Things you need to know about vaginal cancer! Let's talk about this.

Sometimes we hear about different types of cancer that women get. Among them, vaginal cancer is a little rare, but it is something we should definitely be aware of. You may feel a little scared when you hear this, but don't worry. The most important thing is to be aware. So, without being afraid, let's talk about this in some detail?

What is vaginal cancer?

Simply put, vaginal cancer is cancer of the cells lining your vagina. As you know, the vagina is a tube-like organ that connects your cervix (the lower part of your uterus) to your external genitalia (the vulva).

Usually, it happens that cancer starts somewhere else in the body, like cervical cancer or uterine cancer, and spreads to the vagina. However, it is a little less common for cancer to start in the vagina itself. That's why we call it vaginal cancer .

What are the types of vaginal cancer?

Okay, now let's see if there are different types of vaginal cancer. Yes, there are. They are named after the type of cells in the vagina where the cancer starts.

• Squamous cell carcinoma : This is the most common type. There are flat cells that line the inside of your vagina , called squamous cells. These are the cells where this cancer starts. About 90% of all vaginal cancers are of this type.
• Adenocarcinoma: This starts in the gland cells of the vagina. It is most common in people over the age of 50. However, there is a special type of this cancer called clear cell adenocarcinoma . This type of cancer is most common in women under the age of 50 who were exposed to a drug called diethylstilbestrol (DES) while they were in the womb. In the past, DES was used to prevent complications during pregnancy.
• Melanoma: Your vagina has cells called melanocytes that give it color, and this cancer starts in those cells. However, melanoma in the vagina is very, very rare.
• Sarcoma: This starts in the connective tissue and muscle tissue that make up the wall of the vagina. Like melanoma, this sarcoma is very rare. There are different types of sarcoma. Rhabdomyosarcoma is the most common type, and it often occurs in children. Leiomyosarcoma is the most common type, and it usually occurs in people over 50.

How common is this cancer?

Now you might be wondering how common this vaginal cancer is. In fact, it is a very rare cancer. Only about one in 100,000 women develop this disease, and the most common type is squamous cell carcinoma. When it comes to gynecological cancers, vaginal cancer only accounts for 1% to 2%.

Who is more likely to develop vaginal cancer?

Okay, so who is more likely to develop vaginal cancer? Let's see if you have any of these risk factors:

• If you are over 60: Your risk of developing vaginal cancer increases with age. The most common type of cancer, squamous cell carcinoma, is usually diagnosed in people over the age of 60. However, it can sometimes develop in people under the age of 60.
• If you have been infected with the human papillomavirus ( HPV ): HPV is a sexually transmitted virus. It can increase the risk of cervical cancer and vaginal cancer. Having multiple sexual partners and not being vaccinated against HPV increases the risk of this infection.
• If you have been diagnosed with Vaginal Intraepithelial Neoplasia (VAIN): VAIN means that the cells in the lining of your vagina are abnormal, but not cancerous. Some people with VAIN can eventually develop into vaginal cancer, but not everyone does. This is because researchers still don't know for sure. You are more likely to develop VAIN if you have HPV.
• If you have had cervical cancer or cervical dysplasia before: You can still develop vaginal cancer after treatment for cervical cancer. Also, if you have abnormal cells on your cervix (cervical dysplasia), that can also increase your risk of vaginal cancer .
• If you have been exposed to the drug diethylstilbestrol (DES): DES is a synthetic estrogen that was given to prevent complications during pregnancy between 1940 and 1971. If your mother took DES while she was pregnant with you, you are at increased risk of developing a type of cancer called adenocarcinoma.
• If you are a smoker: Smoking doubles the risk of developing vaginal cancer.

What are the symptoms of vaginal cancer?

It's important to know the symptoms of vaginal cancer. However, sometimes you can have this cancer without showing any symptoms. When you go for a routine screening, your doctor may find abnormal cells and tell you that you have it. That's why it's important to get regular checkups. Your doctor can detect this cancer even if your body doesn't tell you anything.

