What is Vaginal Cancer? Symptoms, Causes, & Treatment

Vaginal cancer is a rare type of cancer that develops in the tissues of the vagina, the muscular tube that connects your uterus to the outside of your body. While it's one of the less common gynecologic cancers, affecting fewer than 1 in 1,000 women, understanding its signs and symptoms can help you stay informed about your health.

Most vaginal cancers develop slowly over time, often beginning as precancerous changes in the vaginal lining. The good news is that when caught early, vaginal cancer is highly treatable, and many women go on to live full, healthy lives after treatment.

What is Vaginal Cancer?

Vaginal cancer occurs when normal cells in your vaginal tissue begin to grow abnormally and form a tumor. Your vagina is lined with different types of cells, and cancer can develop from any of these cell types, though some are more common than others.

There are two main types of vaginal cancer. Squamous cell carcinoma makes up about 85-90% of all vaginal cancers and develops in the thin, flat cells that line the vagina. Adenocarcinoma accounts for about 10-15% of cases and starts in the glandular cells that produce mucus and other fluids.

Less common types include melanoma, which develops from pigment-producing cells, and sarcoma, which forms in the muscle or connective tissue of the vaginal wall. These rare forms account for less than 5% of all vaginal cancer cases.

What are the Symptoms of Vaginal Cancer?

Early vaginal cancer often doesn't cause noticeable symptoms, which is why regular gynecologic checkups are so important. When symptoms do appear, they can be subtle and easily mistaken for other common conditions.

Here are the symptoms you might experience, keeping in mind that having these symptoms doesn't necessarily mean you have cancer:

• Unusual vaginal bleeding, especially after menopause or between periods
• Watery or bloody vaginal discharge that may have an unusual odor
• A lump or mass you can feel in your vagina
• Pain during sexual intercourse
• Pelvic pain that doesn't go away
• Painful or frequent urination
• Constipation or pain during bowel movements
• Pain in your back or legs that persists

It's worth noting that these symptoms can also be caused by many other conditions, including infections, hormonal changes, or benign growths. If you're experiencing any of these symptoms, especially if they persist for more than a few weeks, it's important to see your healthcare provider for proper evaluation.

What Causes Vaginal Cancer?

Like many cancers, vaginal cancer develops when something causes normal cells to change and grow uncontrollably. While we don't always know exactly what triggers these changes, researchers have identified several factors that can increase your risk.

The human papillomavirus (HPV) is the most significant risk factor for vaginal cancer. Certain high-risk types of HPV, particularly HPV 16 and 18, can cause changes in vaginal cells that may eventually lead to cancer. HPV is very common and is spread through sexual contact, but most HPV infections clear up on their own without causing problems.

Age plays a role, as vaginal cancer is most commonly diagnosed in women over 60. Your immune system also matters - conditions or medications that weaken your immune system can make it harder for your body to fight off HPV infections and other cellular changes.

Previous treatment with diethylstilbestrol (DES), a synthetic estrogen given to pregnant women between 1940 and 1971, increases the risk of a specific type of vaginal cancer called clear cell adenocarcinoma in daughters who were exposed in the womb.

What are the Types of Vaginal Cancer?

Understanding the different types of vaginal cancer can help you better grasp your diagnosis and treatment options. Each type behaves differently and may require different approaches to treatment.

Squamous cell carcinoma is by far the most common type, representing about 85-90% of all vaginal cancers. This cancer develops in the squamous cells, which are the thin, flat cells that line the surface of your vagina. It typically grows slowly and is often linked to HPV infection.

Adenocarcinoma makes up about 10-15% of vaginal cancers and starts in the glandular cells that produce vaginal secretions. There are two main subtypes: clear cell adenocarcinoma, which is associated with DES exposure, and other adenocarcinomas that can occur at any age.

Rare types include melanoma, which develops from the cells that give skin its color and accounts for about 2-3% of vaginal cancers. Sarcoma, which forms in the muscle or connective tissue of the vaginal wall, is even rarer and accounts for less than 2% of cases. These uncommon types often require specialized treatment approaches.

