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Vaginal Cancer

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Introduction

Vaginal Cancer is where malignant cells form in the vagina or the birth canal. The vagina is the tube that connects the uterus (cervix) with your outer genital area. It is a muscular tube. This type of cancer is quite rare. Generally, cancer from other parts of the body can cause metastasis to the vagina. This type is more common than the primary form where cancer begins in the vagina. Early diagnosis is the key to better chances of cure.

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What are the types of Vaginal Cancer?

  • Squamous cell carcinoma: This form of Vaginal Cancer occurs at the inner lining of the vagina. The cells in the inner lining are thin and flat. Metastasis of this type of cancer is not common. Although if it occurs then they metastasis more often to the lungs, liver, or bone. This is the most common type of vaginal cancer.
  • Adenocarcinoma: Cancer of the glandular cells in the vagina. Glandular cells produce and release mucus in the vagina. This type of cancer metastasis more often than the other variant. It generally spreads to the lungs and lymph nodes.

What are the Causes of Vaginal Cancer?

  • As seen in most other cancers, the exact reason is unknown, but having risk factors predisposes factors causing Vaginal Cancer. The following factors are identified as causes of Vaginal Cancer.
  • History of Cervical Cancer: HPV causes cervical cancer also.
  • In-utero exposure to diethylstilbestrol: previously, this drug was given to pregnant women to prevent miscarriage. Exposure to this drug in the womb acts as a triggering factor for Vaginal Cancer. However, it has been banned after the 70s.

What are the Symptoms of Vaginal Cancer?

On a general note, Vaginal Cancer doesn’t cause any symptoms; it is accidentally diagnosed during a routine exam or PAP smear test. Although a few patients may have a few symptoms, including:

  • ● Abnormal bleeding from the vagina.
  • ● Thin watery, foul-smelling vaginal discharge.
  • ● Pelvic pain.
  • ● Pain during or after sex.
  • ● Increased uresis (urination).
  • ● Constipation.
  • ● Lump in the vaginal region.

These symptoms may not necessarily indicate Vaginal Cancer; it may just be a common infection. However, it is important to get it checked.

How is Vaginal Cancer Diagnosed?

If the doctor finds something unusual in a routine test or PAP smear, he might prescribe for a colposcopy. Colposcope is using an illuminated magnifying device to closely check the vagina and cervix for abnormality. This allows the doctor to distinguish between normal and abnormal cells up close. Hence, allowing the doctor to perform a guided biopsy if need be. A biopsy is where the doctor removes a bit of the tissue and looks under the microscope for abnormality.

The key to increased chances of cure is early diagnosis.

What are the stages of Cancer?

Staging of Cancer helps the doctor to plan the treatment appropriately.

  • Stage 1: where the cancer is confined to your vaginal wall.
  • Stage 2: malignant cells have spread to the surrounding tissues.
  • Stage 3: The pelvic wall is affected.
  • Stage 4 a: Malignancy has reached the bladder lining, rectal lining, and other pelvic regions.
  • Stage 4 b: Metastasised to other parts of the body more often to the lungs or bones.

How is Vaginal Cancer Treated?

Treatment depends on the stage of cancer. The doctor will discuss the various treatment options available based on which stage of cancer you are in if you have a history of hysterectomy or previous radiation therapy.

  • Surgery: This is the first line of treatment where your doctor will use a laser to cut the malignant tissue. In a few cases, a part or full vagina may be removed. This treatment option is quite successful, and many women return to their normal sex life after surgery. But a few of them may experience increased chances of infection further leading to bleeding and straining of the surgical site.

What are the Risks Associated with Vaginal Cancer treatments?

  • Age: more common in older people above 60 years of age.
  • HPV infection: having human papillomavirus infection triggers the chances of Vaginal Cancer at later stages of life.
  • Hysterectomy: having a history of hysterectomy for the benign tumour is also a risk factor.
  • HIV: having HIV acts as a predisposing factor.
  • Smoking: doubles the risk of Vaginal Cancer.
  • Infection: as seen in any surgery infection is a common risk. This can be combated with the use of antibiotics.
  • Bowel incontinence: defecation without self-control.
  • Recurrence: recurrence of malignancy should also be considered.

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FAQ's

How Can I Lower My Risk of Getting Vaginal Cancer?

We women should be very diligent about following the screening guidelines and getting the screening test(PAP smear test)  every three years for women between the age of 21 and 65. HPV vaccines are especially useful in preventing cervical cancer and Vaginal Cancer. Limit sexual partners to just one and the use of condoms is recommended. Quit smoking doubles the chance of preventing malignancies.

How Can I Maintain My Quality of Life During Treatment?

Talk to your doctor about how you feel and what reactions your body shows to various treatments being given. Your doctor might prescribe various medications to alleviate your side effects. A nutritionist can give you a balanced diet with sufficient nutrients. In the case of chemotherapy-induced diarrhoea, the nutritionist can help you appropriately.

What are the New Types of Treatment Options Still Under Trial?

  • ● Immunotherapy
  • ● Radiosensitizers

How Effective are the New Forms of Treatment?

The new forms of treatment are still underway of clinical trials. The results of which are quite promising and hope building. We can look forward to a huge leap in the new therapies in the near future.

Will I Need Follow-Up Tests?

To see if the treatment is working your doctor may ask to repeat a few tests. Your doctor may want to make important decisions like whether to continue, change or stop the treatment based on the results of your follow up tests.

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