of Human Papilloma Virus (HPV- 16 & 18) infection plays a role in the aetiology of cancer of the vagina. HPV can be spread from one person to another through either skin-to-skin contact or through unprotected sex. Being immunocompromised (such as having AIDS or HIV infection) also can predispose to HPV infection and thus, vaginal cancer.
- Smoking : Women smokers are more than double likely to get vaginal cancer as women non-smokers. Tobacco by-products have been detected in the cervical mucus of women smokers.
What are the types of vaginal cancer ?
There are several types of cancer that can initiate in the vagina. However, the chief types of vaginal cancers include squamous cell carcinomas and adenocarcinomas.
- Squamous cell carcinoma: A majority of the vaginal cancers are mostly squamous cell carcinomas. They initiate in the lining squamous cells, mostly in that area of the vagina close to the cervix. The changes in the squamous cells are first precancerous. Then the precancerous lesions may progress to become squamous cell carcinomas or invasive cancers, over a period of time. The medical term coined for this pre-cancerous change is vaginal intraepithelial neoplasia (VAIN). “Intraepithelial” implies that atypical squamous cells are merely found in the superficial surface layer of the vaginal mucosa or its epithelium. There are 3 described types of VAIN, that is VAIN1, VAIN2, and VAIN3, with 3 being maximum progression to a true cancer.
- Adenocarcinoma: Most of the other vaginal cancers, apart from squamous cell carcinomas are adenocarcinomas. Adenocarcinomas are cancers that arise from glandular cells, that is from the mucus-producing cells of the vagina. These are also invasive, as well.
Other types of cancer are also known to develop in the vagina. These other types of cancers, such as melanoma, sarcoma, and lymphoma are quite rare.
What are the clinical features of vaginal cancers ?
Symptoms of vaginal cancers include vaginal bleeding or foul smelling, yellowish discharge. Pain during sex or spotting after sex can also be noted. In the later stages of vaginal cancers, back pain, lethargy, or nausea/vomiting can also be present.
How are vaginal cancers diagnosed ?
- A complete Physical Examination of the body is mandatory.
- The Pap Smear Test : The gynaecologist will examine your vagina & cervix and take smears from the surface for a microscopic cellular examination. A suspicious Pap smear shows the need for a biopsy, i.e. the surgical resection of part or whole of a tissue containing all the cervix layers. This allows visualisation not only of individual cells, as in a smear, but of the whole tissue structure.
- Colposcopy : In case of abnormal or atypical results, of the Pap smear, colposcopy will be performed in the clinical examination. Colposcopy is a practice in which the patient lies down on the examination table and a speculum is put in the vagina to help good visualization of the vagina and cervix. The doctor then utilizes a colposcope to thoroughly examine the tract. The colposcope is an instrument endowed with magnifying lenses that can be compared to binoculars. An acetic acid wash can also be utilized to assess the vagina & cervix clearly.
- Biopsy : Removed tissue examined under a microscope by a pathologist is the only sure-shot way to make a vaginal cancer diagnosis.
- Imaging Tests : To determine the exact extent of disease, additional tests may need to be performed so doctors can view, assess and judge the cancer. These imaging tests include the following such as X- rays, CT Scan, MRI Scan or PET Scans.
How are vaginal cancers staged ?
The stage is the exact spread of the disease in the human body. Staging is used to assess the risks and prognosis associated with the cancer extent to determine the appropriate treatment. The less advanced the stage, the better the prognosis.
How are vaginal cancers treated ?
For invasive vaginal cancer, there are 3 main treatments:
- Radiation therapy
- Surgery
- Chemotherapy
The standard treatment is first surgical. A surgical intervention has to be done on the vagina and the removal of lymph nodes, as well within the pelvis.
For more advanced stages, radiotherapy and chemotherapy should be given together. In this external radiotherapy, radiation is produced by an external source and targeted to the tumour as well as lymph nodes & vessels. The chemotherapy has an arsenal of drugs to kill the remnant cancer cells in the body.
What is the care to be taken after the removal of a vaginal cancer ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans.
Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
Are vaginal cancers preventable ?
Either we can prevent the pre-cancer from occurring or we can prevent the progression of pre-cancer into full blown cancers.
Avoiding exposure to the Human Papilloma Virus (HPV) by practising safe sex &taking the HPV vaccine help in preventing vaginal as well as cervical cancer.
The best way to find cancer early on is to have routine & regular screening with a smear test called the PAP test (which can be combined with a test for human papilloma virus or HPV).
How to find and reach cancer specialists for vaginal cancer treatment ?
Now you can find and reach cancer specialists for vaginal cancer treatment from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for vaginal cancer treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for vaginal cancer treatment.
Find, reach and choose a cancer specialist for vaginal cancer treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
