VAGINAL CANCER

Vaginal cancer happens when normal cells in the vagina (figure 1) change into abnormal cells and grow out of control. There are different types of vaginal cancer, depending on the cells involved.

This article discusses cancer that starts in the vagina. But it is also possible for cancer to start in another part of the body and then spread to the vagina.

Some people with vaginal cancer have no symptoms. They find out they have it when their doctor or nurse does a routine “screening test” to check for cancer of the cervix (figure 1). During a screening test, a doctor or nurse gently places a device called a “speculum” in the vagina. The device helps to push apart the walls of the vagina, so the doctor or nurse can see the vagina and cervix. Then they can use a small brush to collect cells from the cervix. The cells are then examined under a microscope or tested in a lab.

When vaginal cancer causes symptoms, the most common symptom is abnormal bleeding from the vagina. The bleeding usually happens after sex or in people who have already gone through menopause. Menopause is when a person stops having monthly periods.

Other symptoms of vaginal cancer can include:

• Fluid coming out of the vagina that is watery, bloody, or bad-smelling
• Pain when urinating, blood in the urine, or feeling the need to urinate often
• Trouble having bowel movements, black-colored bowel movements, or feeling the need to have a bowel movement when your bowels are empty

All of these symptoms can also be caused by conditions that are not vaginal cancer. But if you have these symptoms, tell your doctor or nurse.

Yes. To check for vaginal cancer, your doctor or nurse will do a pelvic exam. They might use a special magnifying lens called a “colposcope” to see the vagina more clearly.

During the exam, they will do a test called a biopsy. This involves taking a small sample of tissue from the area that looks like cancer. Then another doctor will look at the sample under a microscope.

Cancer staging is a way in which doctors find out if a cancer has spread past the layer of tissue where it began, and, if so, how far.

The right treatment for you will depend a lot on the stage of your cancer, how big the cancer is, and where it is in your vagina. Your treatment will also depend on your age, other medical problems, and whether you might want to get pregnant in the future.

Treatment for vaginal cancer includes one or more of following:

• Surgery – Vaginal cancer is usually treated with surgery to remove the uterus, cervix, and upper part of the vagina. This is called a “radical hysterectomy” (figure 2).
• Radiation therapy – Radiation kills cancer cells. Sometimes, the radiation comes from a machine that is outside the body. Other times, the radiation comes from tiny seeds or capsules that are put in the body, near the cancer.
• Chemotherapy – Chemotherapy is the medical term for a group of medicines that kill cancer cells or stop them from growing.

After treatment, you will be checked every so often to see if the cancer comes back. Follow-up tests usually include pelvic exams and tests (similar to Pap tests) to check the cells in the vagina for cancer.

You should also watch for the symptoms listed above. Having those symptoms could mean your vaginal cancer has come back. Tell your doctor or nurse if you have any symptoms.

If your vaginal cancer comes back or spreads, you might have more surgery or chemotherapy.

If you have not yet gone through menopause and want to have a baby in the future, talk with your doctor before starting treatment. Some people can still get pregnant after being treated for vaginal cancer. But it is not possible to get pregnant after some types of treatment, such as a hysterectomy or some types of radiation and chemotherapy.

It’s important to follow all of your doctor’s instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for vaginal cancer involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

• What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
• What are the downsides to this treatment?
• Are there other options besides this treatment?
• What happens if I do not have this treatment?