Vaginal cancer is an uncommon disease in which cancer cells grow in the vaginal lining. The vagina is a tube that connects the vulva (external female genitals) to the cervix (lower end of the uterus).
There are several types of vaginal cancer:
- Squamous cell carcinoma—Occurs in the lining of the vagina.
- Adenocarcinoma—Occurs in the area of the vagina lined with cells similar to those in the glands of the cervix and uterus.
- Clear cell adenocarcinoma—Occurs in women whose mother used a drug called diethylstilbestrol (DES) during pregnancy. This drug was introduced in the late 1930s and no longer used after 1971, so the incidence of this particular type of adenocarcinoma is expected to decline.
- Melanoma—Usually affects lower or outer portion of the vagina.
- Sarcoma—Forms deep in the walls of the vagina, not on the surface.
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Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Vaginal cancer is more common in women after age 60 years of age. Other factors that may increase your chance of vaginal cancer include:
- History of cervical cancer
- History of precancerous conditions in the cervix or vagina
- Having a mother who took diethylstilbestrol (DES) while pregnant
- Human papillomavirus infection (HPV)—a sexually transmitted disease (STD)
- Vaginal adenosis—when cells lining the vagina look like those found in the cervix and uterus
Vaginal cancer may cause:
- Bleeding or discharge not related to menstrual periods
- Pain or difficulty when urinating
- Pain during intercourse
- Pain in the pelvic area
- New or worsening constipation
- A mass in the vagina that can be felt
Your doctor will ask about your symptoms and medical history. A physical and pelvic exam will be done.
Your bodily fluids and tissue may be tested. This can be done with:
- Pap test —tissue from the inside of the cervix and upper vagina is scraped and tested
- Colposcopy —a lighted, magnifying instrument is used to examine the vagina and cervix
- Biopsy —removal of a sample of vaginal tissue for testing
Imaging tests may include:
- CT scan
- MRI scan
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, vaginal cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Treatments for vaginal cancer depend on the stage of the cancer. Talk with your doctor about the best treatment plan for you. Treatment options include:
While a Pap smear is an effective screening tool for cervical cancer, it cannot be relied upon to detect vaginal cancer. To help reduce your chance of vaginal cancer:
- Have regular pelvic exams to monitor any changes that may signal cancer.
- Talk to your doctor if you were exposed to DES while your mother was pregnant with you. Your doctor can monitor your risk of vaginal cancer.
- HPV vaccine—Gardasil, that protects against four types of HPV. HPV is associated with certain types of cancer. The vaccine helps to prevent cancers of the cervix, vulva, and vagina.