What Is a Vaginal Neoplasm?
A neoplasm is another name for cancer. Cancer is a disease characterized by the uncontrollable multiplication of abnormal cells. It can occur in any organ of the body, including the vagina.
Also called the birth canal, the vagina is a three to four-inch tube that connects the cervix (the bottom of the uterus), to the vulva (the external female genitalia).
Vaginal cancer is rare, and comprises less than three percent of female reproductive cancers, states the University of California-San Francisco (UCSF) Medical Center (UCSF, 2012).
Types of Vaginal Cancer
There are four main types of vaginal cancer.
Squamous Cell Cancer
This is the most common type of vaginal cancer. This type develops from the squamous cells in the lining of the vagina. It is usually a slow-growing cancer, and is often found in its precancerous stages. Vaginal intraepithelial neoplasia (VAIN) is a precancerous condition that occurs when squamous cells start to display abnormal changes that can lead to cancer.
This type of vaginal cancer starts in the gland cells and is the second most common type.
While melanoma of the skin is fairly common, it rarely affects the vagina. Melanoma develops from skin cells that produce pigment.
Sarcomas originate in bone, muscle, or connective tissue.
Causes of and Risk Factors for Vaginal Cancer
Many times, the cause of an individual’s vaginal cancer is unknown. However, some risk factors may increase your risk. Women who are at greater risk for developing vaginal cancer include:
- Women over 70 years of age
- Women whose mothers took the drug DES while pregnant with them
- Women infected with the human papillomavirus (HPV)
- Women infected with HIV
- Women who smoke cigarettes and drink alcohol
Talk with your doctor if you are worried about your risk of vaginal cancer. He or she can review your health history and give you more information about your specific risk for this cancer. Even if you have one or more risk factors, you won’t necessarily get vaginal cancer.
Symptoms of Vaginal Cancer
Some women may be asymptomatic. However, when symptoms are exhibited, they can include:
- vaginal bleeding after intercourse
- abnormal vaginal discharge or bleeding
- pelvic or vaginal pain
Sometimes this cancer is found during a routine gynecologic checkup in those with no symptoms.
How Is Vaginal Cancer Diagnosed?
Vaginal cancer may be found unexpectedly during a yearly pelvic exam or Pap smear. As part of every pelvic exam, your doctor will insert a gloved finger into your vagina while pressing down on your abdomen. He or she is looking for unusual growths, pain, and tenderness.
During a Pap smear, your doctor will take a swab of cells from your cervix and vagina. These cells will then be tested for abnormalities.
Unusual pain, tenderness, growths, or abnormal cells are all cause for concern, as they may be symptoms of vaginal cancer. However, this is rare.
If your doctor suspects you may have cancer, he or she may take a biopsy (a small sample of tissue) from your vagina to see if cancer cells are present. Your doctor may also order a vaginoscopy. The endoscope (small microscope) used in this procedure will allow your doctor to examine your vagina in greater detail. CT scans and MRIs of the area are often given as well.
Once your doctor diagnoses vaginal cancer, your cancer will be staged. The staging system classifies cancers based on their spread in the body. According to the Mayo Clinic, the stages of vaginal cancer include (Mayo, 2010):
- Stage I: limited to the vaginal wall
- Stage II: spread to tissue next to the vagina
- Stage III: spread to lymph nodes in the area, the pelvis, or both
- Stage IVA: spread to lymph nodes in the area and the bladder, rectum, or pelvis
- Stage IVB: spread to other areas in the body
Your doctor will order a CT scan or MRI. He or she will want to view your surrounding organs to see if the cancer has spread.
How Is Vaginal Cancer Treated?
Like other cancers, vaginal cancer is treated based on type, location, and stage. One or more treatments may be used, including surgery, radiation, or chemotherapy.
Surgery is the most common treatment, regardless of the stage of the cancer, according to the UCSF Medical Center (UCSF, 2012). Laser surgery or a simple excision may be done. In more severe cases, the vagina or other organs to which the cancer has spread are removed.
Radiation therapy uses high-energy rays to kill cancer cells. External radiation uses a machine outside the body to aim rays at the affected area. Internal radiation involves placing radioactive tubes or pellets into the cancerous tissues or area.
Chemotherapy uses drugs to kill cancer cells. Depending on the specific drug, it may be administered intravenously or orally. The drug can then travel throughout your body, attempting to kill any cancer that has spread to distant organs.
Coping: Life with and After Vaginal Cancer
A cancer diagnosis can be scary, and cancer treatment can be both physically and emotionally trying. You don’t have to go through it alone. A support group, counselor, or your treatment team can help you cope with any problems and feel less alone.
On its website, The American Cancer Society (ACS) lists a number of organizations that can provide support to those with vaginal cancer (ACS, 2012). These include:
Foundation for Women’s Cancer (formerly the Gynecologic Cancer Foundation)
Toll-free number: (800) 444-4441
Telephone number: (312) 578-1439
National Cancer Institute
Toll-free number: (800) 422-6237 (1-800-4-CANCER); TYY: (800) 332-8615
National Coalition for Cancer Survivorship
Toll-free number: (888) 650-9127
The American Cancer Society staff is also available 24 hours a day to provide support at (800) 227-2345 or at www.cancer.org.
It is important to continue with follow-up. Regular checkups help monitor side effects and complications from the cancer or treatment. They also help to make sure the cancer has not returned.
Outlook for Vaginal Cancer
Vaginal cancer is commonly asymptomatic, so it is often diagnosed in its later stages. However, having yearly Pap smears and pelvic exams increases your likelihood of finding this cancer in its earlier stages.
The latest American Cancer Society’s five-year survival estimates are 54 percent for squamous cell carcinoma of the vagina, 60 percent for adenocarcinoma of the vagina, and 13 percent for vaginal melanoma (ACS, 2012).
Research is ongoing, however, and there are many new developments and studies underway. These include gene therapy and the connections of vaccines like the HPV vaccine Gardasil to reducing the risk of vaginal cancer (ACS, 2012).