Vaginal Cancer: Causes, Symptoms, Types, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Vaginal cancer is an uncommon type of cancer that develops in the muscular tube that joins your uterus to your external genitalia. The cells lining your vagina, commonly known as the birth canal, are most frequently affected by vaginal cancer.

Primary vaginal cancer is an uncommon kind of cancer that starts in the vagina, however, many cancers can migrate from other parts of your body to your vagina.

The best chance of recovery is for those with vaginal cancer that is detected early. When vaginal cancer spreads outside the vagina, treatment becomes considerably more challenging.

Causes Of Vaginal Cancer

It is uncertain what causes vaginal cancer. In general, a genetic mutation that arises in healthy cells causes normal cells to become aberrant, which is how cancer begins.

A predefined age is reached by the division and expansion of healthy cells at a predetermined rate. Instead of dying, cancer cells multiply and spread uncontrollably. Tumours are lumps that are formed when abnormal cells accumulate.

Cancer cells can break out from their parent tumour and spread throughout the body by infiltrating nearby tissues (metastasis).

Symptoms Of Vaginal Cancer

There may be no symptoms in the early stages of vaginal cancer. As it progresses, vaginal cancer may show the following symptoms and indicators:

• Atypical vaginal bleeding, such as that which happens postmenopause or following intercourse
• Wet vaginal discharge
• A growth or bump inside your vagina
• Uncomfortable urinating
• Frequent urination
• Bloating
• Pain in the Pelvis

Types Of Vaginal cancer

Based on the type of cell in which the disease first appeared, several forms of vaginal cancer can be distinguished. There are several types of vaginal cancer.

• Vaginal squamous cell carcinoma: The most prevalent kind of vaginal squamous cell carcinoma begins in the thin, flat cells that line the vaginal surface and are referred to as squamous cells.
• Vaginal adenocarcinoma: It is the name for a cancer that starts in the glandular cells that line your vagina.
• Vaginal melanoma: The melanocytes, or pigment-producing cells, in your vagina, are what causes vaginal melanoma.
• Vaginal sarcoma: It is a cancer that arises in the muscles or connective tissue cells that line your vagina.

Risk factors Of Vaginal Cancer

Some variables that may increase your risk of vaginal cancer include the following:

• Becoming older: Your risk of vaginal cancer increases with age. Most people over 60 are diagnosed with vaginal cancer.
• The abnormal cells observed in the vagina are referred to as vaginal intraepithelial neoplasia. If you are diagnosed with vaginal intraepithelial neoplasia (VAIN), your risk of developing vaginal cancer increases.
• Although vaginal cells with VAIN differ from normal cells in appearance, they do not differ sufficiently to be categorised as cancerous. A small fraction of patients with VAIN develop vaginal cancer, a rare but potentially deadly disorder. Medical experts are unsure of the reason why some cases develop into cancer while others stay benign.
• VAIN is frequently caused by the human papillomavirus (HPV), which is transmitted through sexual contact and can result in cancers of the cervical, vaginal, and vulvar regions. Certain types of HPV infection are preventable with vaccinations.
• Exposure to specific anti-pregnancy drugs: If your mother took diethylstilbestrol (DES) in the 1950s while she was pregnant, you may be more susceptible to a particular type of vaginal cancer called clear-cell adenocarcinoma.

Diagnosis Of Vaginal Cancer

Examinations for vaginal cancer in women

Occasionally vaginal cancer is detected before symptoms appear during a routine pelvic exam.

During a pelvic exam, your doctor will examine your outer genitalia with great care, examine your ovaries and uterus with two inserted fingers into your vagina, and press the abdomen with the other hand. He or she also inserts a speculum, or instrument, into your vagina. When the speculum opens your vaginal canal, your doctor can check your vagina and cervix for abnormalities.

In addition, your physician may do a Pap test. Although Pap tests can occasionally detect vaginal cancer cells, they are mostly used to screen for cervical cancer.

Your cancer risk factors and the history of abnormal Pap tests will influence how frequently you have these screenings performed. To find out how frequently these screenings should be performed, speak with your doctor.

Diagnostic tests for vaginal cancer

A pelvic examination and Pap test may be performed by your doctor to check for abnormalities that may indicate vaginal cancer. Based on such findings, your doctor may order more tests to determine if you have vaginal cancer, such as:

• Using a magnifying glass to examine the vagina: A colposcopy involves the use of a colposcope, a specialised light-powered magnification equipment, to examine your vagina. Your doctor will be able to magnify your vagina to see any regions of abnormal cells during a colposcopy.
• Taking a sample of vaginal tissue for analysis: During a biopsy, a sample of dubious tissue is taken to check for malignant cells. During a colposcopy examination, your doctor may obtain a tissue biopsy. Your doctor sends the tissue sample to a lab for examination.
• Your doctor will stage the cancer after a vaginal cancer diagnosis to determine where it is situated. Depending on the stage of your cancer, your doctor can advise you on the best course of treatment. To determine the stage of your cancer, your doctor could employ one of the following techniques:
  • Imaging examination: Your doctor may order imaging tests to see whether the cancer has spread. Imaging tests include CT scans, MRIs, X-rays, positron emission tomography (PET), and magnetic resonance imaging (MRI).
  • Tiny cameras that record your body's movements: With the use of techniques that employ tiny cameras to see inside your body, your doctor might be able to determine whether cancer has spread to particular areas of your body. Cameras help your doctor see inside your bladder and rectum during a cystoscopy or proctoscopy.

