Vaginal Cancer

[BSHC]

What is the vagina?

The vagina is the passageway through which fluid passes out of the body during menstrual periods. It is also called the "birth canal." The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia).

What is vaginal cancer?

Cancer of the vagina, a rare kind of cancer in women, is a disease in which malignant cells are found in the tissues of the vagina. According to the American Cancer Society (ACS), about 2,140 cases of vaginal cancer will be diagnosed in the US in 2007.

There are several types of cancer of the vagina. The two most common are:

• squamous cell cancer (squamous carcinoma)
  • Squamous carcinoma is most often found in women between the ages of 60 and 80, and accounts for 85-90 percent of all vaginal cancers.
• adenocarcinoma
  • Adenocarcinoma is more often found in women older than 50 and accounts for 5-10 percent of all vaginal cancers.
  • A rare form of cancer called clear cell adenocarcinoma results from the use of the drug DES (diethylstilbestrol) given to pregnant women between 1945 and 1970 to keep them from miscarrying.

Other types of vaginal cancer include:

• malignant melanoma
• leiomyosarcoma
• rhabdomyosarcoma

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.

Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop cancer, while others develop cancer and have no known risk factors.

But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What are risk factors for vaginal cancer?

The following have been suggested as risk factors for vaginal cancer:

• age
  Half of women affected are older than 60, with most between ages 50 and 70.
• exposure to diethylstilbestrol (DES) as a fetus (mother took DES during pregnancy)
• history of cervical cancer
• history of cervical precancerous conditions
• human papillomavirus (HPV) infection
• vaginal adenosis
• vaginal irritation
• uterine prolapse
• smoking

What are the symptoms of vaginal cancer?

The following are the most common symptoms of vaginal cancer. However, each individual may experience symptoms differently. Symptoms may include:

• bleeding or discharge not related to menstrual periods
• difficult or painful urination
• pain during intercourse
• pain in the pelvic area
• constipation
• a mass that can be felt

Even if a woman has had a hysterectomy, she still has a chance of developing vaginal cancer. The symptoms of vaginal cancer may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is vaginal cancer diagnosed?

There are several tests used to diagnose vaginal cancer, including:

• pelvic examination of the vagina, and other organs in the pelvis, checking for tumors, lumps, or masses (i.e., may include colposcopy)
• colposcopy - a procedure that uses an instrument with magnifying lenses, called a colposcope, to examine the cervix for abnormalities. If abnormal tissue is found, a biopsy is usually performed (colposcopic biopsy).
• Pap test (also called Pap smear) - test that involves microscopic examination of cells collected from the cervix, used to detect changes that may be cancer or may lead to cancer, and to show noncancerous conditions, such as infection or inflammation.
• computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure using a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
• positron emission tomography (PET) scan - radioactive-tagged glucose (sugar) is injected into the bloodstream. Tissues that use the glucose more than normal tissues (such as tumors) can be detected by a scanning machine. PET scans can be used to find small tumors or to check if treatment for a known tumor is working.
• biopsy - a procedure in which tissue samples are removed from the vagina for examination under a microscope; to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.

Treatment for vaginal cancer:

Specific treatment for vaginal cancer will be determined by your physician based on:

• your overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Generally, there are three kinds of treatment available for patients with cancerous or precancerous conditions of the vagina:

• surgery, including:
  • laser surgery to remove the cancer, including LEEP (loop electroexcision procedure)
  • local excision to remove the cancer
  • (partial) vaginectomy to remove the vagina
• chemotherapy (topical)
• radiation therapy

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WIKIPEDIA.COM

Vaginal cancer is any type of cancer that forms in the tissues of the vagina. Vaginal cancer is not common. It occurs primarily in women over age 50, but can occur at any age, even in infancy. When found and treated in early stages (see cancer staging), it often can be cured.

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 Types of vaginal cancer

There are two primary types of vaginal cancer: squamous cell carcinoma and adenocarcinoma.^[1]

• Vaginal squamous cell carcinoma arises from the thin, flat squamous cells that line the vagina. This is the most common type of vaginal cancer. It is found most often in women aged 60 or older.
• Vaginal adenocarcinoma arises from the glandular (secretory) cells in the lining of the vagina that produce some vaginal fluids. Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes. It is found most often in women aged 30 or younger. It is also found in a small percent of women born between 1938 and 1971 that were exposed to the drug diethylstilbestrol (DES). DES was prescribed to 5 to 10 million mothers in that timespan to prevent possible miscarriages and premature birth. ^[2] Typically, patients present with adenocarcinoma before age 30, but increasing evidence indicates effects in later years as well. DES-exposed patients may also suffer various infertility and pregnancy complications as well.^[3]

There are also less common forms of vaginal cancer:

• Vaginal germ cell tumors (primarily teratoma and endodermal sinus tumor) are rare. They are found most often in infants and children.
• Sarcoma botryoides, a rhabdomyosarcoma also is found most often in infants and children.

 Signs and Symptoms

Often there are no symptoms, and cancer is found through a routine gynecologic exam. If there are symptoms, they are commonly abnormal vaginal bleeding, which may be postcoital, intermenstrual, prepubertal, or postmenopausal.^[4] Other, less specific signs include difficult or painful urination, pain during intercourse, and pain in the pelvic area.

 Diagnosis

Several tests are used to diagnose vaginal cancer, including:

• Physical exam and history
• Pelvic exam
• Pap smear
• Biopsy
• Colposcopy