What is Vaginal Cancer?
Vaginal cancer is a rare form of cancer, it affects around 250 women in the UK each year. Cancer can be defined as a malignant growth or tumour that has resulted from uncontrolled division of cells.
Primary vaginal cancer relates to cancer that has started in the vagina. Other forms of cancer, such as cervical cancer can spread to the vagina, this is termed secondary vaginal cancer and is more common than primary vaginal cancer.
Vaginal cancer can be divided into the cell from which it originates.
The commonest type of vaginal cancer starts in the squamous cells, these are flat cells that cover the surface of the vagina. Over 80% of vaginal cancers are squamous cell carcinomas. Before the squamous cell carcinoma develops, there are ‘pre-cancerous changes’ within the cells known as vaginal intraepithelial neoplasia (VAIN). Many women who have VAIN do not develop cancer and can be treated to clear the abnormal cells.
Other rarer types of vaginal cancer include adenocarcinoma (10%), sarcoma (3%) and melanoma (3%).
Although no direct cause for vaginal cancer has been identified, factors that could increase your risk of vaginal cancer include:
- Aged over 60
- Human Papillomavirus infections (Particularly HPV 16)
- Pre-cancerous changes in the vagina (VAIN)
- Pre-cancerous changes in the cervix (CIN)
- Weakened immune system
- HIV or AIDS
What are the symptoms of Vaginal Cancer?
It can be difficult to diagnose vaginal cancer early as there tend not to be clear cut symptoms.
Symptoms that may be experienced include:
- Post-menopausal bleeding
- Bleeding after sex
- Pain in your pelvis during sex
- Bloodstained vaginal discharge
- Inter-menstrual bleeding (bleeding inbetween periods)
- A lump in your vagina
- Pain on passing urine
- Blood in urine
- Increased frequency of passing urine
If you are experiencing any of the symptoms above and believe you could have vaginal cancer be sure to see your GP. It is important to get checked to rule out any serious problems.
If you do have vaginal cancer, early diagnosis can improve treatment outcomes.
Your GP will ask about all of the symptoms you have been experiencing and may ask to do an examination of your vagina.
Your GP will refer you to a specialist for more specialist tests to help diagnosis.
When seeing a specialist they may undertake scans (such as an ultrasound) to visualise the vagina.
A colposcope (small microscope with a light) is used to look at the vagina and cervix. Special formulations of liquids are applied to highlight any abnormal areas. A small sample of tissue (biopsy) may be taken from any abnormal areas to be examined in a laboratory.
If you are diagnosed with vaginal cancer, your specialist will suggest further tests to see whether the cancer has spread to other areas of the body. This will help decide the most appropriate management plan going forwards. These tests can include a chest x-ray, CT-scan and MRI scan.
Waiting for these test results can be a very difficult time, support may be available through your specialist nurse and support groups such as ‘Macmillan cancer support specialists’.
Staging & Grading
Staging of cancer takes into account how far the cancer has grown from where it started and if it has spread to other areas of the body. Staging of your cancer only happens when all test results are received. Staging helps the medical team decide on the most appropriate treatment plan. Your specialist will explain what the staging means. Grading of cancer refers to how the cancer cells look under a microscope and indicates how the cancer may develop and spread.
What treatments are available?
Treatment of any form of cancer is complex and requires multidisciplinary input from many medical professionals.
Treatment plans are personalised for each patient and take into account the stage of cancer, location and the health and wishes of the patient.
All results will be discussed fully with a team of oncologists, surgeons, radiologists and other healthcare professionals to create a personalised treatment plan. Your doctor or nurse will explain the treatment options going forwards, it is important that you ask all the questions you have and explain if you need more information to make an informed decision regarding treatment.
If you are wishing to start a family and have been diagnosed with vaginal cancer you may wish to discuss preserving your fertility with your doctor.
The main treatments for vaginal cancer are radiotherapy, chemotherapy and surgery. You may have a single treatment or a combination of treatments.
- Radiotherapy uses radiation from a machine to destroy the cancer cells in your vagina.
- Surgery for vaginal cancer may involve removing a small part of your vagina or a larger part of the vagina and subsequent reconstruction. Nearby tissue may also be removed depending on the extent of the vaginal cancer.
- Chemotherapy is medication that is taken to destroy cancer cells if they have spread to other areas of the body.
This page has been written by Wellbeing of Women Contributor Dr Alice Bolton