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What is vaginal cancer?

The vagina is the passageway through which fluid passes out of the body during menstrual periods. It is also called the birth canal. The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia). Cancer of the vagina, a rare kind of cancer in women, is a disease in which malignant (cancerous) cells are found in the tissues of the vagina.

There are several types of cancer of the vagina. The two most common are:

  • Squamous cell cancer (squamous carcinoma) —Squamous carcinoma is most often found in women older than age 60 and accounts for about 70 percent of all vaginal cancers.
  • Adenocarcinoma—Adenocarcinoma is more often found in women older than 50 and accounts for about 15 percent of all vaginal cancers. A rare form of cancer called clear cell adenocarcinoma results from the use of DES (diethylstilbestrol), a drug that was given to pregnant women between 1940 and 1971 to keep them from miscarrying. It occurs most often in the daughters of the women who took DES. 

Other, less common types of cancer that can be found in the vagina include: 

  • Malignant melanoma
  • Leiomyosarcoma
  • Rhabdomyosarcoma
  • Cancers that begin in other organs (such as the cervix and rectum) and spread to the vagina

Our approach

Northwell Health Cancer Institute is a leader in integrative treatment for vaginal cancer. Our multidisciplinary team of oncologists works to achieve the best possible outcome, collaborating with specialists to carefully coordinate your cancer treatment along with any other existing conditions. Every vaginal cancer diagnosis is unique, so your team of physicians will meet once a week to share ideas, review every step of your care and ensure milestones are being reached.

You also are guided throughout your treatment journey. We are here to answer questions and coordinate integrative care and support services. Because convenience is a primary focus, every effort is made to provide services in one location. Within the first several days of a visit, the team will conduct comprehensive tests and develop a personalized cancer treatment program.

Highlights of our vaginal cancer treatments and services include:

  • The latest technology to diagnose and treat both early-stage and recurrent vaginal cancers
  • The latest surgical innovations, with an emphasis on minimally invasive, fertility-sparing and reconstructive techniques
  • An extensive clinical trials program with access to the most advanced treatment options

Research at Northwell

As part of your vaginal cancer treatment plan, you may have opportunities to participate in clinical trials. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Symptoms

The following are the most common symptoms of vaginal cancer. However, you may experience symptoms differently. Symptoms may include:

  • Bleeding or discharge not related to menstrual periods
  • Difficult or painful urination
  • Pain during intercourse
  • Pain in the pelvic area
  • Constipation
  • A mass that can be felt near or in the vagina

Even if you have had a hysterectomy, there still is a chance of developing vaginal cancer. The symptoms of vaginal cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.

Causes

The most common type of vaginal cancers are squamous cell carcinoma and adenocarcinomas (cancers that begin in glandular cells). A condition called vaginal intraepithelial neoplasia (VIN) may undergo a change with abnormal cells slowly, over many years, eventually mutating to vaginal cancer.

Risk factors

The following have been suggested as risk factors for vaginal cancer:

  • Age (almost half of cases are in women age 70 or older)
  • Exposure to diethylstilbestrol (DES) as a fetus (mother took DES during pregnancy)
  • History of cervical cancer
  • History of cervical precancerous conditions
  • Human papillomavirus (HPV) infection
  • HIV infection
  • Vaginal adenosis
  • Vaginal irritation
  • Smoking

Diagnosis

The first step in making a diagnosis of vaginal cancer is usually a physical, during which your Northwell Health specialist will perform a pelvic exam and review personal and family medical history. If vaginal cancer is suspected, you will be referred for further tests. 

There are several tests used to diagnose vaginal cancer, including:

  • Pelvic exam—An exam of the vagina, cervix, uterus, fallopian tubes and ovaries.
  • Pap smear (Pap test)—An examination of the vulva, vagina, cervix, uterus, ovaries and fallopian tubes and rectum. The doctor may use a speculum, a tool that holds open the sides of the vagina, to examine the cervix and scrape a sample of cells from the outside of the cervix and vagina.
  • Vaginal biopsy—A tissue sample is taken by pinching off a small amount of vaginal tissue. A pathologist examines the tissue under a microscope to determine whether cancer is present. 
  • Colposcopy—A lighted, magnifying instrument is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken and checked for signs of disease.

Treatment types

There are four primary types of treatments for vaginal cancer diagnosis:

  • Surgery—Surgery is the most prevalent treatment for vaginal cancer. Surgical procedures may include excision of the tumor, total hysterectomy, vaginectomy and dissection of lymph nodes. 
  • Chemotherapy—Chemotherapy for vaginal cancer typically involves using drugs to prevent cancer cells from dividing post-surgery, which is the most common treatment used. It is often used in conjunction with internal and external radiation therapy. Topical creams or lotions may be applied as part of your chemotherapy treatment.
  • Radiation therapy—Post-surgery, external and internal radiation therapies may be used. In some cases, it will be used in conjunction with chemotherapy. At Northwell Health Cancer Institute, leading-edge radiation therapies are offered, including stereotactic and hypo-fractionated radiation therapy.

Living with

  • Take your medicines exactly as prescribed. Call your doctor if you have any problems with your medicine. You may get medicine for nausea and vomiting if you have these side effects.
  • Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
  • Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
  • Take steps to control your stress and workload. Learn relaxation techniques.
    • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
    • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
    • Express yourself through art. Try writing, crafts, dance, or art to relieve stress. Some dance, writing, or art groups may be available just for people who have cancer.
    • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and can help reduce stress.
    • Get help if you need it. Discuss your concerns with your doctor, counselor, or other health professional.
  • If you are vomiting or have diarrhea:
    • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
  • If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.
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