However, when symptoms appear, you may see things like:

• Vaginal bleeding after sex (this is bleeding that is not related to menstruation ).
• Vaginal bleeding after menopause (that is, after menstruation has completely stopped).
• Vaginal discharge that is watery, blood-tinged, or has a foul odor.
• Feeling pain during sexual intercourse.
• Feeling something like a lump in the vagina.
• Pain during urination or a feeling of having to urinate frequently.
• Constipation or passing black stools.
• Feeling the need to defecate even though the bowels are empty.
• Pelvic pain.

The important thing is that having one or more of these symptoms doesn't always mean it's a serious condition like vaginal cancer. However, if you have any of these symptoms, it's important to see a doctor as soon as possible to get checked out.

What are the causes of vaginal cancer?

Researchers are not yet sure what exactly causes vaginal cancer. However, as with cervical cancer, it is thought that there is a link between vaginal cancer and high-risk strains of HPV. Some studies have shown that many people who develop vaginal cancer have antibodies to the types of HPV that are linked to cervical cancer.

How does this cancer spread?

You know how cancer cells behave. Instead of growing, dividing, and eventually dying like normal cells, cancer cells keep growing. These cells divide and divide to form tumors. Over time, these tumors can spread (metastasize) to other parts of the body, and they can also invade healthy tissue. Vaginal cancer cells behave in the same way.

How is vaginal cancer diagnosed?

When you go to see a doctor with symptoms, they will first ask you about your symptoms. Then, they will do several tests to see if there is cancer or precancerous cells. Imaging procedures can help determine the stage (staging) of the cancer, or whether the cancer has spread.

Testing

Most often, you will have a pelvic exam and a Pap smear (Pap test). If the doctor finds abnormal cells, you may need further tests, such as a colposcopy and a vaginal biopsy. This biopsy is the only test that can definitively confirm whether cancer is present.

• Pelvic exam: The doctor will look at your external genitalia (vulva) and insert two fingers into your vagina to check for any abnormalities. The vagina will be slightly widened using a device called a speculum to allow a clear view of the vaginal canal and cervix.
• Pap smear: While keeping your vagina open with a speculum, your doctor will use a spatula-like instrument and a brush to scrape a small sample of cells from your cervix. These cells will be sent to a lab to be tested for signs of cancer or the HPV virus.
• Colposcopy: In this test, the doctor uses a lighted instrument called a colposcope to look inside your vagina and cervix for abnormal cells.
• Biopsy: A biopsy is often done at the same time as a colposcopy. The doctor takes a tissue sample and sends it to a lab to check for cancer cells.

Staging

Staging is another way for your doctor to determine how far your cancer has spread. Vaginal cancer is staged in three main ways: how far the tumor has spread within the vagina, whether it has spread to lymph nodes, and whether it has spread to other parts of the body (metastasized). These three categories are called T (tumor), N (nodes), and M (metastasized).

The doctor can determine the stage of your cancer by using information from the test results and tests that can look inside the body.

Imaging procedures used to determine the stage of cancer are:

• X-rays
• Computerized Tomography (CT) scans
• Magnetic Resonance Imaging (MRI)
• Positron Emission Tomography (PET) scans

MRI can provide details about the size of the tumor. PET scans can show abnormal lymph nodes.

• Cystoscopy: This can be used to see if the cancer has spread to the bladder. For this test, a small, lighted tube with a camera is inserted into your bladder.
• Proctoscopy: This can see if the cancer has spread to the small intestine or rectum. Again, a small, lighted tube with a camera is inserted into your rectum.

How is vaginal cancer treated?

The treatment for vaginal cancer depends on the type of cancer, the stage of the cancer, and your age. Along with your age, whether you hope to have children or not may also affect treatment decisions.

Typically, laser surgery and topical treatments are used to treat precancerous cells. Invasive vaginal cancer often requires surgery, radiation, and chemotherapy. You may also have one or more of these treatments together.

Surgery

• Wide local excision: The doctor removes the cancerous tumor along with some healthy tissue around it.
• Vaginectomy (partial or radical): Depending on the size and location of the tumor, your doctor may remove part or all of your vagina. Depending on how far the cancer has spread, your doctor may recommend removing lymph nodes (lymph node dissection) and removing the uterus and cervix (hysterectomy).
• Pelvic exenteration: This surgery removes several organs from your pelvic cavity. These include the lower part of your large intestine (rectum), bladder, uterus, cervix, vagina, ovaries, and nearby lymph nodes. A hole (stoma or ostomy bag) is created in your abdomen so that you can urinate and defecate. This surgery may be considered if the cancer has come back.