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Treatment Of Vaginal Cancer

The type and stage of your vaginal cancer are two of the numerous factors influencing your options for treatment. You and your doctor work together to choose the best course of therapy based on your treatment objectives and the side effects you are willing to accept. Treatments for vaginal cancer often involve radiation and surgery.

Surgery

Treatment options for vaginal cancer include the following surgical procedures:

• Removal of small tumours or lesions: If the cancer is limited to the surface of your vagina, it might be removed. To ensure that all of the cancer cells are eliminated, just a small amount of healthy tissue might also be removed.
• Vaginectomy, also known as vaginal excision: A radical vaginectomy or a partial vaginectomy, which includes removing a piece of your vagina, may be necessary to eliminate all of the malignancy. Depending on the extent of your cancer, your surgeon can recommend a vaginectomy along with a hysterectomy (removal of the uterus and ovaries) or a lymphadenectomy (removal of the surrounding lymph nodes).
• Pelvic exenteration majority of the pelvic organs are removed during pelvic exenteration: Major surgery may be required if your vaginal cancer has spread throughout your pelvic region or if it has returned.
  • During pelvic exenteration, the surgeon may remove several organs from your pelvic region, including your lower part of the colon, uterus, vagina, ovaries, bladder, and rectum. Your abdomen is designed with openings that allow waste to exit your body (colostomy) and urine to exit your body (urostomy) and collect in ostomy bags.
  • If your vagina needs to be removed completely, you have the option to have a new vagina surgically created. Surgeons may use muscle flaps, skin pieces, or sections of the intestine from other areas of your body for constructing a new vagina.
  • If you make specific adjustments, you can have vaginal sex with a reconstructed vagina. However, a replicated vagina is not the same as an actual one. For instance, a reconstructed vagina lacks natural lubrication and feels different when touched because of changes in the surrounding nerves.

Radiation therapy

Radiation therapy uses powerful energy beams, similar to X-rays, to kill cancer cells. There are two ways by which Radiation can be given:

• External radiation: External beam radiation therapy may target your pelvis only or your entire abdomen, depending on the extent of your cancer. During external beam radiotherapy, you lie on a table and a large piece of radiation equipment moves around you to target the treatment area. The majority of women with vaginal cancer undergo radiation treatment using an external beam.
• Internal radiation: Internal radiation therapy, also referred to as brachytherapy, involves implanting radioactive objects, such as wires, cylinders, seeds, or other materials, into your vagina or the surrounding tissue. Removal of the device is feasible after a set amount of time. For patients with very early-stage vaginal cancer, only internal radiation therapy is permitted. Others could obtain inner radiation after being exposed to outside radiation.
• Radiation therapy kills cancer cells that spread quickly, but if it harms nearby healthy cells, it may have undesirable side effects. The radiation's adverse effects depend on how strong it is and where it is incident.

Further options

If radiation and surgery are insufficient to manage your cancer, additional therapy like the following might be suggested:

• Chemotherapy: Chemotherapy uses chemicals to kill cancer cells. Chemotherapy may or may not help treat vaginal cancer. Chemotherapy alone is therefore rarely used to treat vaginal cancer. Chemotherapy and radiation therapy can be used together to maximise the effects of radiation.
• Clinical assessments: Clinical trials are investigations carried out to assess new treatment modalities. While there is no assurance of a cure, taking part in a clinical study allows you to try the most recent developments in medicine. Consult your physician about the clinical studies that are now accepting participants to find out more about your options. 

Also Read: Bacterial Vaginosis: Causes, Symptoms, Risk Factors, Complications, Prevention, Diagnosis And Treatment

Prevention Of Vaginal Cancer

Vaginal cancer cannot be fully prevented. However, you could reduce your risk if you:

• Frequently get a pelvic examination and Pap test: The chance that vaginal cancer is discovered early can be increased with routine pelvic exams and Pap tests. Recovery from vaginal cancer is more likely with early detection. Discuss with your physician the ideal timing to begin these tests and the frequency at which they should be performed.
• Talk to your doctor about getting the HPV vaccine: Having an HPV vaccination can reduce your risk of vaginal cancer and other diseases associated with HPV. Consult your physician to see if receiving the HPV vaccination would benefit you.
• Avoid smoking: Quit smoking. If you don't smoke, don't start. Smokers are more prone to develop vaginal cancer.

Complications Of Vaginal Cancer

Vaginal cancer has the potential to metastasize, or spread, to other body organs such as the liver, lungs, or bones.

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