Vaginal Cancer is a rare disease that afflicts women, affecting their reproductive organs. Vaginal cancer can form in the tissues of the vagina or travel to the vagina from a different location in the body. Vaginal cancer is made up of different types of tumors such as squamous cell carcinoma, adenocarcinoma, sarcoma cells and more. Vaginal only makes up for about 1% of all reproductive system cancers women suffer from. Just over 2,000 women are diagnosed with vaginal cancer yearly and less than 1,000 die from the disease each year.

Vaginal cancer is not a disease that can be prevented or caused by lifestyle choices, although smoking may increase a woman's risk of developing the disease. If the cancer is caught at an early stage it can be successfully treated. If the cancer is left alone to advance to higher stages, the disease can be deadly.

Causes of Vaginal Cancer

Vaginal Cancer is a rare disease found in women and the direct causes are not known. There may not be direct causes, but there are risk factors that women need to look out for and try to avoid. The majority of women do not develop vaginal cancer until at least age 50, although females of any age can develop the disease. A major cause of vaginal cancer is a pregnancy drug given to women to reduce miscarriages from 1940-1971. The FDA but a stop to the drug diethylstilbestrol, also known as DES because there was a strong connection with the drug and vaginal cancer in the daughters of women who took the drug during pregnancy. In a few years, enough time will have passed since DES was discontinued that it will no longer be a factor in causing vaginal cancer. Vaginal cancer is also asscoiated with human papilloma virus and HIV. Viruses are capable of causing infections and a disruption of proper cell division resulting in vaginal cancer.

Vaginal Cancer Prevention

There is no way a woman can be sure she will not be diagnosed with vaginal cancer. The best way to prevent vaginal cancer is to avoid the sexually transmitted disease HPV which is known to cause vaginal cancer. HPV can be transmitted from skin to skin contact, usually sexual intercourse, anal intercourse or oral sex. Standard safe sex practices such as using condoms, limiting the number of sexual partners one has or committing to abstinence are the most effective ways to prevent HPV and vaginal cancer. Since HIV is also believed to be a cause of vaginal cancer, safe sex is important when looking to prevent vaginal cancer.

The pregnancy drug DES was once a major cause, but the drug is no longer used. The discontinuation of DES by the FDA was a major step in preventing vaginal cancer. Smoking may make women two or three times as likely to develop vaginal cancer. The best thing a woman can do is have regular check-ups to discover any abnormalities as soon as possible.

Types of Vaginal Cancer

There are several types of vaginal cancer and they vary greatly in incidence. Types of vaginal cancer include squamous cell cancer, adenocarcinoma, melanoma, sarcoma and small cell vaginal cancer. There are subtypes of adenocarcinoma cancer such as papillary, mucinous adenocarcinomas and clear cell adenocarcinoma. The type of vaginal cancer cells present in the vagina determine how much or how fast the cancer will spread to other organs and tissues.

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common type of vaginal cancer, making up about 70% of all vaginal cancer. It develops in the thin, flat squamous cells that make up the epithelial lining of the vagina. Women are usually at least 60-years old when squamous cell carcinoma is discovered in the walls of the vagina. Squamous cells develop in the upper region of the vagina, usually over a period of many years. Vaginal intraepithelial neoplasia, or VAIN, is known to be a main cause of squamous cell carcinomas.

Squamous cell carcinomas usually stay in the vagina area and spread very slowly. Even though they have the ability to, they rarely spread to the lungs and liver. Vaginal cancer that does not spread to the lungs and liver will give a patient a more hopeful prognosis.

Metastatic Vaginal Cancer

Metastatic vaginal cancer is cancer that has reached the vagina after having spread from a different infected location in the body. Metastatic vaginal cancer is the most common form of vaginal cancer.
Radiation is main treatment used to combat metastatic vaginal cancer. Doctors try to avoid surgery to the vagina area to preserve the anatomy and function of the sensitive area. Additionally, radiation is used to stop the current or future spread of cancer cells to nearby lymph nodes.

Vaginal Cancer Symptoms

Early stages of vaginal cancer often do not have any symptoms. This can allow higher stages of the cancer to be reached without a woman knowing she has vaginal cancer. When symptoms are finally experienced they do not always point doctors directly to a vaginal cancer diagnosis because other vaginal complications share similar symptoms.

Vaginal cancer symptoms that a woman will start to notice usually begins with vaginal bleeding not associated with a menstruation period. A vaginal discharge may follow soon after, sometimes resulting in a foul odor. The next symptom to present itself following a vaginal discharge is vaginal itching. These symptoms are often linked to vaginal infections resulting in patients being wrongfully diagnosed and put on antibiotics. Antibiotics will not help or cure vaginal symptoms caused by vaginal cancer. Being aware of the disease and looking for symptoms is not an effective form of prevention, only examinations from doctors can effectively prevent the disease.

