Vaginal Cancer

Services: Cancer

Vaginal Cancer

Vaginal Cancer starts in the vagina. There are many different types of vaginal cancer, but the most common is called squamous cell carcinoma. It begins in the lining of the vagina.

When vaginal cancer is small and only in the cells lining the vagina, it may not cause symptoms. Invasive vaginal cancer tends to be bigger and has spread into nearby tissues, like deeper into the wall of the vagina.

If you have any of the signs or symptoms of vaginal cancer, you should see a doctor. A Pap test might be done for sure signs and symptoms.

What Is Vaginal Cancer?

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and spread to other body areas.

Vaginal Cancer starts in the vagina. There are many different types of vaginal cancer, but the most common is called squamous cell carcinoma. It begins in the lining of the vagina.

Types of vaginal cancer:

Though it’s pretty rare, there are many types of vaginal cancer. Each type forms from a different kind of cell in the vagina.

Squamous cell carcinoma:

Nearly 9 out of 10 cases of vaginal cancer are squamous cell carcinomas. These cancers start in the squamous cells that make up the epithelial lining of the vagina. They’re most common in the upper part of the vagina near the cervix. If not treated, they can grow deeper into and, over time, through the vaginal wall and spread to nearby tissues. They can also apply to other parts of the body, most often the lungs, liver, and bones.

Squamous cell cancers of the vagina often develop slowly. First, some of the normal cells of the vagina get pre-cancerous changes (VAIN). Then some of the pre-cancer cells turn into cancer cells. This process can take many years.

Adenocarcinoma:

Cancers that start in gland cells are called adenocarcinomas. About 1 out of 10 cases of vaginal cancer are adenocarcinomas.

The most common type of vaginal adenocarcinoma is found in women older than 50. Another type, called clear cell adenocarcinoma, is more common in young women exposed to diethylstilbestrol (DES) in utero (when they were in their mother’s womb).

Very rare vaginal cancers:

Melanoma:

Melanomas start in pigment-producing cells that give skin its color. These cancers usually are found on sun-exposed skin parts, but they can also form in the vagina or other internal organs. Fewer than 3 of every 100 cases of vaginal cancer are melanomas.

Melanoma tends to affect the lower or outer portion of the vagina. The tumors vary significantly in size, color, and growth pattern. More information on this can be found in Melanoma Skin Cancer.

Sarcoma:

Sarcomas are cancers that start in bones, muscles, or connective tissue cells. Fewer than 3 out of every 100 cases of vaginal cancer are sarcomas. These cancers form deep in the wall of the vagina, not on its surface.

There are several types of sarcomas. Rhabdomyosarcoma is the most common type of sarcoma that affects the vagina. It’s most often found in children and is rare in adults. A sarcoma called leiomyosarcoma is seen more frequently in adults. It tends to occur in women older than 50.

Signs and Symptoms of Vaginal Cancer:

When vaginal cancer is small and only in the cells lining the vagina, it may not cause symptoms. Invasive vaginal cancer tends to be bigger and has spread into nearby tissues, like deeper into the wall of the vagina. Most women with invasive vaginal cancer have one or more symptoms, such as:

  • Abnormal vaginal bleeding (often after sex)
  • Abnormal vaginal discharge
  • A mass or lump in the vagina that can be felt
  • Pain during sex

Advanced vaginal cancer has spread beyond the vagina to nearby structures and lymph nodes. Symptoms of advanced vaginal cancer may be:

  • Painful urination
  • Constipation
  • Pain in the pelvis or low in the belly
  • Back pain
  • Swelling in the legs

Having these symptoms does not always mean that you have cancer. These symptoms are more likely to be caused by cancer, like an infection. The only way to know what’s causing these problems is to see a health care professional.

If you have any of these symptoms, discuss them immediately with a doctor. The sooner the problem is correctly diagnosed, the sooner you can start treatment, and the better the treatment will work.

Tests for Vaginal Cancer:

If you have any of the signs or symptoms of vaginal cancer, you should see a doctor. A Pap test might be done for sure signs and symptoms. More tests will be needed to show abnormal cells or if pelvic exam results are not typical. This may mean referral to a gynecologist (a doctor specializing in the female genital system).

Medical history and physical exam:

The first step is for the doctor to take a complete medical history. Risk factors and symptoms will be discussed. Then your doctor will physically examine you, including a pelvic exam and possibly a Pap test and a vaginal biopsy.

