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The vagina is a female reproductive organ located alongside the uterus. Vaginal cancer develops when cells in the vagina begin to grow uncontrollably, leading to the development of abnormal cells or tumors. Although vaginal cancer is classified as a rare form of cancer among women, it typically arises when another part of the body develops cancer and spreads to the vagina (metastatic). Primary vaginal cancer is very uncommon. Most vaginal lesions and abnormalities do not exhibit any symptoms until they reach an advanced stage, meaning that they may be mistaken for something else during the early stages. Typically, women diagnosed with vaginal cancer report different symptoms than would be expected (for example, persistent pain).
The precise cause of vaginal cancer is not known, although it is presented with genetic alterations in theDNA, leading to the development of abnormal cells. There are several types of vaginal cancer, depending upon which layer of the vagina is affected. While several risk factors appear to increase the likelihood of developing vaginal cancers, there is no definitive way to determine whether one will be affected by the disease.
Treatment options for vaginal cancer are determined by the type and stage of cancer diagnosed. Treatment for vaginal cancer can be curative if diagnosed at an early stage. In contrast, in later and/or more aggressive stages, a combination of treatments will be used to treat vaginal cancers. For advanced cases of vaginal cancer, palliative care (which focuses on relieving symptoms and providing comfort for the patient) becomes increasingly important, while curing the disease itself becomes secondary.
What Is Vaginal Cancer?
Vaginal cancer starts as a malignant growth in the vagina, usually in the thin lining that coats its inner wall. If it begins right there in the vagina, doctors call it primary vaginal cancer—though that doesn’t happen often. More commonly, it’s secondary, which means it spreads from places like the cervix, uterus, or bladder. Squamous cell carcinoma shows up most often and tends to form in the upper part of the vagina.
Sometimes, though, the cancer starts in other kinds of cells—glandular cells, connective tissue, or even pigment cells. That’s when you get less common types like adenocarcinoma, sarcoma, or melanoma. Doctors figure out the stage of the cancer by looking at how far it’s pushed beyond the vaginal wall, whether it’s moved into nearby tissue, or even farther. As it grows, it can reach the bladder, rectum, or pelvic wall, making things a lot more complicated.
Vaginal cancer originates from different types of cells found in the vagina, and each one has its own unique characteristics and treatment methods. Vaginal cancers are classified by the type of cell the cancer develops in (the cell type).
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is by far the most prevalent form of vaginal cancer, constituting nearly 90% of vaginal primary malignancies. SCC derives from the squamous cells that comprise the vaginal lining (the flat, thin surface cells). SCC generally has a slow growth pattern and therefore does not manifest symptoms until later in its development. If untreated, it often spreads to adjacent structures (cervix, bladder, or rectum) over time. SCC is most commonly found in postmenopausal women who have a history of chronic HPV (human papillomavirus).
Adenocarcinoma
Adenocarcinoma is a type of cancer that begins within the glandular tissue (glandular cells) of the vagina; these cells create fluids, like mucus. Adenocarcinoma is not as frequent as squamous cell carcinomas, but is more aggressive in nature, tends to metastasise more quickly to lymph nodes and other distant organs, and primarily occurs in older women. Adenocarcinomas commonly go undetected, as they typically form deeper within the vaginal wall than most vaginal cancers. One rare subtype of adenocarcinoma, clear cell adenocarcinoma, is linked to fetal exposure to the drug diethylstilbestrol (DES).
Melanoma
Vaginal melanoma is a type of cancer that arises from the melanocyte cells of the vagina; these are the cells that give pigmentation to skin and mucous membranes. The primary method of diagnosis for vaginal melanomas is the use of imaging examinations. Melanoma of the vagina usually presents itself as a darkly pigmented (brown to black) lesion, often found within the lower third or outer third of the vagina. While most cases of vaginal melanoma will occur sporadically and may not be diagnosed until months or years after the onset of symptoms, they generally have a high metastatic risk, therefore, require immediate and aggressive treatment.
Sarcoma
Sarcomas primarily affect connective tissue, which includes fat, muscle, and blood vessels of the vagina, but sarcomas are responsible for only a very small percentage of cases of vaginal cancer. Younger age groups (adolescents & female patients aged under 40 years) constitute a higher percentage of patients with sarcomas found in the vagina, which is a type of malignant tumour. Subtypes of vaginal sarcomas include: Leiomyosarcoma & Rhabdomyosarcoma. Each of the subtypes has its own mode of behaviour & growth pattern. Sarcomas, in general, develop rapidly & are often large enough to create a visible lump or pain in the area of the pelvis.
Radiation Therapy
Radiological treatment that utilizes high levels of radiation to kill the cancer cells found in the vagina. The radiation source may be external to the body and it may also be a source of high-energy radiological isotopes implanted directly into the cancerous tissue.