Radiation therapy

Radiation therapy is the use of targeted energy beams, such as X-rays, to kill cancer cells or stop them from dividing.

• External radiation therapy: A machine outside your body directs high-energy radiation beams at your tumor.
• Internal radiation therapy: Sealed wires or catheters containing radioactive material are placed inside your vagina, either into or near the tumor.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy alone is not an effective treatment for vaginal cancer. However, chemotherapy may be given at the same time as radiation therapy to increase its effectiveness. Sometimes, chemotherapy is also used to treat tumors that have disappeared after treatment and then come back.

Clinical trials

Your doctor may ask you to take part in a clinical trial to try out new cancer treatments that are being developed. Organizations like the American Cancer Society and the National Cancer Institute are good places to find out about ongoing clinical trials for vaginal cancer treatments.

How to reduce the risk of vaginal cancer?

Okay, now let's see what we can do to reduce our risk of developing vaginal cancer. Although it cannot be completely prevented, the following things can help reduce the risk:

• Get regular pelvic exams and Pap tests. Talk to your doctor about how often you should have these tests done by a gynecologist.
• Get the HPV vaccine. Talk to your doctor about getting vaccinated against HPV. There are currently three FDA-approved vaccines: Gardasil, Gardasil 9, and Cervarix.
• Don't smoke. Smoking increases the risk of all cancers, including vaginal cancer.

What is the outlook for vaginal cancer?

The prognosis for someone with vaginal cancer depends on the stage at which it is diagnosed. Vaginal cancer that is detected early can often be treated successfully. You can then live a full life. Cancers that are detected late, that is, in later stages, are more difficult to treat. They may require ongoing chemotherapy and other treatment options. That is why it is important to have regular gynecological check-ups, even if you do not feel sick. Seek medical advice as soon as you notice any symptoms.

Some frequently asked questions

Can vaginal cancer develop?

Yes, it is possible to get cancer in the vagina. However, it is very rare for cancer to start in the vagina itself. Most often, cancer that starts elsewhere in the body spreads to the vagina. Cancers that spread to the vagina most often start in your cervix (cervical cancer) or the lining of your uterus (uterine cancer / endometrial cancer).

What cancer is vaginal bleeding a symptom of?

Vaginal bleeding is a common symptom of several types of cancer, including vaginal cancer, cervical cancer, uterine cancer, and ovarian cancer. However, abnormal bleeding is not a sign of cancer, but can be a sign of a number of other conditions. Therefore, don't assume that you have cancer just because you have abnormal bleeding. But, be sure to see a doctor and get checked out.

What does vaginal cancer feel like?

The most common symptom of vaginal cancer is painless vaginal bleeding. This means you may not feel anything at all if you have vaginal cancer. Rarely, you may experience pelvic pain, pain when urinating , or discomfort due to constipation.

If you are diagnosed with vaginal cancer, it is important to talk honestly with your doctor about the type of cancer, whether it has spread, and what treatment options you have. Your prognosis depends on many factors. Your doctor is the best person to explain how this diagnosis will affect you.

In the meantime, building a strong support network that includes your family, friends, cancer survivors, and others who have experienced cancer is also an essential part of your care plan. Talk to a counselor to talk about your feelings about your diagnosis. It is important to have your emotional needs met, as well as the clinical care you receive.

The most important things you need to remember (Take-Home Message)

Okay, let's look at some of the main points you need to keep in mind from all of this:

• Although vaginal cancer is a rare cancer , it is important to be aware of it.
• Get regular pelvic exams and Pap tests. These can detect abnormalities at an early stage.
• Getting the HPV vaccine can reduce your risk of vaginal cancer. Talk to your doctor about this.
• Avoid smoking.
• If you experience symptoms such as unusual vaginal bleeding, abnormal discharge, or pain during sex, do not ignore them. Seek medical advice immediately.
• If you are diagnosed with cancer, don't panic. There are doctors, counselors, and support groups to help you. Get the right information and face treatment with strength.