Colposcopy:

If specific symptoms suggest cancer or a Pap test shows abnormal cells, you will need a colposcopy. In this procedure, you lie on the exam table, and a speculum is placed in your vagina to keep it open — just like a pelvic exam. The doctor will use a colposcope to examine the cervix and vagina. The colposcope stays outside the body and has magnifying lenses (like binoculars). When the doctor looks through the colposcope, they can see the vaginal walls and the surface of the cervix closely and clearly. Sometimes a weak solution of acetic acid (much like vinegar) or iodine makes any abnormal areas easier to see. Using a colposcope to look at the vagina is called vaginoscopy.

Colposcopy is no more painful than a regular pelvic exam and can be done safely, even pregnant. A biopsy will be done if an abnormal area is seen on the cervix or vagina. The biopsy can be slightly painful and may cause pelvic cramping.

Biopsy:

Sure, signs and symptoms may strongly suggest vaginal cancer, but other problems can cause many. The only way to be sure that it’s cancer is to do a biopsy. In this procedure, a small piece of tissue from the suspicious area is removed. A doctor specializing in diagnosing diseases with lab tests (a pathologist) will then look at the tissue sample under a microscope to see if cancer or a pre-cancerous condition is present and, if so, what type it is.

Imaging tests:

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests may be done after a diagnosis of vaginal cancer to learn more about cancer and see if it has spread.

Treatments for vaginal pre-cancers:

Some treatments are only used to treat pre-cancers of the vagina (vaginal intraepithelial neoplasia or VAIN).

Many cases of low-grade VAIN will go away on their own, so some doctors will choose to watch them closely without starting treatment. If the area of VAIN doesn’t go away or gets worse, treatment is usually started. Higher grade VAIN is not likely to go away, so treatment is usually started immediately.

Treatments for invasive vaginal cancer:

Invasive vaginal cancer is treated mainly with radiation therapy and surgery. Chemotherapy given along with radiation might be used to treat advanced disease.

Common treatment approaches:

The type of treatment your cancer care team recommends depends on the type of vaginal cancer, how far the cancer has spread, your overall health, and preferences. You may need more than one type of treatment.

Because vaginal cancer is rare, it has been hard to study it well. There are no “standard” treatments that experts agree on. Most experts agree that treatment in a clinical trial should be considered for any type or stage of vaginal cancer. This way, women can get the best treatments available now and even better treatments.

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also essential to ask questions if there’s anything you’re not sure about.

It is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

What are BRCA1 and BRCA2 Genes?

BRCA1 and BRCA2 are tumor suppressor genes, which means that they keep cells from growing too rapidly. Everyone has these genes. Changes or mutations in these genes mean they do not work properly and cells can grow out of control, which can lead to cancer.

How much do BRCA mutations increase the risk of cancer?

The risk of breast cancer for the average American woman is about 12% in her lifetime. Having a BRCA mutation greatly increases the risk. The estimated risk of breast cancer in women with a BRCA mutation is 45–85% by age 70 years.

The risk of ovarian cancer for the average American woman is about 2% in her lifetime. The estimated risk of ovarian cancer in women with a BRCA1 mutation is 39–46% by age 70 years. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 years is 10–27%.

Women who have a BRCA mutation also have an increased risk of cancer of the fallopian tube, peritoneum, pancreas, and skin (melanoma). Men who have a BRCA mutation have an increased risk of cancer of the breast, prostate, and pancreas.

Why don’t doctors test everyone for BRCA mutations?

BRCA testing is only recommended for people with a high risk of having BRCA mutations. It is important to remember that most cases of breast and ovarian cancer are not caused by gene mutations. If there is a low chance of finding a BRCA mutation, your ob-gyn or other health care professional may not recommend genetic testing.

What is multigene panel testing?

Multigene panel testing is a type of genetic testing that looks for mutations in several genes at once. This is different from single-gene testing, which looks for a mutation in a specific gene. Single-gene testing is often used when a known gene mutation is already in a family. You may consider genetic testing if your personal or family history shows an increased cancer risk.

How can I prevent cancer if I test positive for a gene mutation?

If you test positive for a gene mutation, you can discuss cancer screening and prevention options with your ob-gyn, genetic counselor, or other healthcare professionals. It may be helpful to have earlier or more frequent cancer screening tests to find cancer at an early and more curable stage. Risk reduction steps like medication, surgery, and lifestyle changes also may be recommended.

If I have a gene mutation, should I tell my family?

Having a gene mutation means you can pass the mutation to your children. Your siblings also may have the gene mutation. Although you do not have to tell your family members, sharing the information could be life-saving. With this information, your family members can decide whether to be tested and get cancer screenings early.

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