Chemotherapy
Chemotherapy uses drugs that can kill or slow down the rapid growth of cancer cells. Usually, chemotherapy is used in conjunction with radiotherapy to enhance the effectiveness of both treatments.
Surgery
With the surgical treatment of vaginal cancer, a complete removal of the malignant tumor from the vagina is accomplishedin patients who are surgically treated because the tumour is not be treated with radiotherapy.
Targeted Therapy
Sometimes doctors go with targeted drug therapy. These meds go straight after the cancer cells in the vagina and wipe them out, doing less harm to the healthy tissue nearby.
Immunotherapy
Then there’s immunotherapy. These drugs help the body’s own defense system fight the cancer. People with early-stage vaginal cancer can use this approach on its own, but in later stages, doctors usually combine it with other treatments.
Palliative Care
Palliative care focuses on making life better for people with advanced vaginal cancer. It’s about easing symptoms, managing pain, and offering emotional support—not just for patients, but for their families, too.
In India, the price range for treating vaginal cancer is between $1500 and $2200. The complexity of each patient with vaginal cancer and the cancer's stage can both affect the expense. Depending on the kind of treatment each patient receives, the price may also change.
Vaginal cancer can be hard to diagnose in its initial phases as it may produce no symptoms at all. When the condition advances, some signs would start showing up. Such symptoms tend to impact on the vaginal or pelvic region and become confused with other prevalent disorders. Any medical professional should examine any unusual changes, especially when they are continuous. The typical clinical findings and symptoms include:
These symptoms can be attributed to some other health disorders but their existence cannot be overlooked. The cause can be identified early, and timely treatment can be provided in case it is necessary.
There are several ways to diagnose vaginal cancer, including the following:
Pelvic Exam
To diagnose vaginal cancer, a pelvic exam must be performed by the physician to examine the vagina and surrounding tissues for signs of abnormality or tumor formation.
Pap Smear (Pap Test)
If the physician conducts a pelvic examination, he/she will also take a sample of cells from the cervix and/or the upper vagina and send them to a laboratory for examination for evidence of abnormality.
Colposcopy
If abnormalities are indicated on the pelvic exam or the Pap smear, the physician will likely conduct a colposcopy, in which he/she will use a specific instrument with light and magnification to examine the cells and tissues of the vagina closely.
Biopsy
A biopsy is typically performed to confirm whether or not cancer cells exist within a tumour growing in the vagina. A biopsy involves taking a tiny piece of tissue from the tumour for examination in a pathological laboratory.
Imaging Tests
In addition to biopsies, medical providers may also use imaging tests (e.g., MRI and CT scans) to evaluate how far the cancer has spread (or whether it has spread).
Additional Tests
Other test options that may be available include PET scans for imaging and lymph node sampling for testing for potential cancer spread.
Blood Tests
While blood testing does not permit accurate diagnosis of vaginal carcinoma, it is typically performed to evaluate patients' overall health and organ function (such as liver/kidney function). Blood testing is necessary when surgery and/or chemotherapy are being planned because they may use information derived from blood tests to decide on both of these treatment options. In a select number of cases, physicians perform blood tests to detect tumor markers (although not specifically for vaginal carcinoma).
Vaginal Cancer Stages
Stage I – Cancer stays in the vaginal wall.
Stage II – It starts to move into nearby tissues.
Stage III – Now, it’s reached the pelvic wall.
Stage IV – The cancer has spread to the rectal lining and parts of the pelvis.
Stage IVb – At this point, it’s moved to distant places like the lungs or bones.
The following are eight risk factors for vaginal cancer:
Age
Women over 45 years old are at an increased risk of developing Vaginal Cancer due to the rise in the incidence of the disease with advancing age. Most diagnosed cases of Vaginal Cancer occur in women older than 45.
Infection
Sexually transmitted infections increase a woman's risk of developing Vaginal Cancer, as these infections may cause the patient to become immunocompromised, allowing for the development of cancer.
Smoking
Cigarette smoke contains harmful substances that can contribute to the development of cancer and many types of cancer, including Vaginal Cancer.
Prior History Of Cervical Cancer
Women diagnosed with cervical cancer face a significantly increased chance of developing vaginal cancer.
Compromised Immune System
People whose immune systems are compromised and/or those who are receiving certain medications that compromise their immune systems are also likely to develop vaginal cancer.
Radiation Therapy
High levels of radiation may cause disruptions to normal cell function, which may result in cancer. There is an increased risk of developing vaginal cancer if the woman has undergone radiation therapy for a previous cancer.
History Of Family
The presence of cervical cancer or uterine cancer in the family increases the likelihood that someone will have vaginal cancer.
Having Many Sexual Partners
Individuals that engage in sexual activities with numerous sexual partners may be at increased risk of becoming infected, which is a significant risk factor for developing vaginal cancer.
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