When to See a Doctor for Vaginal Cancer?

You should contact your healthcare provider if you experience any unusual vaginal symptoms, especially if they persist for more than two to three weeks. While most vaginal symptoms aren't caused by cancer, it's always better to get them checked out early.

Seek medical attention promptly if you have abnormal vaginal bleeding, particularly if you're postmenopausal and experience any bleeding at all. Any unusual vaginal discharge, especially if it's bloody or has a strong odor, also warrants a medical evaluation.

Don't wait if you feel a lump or mass in your vagina, experience persistent pelvic pain, or have pain during intercourse that's new or getting worse. Changes in your bathroom habits, like painful urination or persistent constipation, should also be discussed with your doctor.

Remember, your healthcare provider has seen it all and wants to help you stay healthy. There's no need to feel embarrassed about discussing intimate symptoms - being open and honest about what you're experiencing is the best way to get the care you need.

What are the Risk Factors for Vaginal Cancer?

While anyone with a vagina can develop vaginal cancer, certain factors can increase your likelihood of developing this condition. Understanding these risk factors can help you make informed decisions about your health and screening.

Here are the main risk factors, keeping in mind that having one or more doesn't mean you'll definitely develop cancer:

• Age over 60 - most vaginal cancers occur in older women
• HPV infection, particularly high-risk types like HPV 16 and 18
• History of cervical or vulvar cancer or precancerous conditions
• Previous hysterectomy, especially for cancer or precancerous conditions
• Weakened immune system from HIV, organ transplant medications, or other conditions
• Smoking, which can weaken your immune system and make HPV infections more likely to persist
• DES exposure in the womb (for women born between 1940-1971)
• History of abnormal Pap tests or cervical dysplasia

Some less common risk factors include chronic vaginal irritation, multiple sexual partners (which increases HPV exposure), and having your first sexual encounter at a young age. It's important to remember that many women with risk factors never develop vaginal cancer, while some women with no known risk factors do develop the disease.

What are the Possible Complications of Vaginal Cancer?

Like other cancers, vaginal cancer can cause complications both from the disease itself and from its treatment. Understanding these potential complications can help you work with your healthcare team to prevent or manage them effectively.

The cancer itself can cause complications as it grows and spreads. It may block your urinary tract, leading to kidney problems, or spread to nearby organs like your bladder, rectum, or bones. Advanced vaginal cancer can also cause severe pain and affect your ability to have comfortable sexual intercourse.

Treatment complications can vary depending on the type of therapy you receive. Surgery may affect your sexual function or cause changes in how your vagina feels or works. Radiation therapy can cause skin irritation, fatigue, and long-term changes to vaginal tissues that might affect sexual comfort.

Chemotherapy can cause side effects like nausea, hair loss, fatigue, and increased infection risk. Some treatments may also affect your fertility, though this is less of a concern since vaginal cancer typically affects older women who are past childbearing age.

The emotional impact shouldn't be overlooked either. A cancer diagnosis can cause anxiety, depression, and relationship stress. The good news is that your healthcare team can help you manage most of these complications, and many are temporary or can be effectively treated.

How Can Vaginal Cancer be Prevented?

While you can't completely prevent vaginal cancer, there are several steps you can take to significantly reduce your risk. Many of these strategies focus on reducing your risk of HPV infection and maintaining good overall health.

Getting the HPV vaccine is one of the most effective prevention strategies, especially if you receive it before becoming sexually active. The vaccine protects against the HPV types most likely to cause vaginal cancer and is recommended for people up to age 26, and sometimes up to age 45.

Regular screening through Pap tests and pelvic exams can help detect precancerous changes before they become cancer. Even if you've had a hysterectomy, you may still need vaginal screening depending on why you had the surgery.

Practicing safer sex by limiting your number of sexual partners and using condoms can reduce your HPV exposure risk. Quitting smoking is also important, as smoking weakens your immune system and makes it harder to fight off HPV infections.

Maintaining a healthy immune system through good nutrition, regular exercise, adequate sleep, and stress management can help your body fight off infections more effectively. If you have conditions that weaken your immune system, work with your healthcare team to manage them as effectively as possible.