Vaginal Cancer Diagnosis

Vaginal cancer is diagnosed through a series of tests that when all completed, should lead to a conclusive result. Diagnosis tests can involve a standard blood tests, imaging tests for locating tumors and cell patterns and endoscopic tests are used to get an up-close look at suspicious areas that may be infected with cancerous cells. All of these tests precede treatment and prognosis discussions, which follow soon after once as much in known about a patient's specific cancer as possible, mainly what stage the cancer is in.

Colposcopy

Colposcopies are tests that check for abnormalities in the vagina. They are usually given after a pap smear test shows possible signs of infection or abnormalities with the vagina's cells. A colposcope uses two magnifying glasses similar to binoculars to look inside the vagina. The colposcopy is painless and has no side effects.

Biopsy

The results of a biopsy is the best way for a doctor to determine if a patient has cancerous cells and if so, what stage the cells are in. During a vaginal cancer biopsy, tissue is taken from inside a vagina or directly from a tumor. The tissue taken is examined to check for the presence of cancer cells. Vaginal cancer biopsies can be performed one of two ways, through an excision biopsy or a punch biopsy.

Vaginal Cancer Staging

The stages of vaginal cancer depend on the severity of the tumor, the effect on the lymph nodes and how the cancer is metastasizing. The American Joint Committee on Cancer created the TNM system which ranks the severity of each letter in the TNM system (tumor, lymph nodes and metastasizing) to fit into certain stages. Stages are used to form a prognosis which informs the patient on how long they have to live and what type of treatment plan should be used. The stages range from 0-4 with some stages have sub-stages for different circumstances and outcomes for vaginal cancer patients. The severity of the stages range from stage 0 which is also known as VAIN 3 and is very treatable. Stage 4 offers patients only a small chance of survival since the cancer has likely spread to the lungs and lymph nodes.

Vaginal Cancer Prognosis

The prognosis for a vaginal cancer patient depends on what stage their cancer is in as well as past medical history and age. The earliest cancer stages offer much more positive prognoses than the deadly later stages.

The prognosis and five-year survival rates depend greatly on the stage of the cancer.

·         Stage 0- Stage 0, also known as VAIN 3, offers an 80%-90% five-year survival rate for women. This is the earliest stage of vaginal cancer and the most treatable.

·         Stage 1- Stage 1 still offers a favorable prognosis with an 80% five-year survival rate.

·         Stage 2- Stage 3 sees a dip in survival, although a 70% five-year survival rate is better than the second stage of many other cancer.

·         Stage 3- The cancer takes over more of the vagina is stage 3, however the five-year survival rate varies at this stage in between 30% and 70%.

·         Stage 4- With other areas of the body beyond the pelvis infected at this stage, the five-year survival rate for stage 4 vaginal cancer drops to about 20%-40%.

Vaginal Cancer Treatment

Vaginal cancer can be treated various ways. Treatment options depend on what stage the cancer is currently in. More advanced stages call for treatments that extend beyond minor surgery to remove a tumor or a few sessions of radiation. Surgeries involving the removal of the entire vagina or more may be necessary for extreme cases where vaginal cancer has spread and infected nearby organs vital to the body. Less serious cases of vaginal cancer require topical treatments that can completely cure a woman or prevent her from being diagnosed with stage 1 or higher vaginal cancer. Radiation treatment can be taken in low or high doses and do not always require a patient to spend an entire night in the hospital. These are just a sample of some of the wide ranging techniques used to treat varying degrees of vaginal cancer.

Surgery

Surgery to treat vaginal cancer is usually only performed to treat stage 1 cancer by removing a cancerous tumor and it's cells. Some more advanced vaginal cancer require complicated surgeries. A vaginectomy involves the removal of the vagina. If the cervix and uterus need to be removed that process is called a hysterectomy. When a vagina is removed there is a procedure that can take place called vaginal reconstruction. Vaginal reconstruction uses muscles and tissues from other areas of the body to rebuild the vagina. The new vagina is capable of experiencing pleasure during sex.

Radiation Therapy

Radiation therapy uses high energy rays or particles similar to the rays of an x-ray to kill cancer cells. Radiation that is shot at a patient is called external beam radiation therapy. Radiation therapy can be used on it's own or combined with chemotherapy. 

Intracavitary brachytherapy refers to radiation particles placed in a tube that settles in the vagina. The low-dose version of this treatment requires a one or two night hospital stay in a bed, remaining still. High-dose therapy does not require a hospital stay but rather three or four treatment sessions one or two weeks apart.

Topical Treatment

Topical treatments for vaginal cancer can be applied to the skin of the the vagina as a cream or lotion. Topical treatments for vaginal cancer generally are only used to stop VAIN from increasing in staging. VAIN can lead to vaginal cancer.