Vaginal Cancer

What is vaginal cancer?

Vaginal cancer is a cancer that affects women, most commonly over the age of 60. It is more common in women who have the human papillomavirus (HPV).

The vagina is the organ that connects the lower part of the uterus, known as the cervix, to the vulva. It is also called the birth canal, as a baby passes through it at birth. Flat cells called squamous cells line the vagina. This layer is also called the epithelium.

Are there different types of vaginal cancer?

There are several types of vaginal cancer, which all affect different cells within the vagina:

• Squamous cell carcinoma: This is the most common vaginal cancer, accounting for about 70% of cases, and starts in the cells lining the vagina near the cervix
• Adenocarcinoma: A cancer that begins in gland cells of the vagina, accounting for around 15% of cases. It usually affects women over 50
• Melanoma: A rarer type of vaginal cancer, melanoma usually occurs in the outer part of the vagina
• Sarcoma: A rare type of vaginal cancer, that starts within the walls of the vagina. There are several types of sarcoma, with rhabdomyosarcoma being the most common, and usually found in children. Leiomyosarcoma is another type of sarcoma but is more common in women over 50

Causes of vaginal cancer

Women who have HPV or who have been infected with the herpes simplex virus, are at higher risk of developing vaginal cancer. Having cervical cancer also puts you at a greater risk. The risk of vaginal cancer is doubled in women who smoke.

Between 1940 and 1971, women were sometimes given a drug called diethylstilbestrol (DES) while pregnant. The daughters of these women are now known to be at a greater risk of developing clear-cell adenocarcinoma, a cancer of the vagina or cervix.

Symptoms of vaginal cancer

There are often no symptoms of vaginal cancer, meaning it is advanced by the time a diagnosis is made. Therefore, regular checkups with a gynecologist are strongly recommended. Symptoms of vaginal cancer can include:

• Bleeding outside of menstruation, sometimes after intercourse
• Painful intercourse
• Unusual discharge
• A lump in the vagina
• Constipation
• Painful urination
• A pain in the pelvic area

Although usually harmless, if you notice any of these symptoms, always talk to your doctor.

Diagnosing vaginal cancer

Your doctor will first discuss your symptoms and medical history. They will then perform a pelvic exam, and a pap smear and biopsy of the vagina. If abnormal cells are found via the pap smear, your doctor will then perform a colposcopy, during which your cervix and vagina will be examined, and a small tissue sample (biopsy) is taken for investigation.

Treatment for vaginal cancer

Treatment will depend on how advanced the cancer is, which type of cells are affected, and a woman's age. If vaginal cancer is affecting a younger woman who hasn't started a family yet, different treatment will be given which can preserve fertility.

Earlier stage cancer can be treated with laser surgery. When caught early, vaginal cancer can often be successfully treated, and survival rates are high.

More advanced vaginal cancer is harder to treat so it is important to report any symptoms to your doctor as soon as you notice them. Treatment may involve surgery, radiation and chemotherapy. A doctor will stage the cancer, to see how advanced it is, and whether it has spread to other organs or the lymph nodes. These stages are called T (tumor), N (nodes), and if it has spread, or metastasized, M.