Definition

Vaginal cancer is a rare growth of cancer cells in the vagina. The vagina is a tube that connects the vulva (outer female genitals) to the cervix (lower end of the uterus).

There are several types of vaginal cancer:

• Squamous cell carcinoma—occurs in the lining.
• Adenocarcinoma—occurs in the gland cells.
• Melanoma—usually affects the lower or outer vagina.
• Sarcoma—forms deep in the walls.

Female Reproductive Organs

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Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

Vaginal cancer is more common in women after menopause. Other things that may raise the risk are:

• Smoking and alcohol use
• Having sex before age 17
• Having 5 or more sex partners in a lifetime
• A history of:
  • Human papillomavirus infection (HPV)
  • Cervical dysplasia or cervical cancer
  • Vulvar cancer
• Past radiation to the pelvic area
• Long term inflammation of the vagina
• A mother who took diethylstilbestrol (DES) while pregnant

Symptoms

Vaginal cancer may not have symptoms. When symptoms occur, they may be:

• Bleeding—after sex and after menopause
• Watery, blood-tinged, or foul-smelling discharge
• A mass in the vagina that can be felt
• Pain or bleeding when urinating
• Pain in the bladder, pelvis, or rectum
• Pain during sex
• Pain or problems when passing stool, or dark stools

Diagnosis

The doctor will ask about your symptoms and health history. A physical and pelvic exam will be done.

Tests may include

• Pap test —tissue from the cervix and vagina is scraped and tested
• Colposcopy —a lighted device is used to check the vagina and cervix
• Biopsy —tissue samples are taken and tested

Imaging tests may include:

• CT scan
• MRI scan
• PET scan

Biopsy will confirm the diagnosis. The exam and test results will be used for staging. This will outline how far and fast the cancer has spread.

Treatment

The goal is to remove the cancer. Treatment depends on the stage of the cancer. A combination of treatments may be used.

Options may be:

• Radiation therapy—to kill cancer cells and shrink tumors
• Surgery to remove:
  • The tumor, nearby tissues, and sometimes the lymph nodes
  • Other structures or organs—depending on how far the cancer has spread
• Chemotherapy by pills, injection, or IV—to kill cancer cells

Prevention

The risk of vaginal cancer may be reduced by the HPV vaccine.