How is Vaginal Cancer Diagnosed?

Diagnosing vaginal cancer typically involves several steps, starting with a thorough medical history and physical examination. Your doctor will ask about your symptoms, risk factors, and previous medical treatments before performing a pelvic exam.

During the pelvic exam, your healthcare provider will carefully examine your vagina and surrounding areas, feeling for any lumps or abnormal areas. They may use a speculum to get a better view of your vaginal walls and cervix, similar to what happens during a routine Pap test.

If suspicious areas are found, your doctor will likely perform a biopsy, which involves taking a small sample of tissue for examination under a microscope. This is usually done in the office using local anesthesia to minimize discomfort. The biopsy is the only way to definitively diagnose cancer.

Additional tests might include colposcopy, where a special magnifying instrument is used to examine your vagina more closely, or imaging tests like CT scans, MRIs, or PET scans to determine if the cancer has spread to other parts of your body.

Your doctor might also recommend additional procedures like cystoscopy (to check your bladder) or proctoscopy (to examine your rectum) if there's concern that the cancer might have spread to these nearby organs.

What is the Treatment for Vaginal Cancer?

Treatment for vaginal cancer depends on several factors, including the type and stage of cancer, your overall health, and your personal preferences. Your healthcare team will work with you to develop a treatment plan that's right for your specific situation.

Surgery is often the primary treatment for early-stage vaginal cancer. For very small tumors, your surgeon might remove just the cancerous tissue and a small margin of healthy tissue around it. Larger tumors may require more extensive surgery, potentially including removal of part or all of the vagina.

Radiation therapy is commonly used either alone or in combination with surgery. External beam radiation directs high-energy rays at the cancer from outside your body, while brachytherapy places radioactive material directly into or near the tumor. Many women receive both types of radiation therapy.

Chemotherapy uses medications to kill cancer cells and is sometimes combined with radiation therapy. This combination, called chemoradiation, can be particularly effective for certain types and stages of vaginal cancer.

For advanced cases, treatment might focus on controlling symptoms and maintaining quality of life rather than curing the cancer. This approach, called palliative care, can include pain management, radiation to shrink tumors, and other supportive treatments.

Reconstructive surgery might be an option after treatment to help restore vaginal function and improve quality of life. Your healthcare team can discuss these options with you based on your specific treatment and recovery.

How to Take Home Treatment During Vaginal Cancer?

Managing your care at home during vaginal cancer treatment involves taking care of both your physical and emotional well-being. Your healthcare team will provide specific instructions based on your treatment, but there are general strategies that can help you feel more comfortable.

Pain management is often a key part of home care. Take prescribed pain medications as directed, and don't wait until pain becomes severe before taking them. Warm baths or heating pads might help with pelvic discomfort, but check with your doctor first, especially if you're receiving radiation therapy.

Maintaining good hygiene is important, but be gentle with the treated area. Use mild, unscented soaps and avoid douching or using harsh products. Wear comfortable, loose-fitting clothing and cotton underwear to reduce irritation.

Eating well can help your body heal and maintain strength during treatment. Focus on nutritious foods, stay hydrated, and ask about nutritional supplements if you're having trouble eating. Small, frequent meals might be easier to tolerate than large ones.

Managing fatigue is crucial - rest when you need to and don't push yourself too hard. Light exercise like walking can actually help with energy levels, but listen to your body and adjust activities as needed.

Don't hesitate to reach out to your healthcare team with questions or concerns. They can provide guidance on managing side effects and will want to know if you're experiencing any new or worsening symptoms.

How Should You Prepare for Your Doctor Appointment?

Preparing for your doctor appointment can help you make the most of your time together and ensure you get all the information you need. Start by writing down all your symptoms, including when they started and how they've changed over time.

Make a list of all medications you're taking, including prescription drugs, over-the-counter medications, vitamins, and supplements. Bring this list with you, or even better, bring the actual bottles if possible.

Gather your medical history information, including previous surgeries, cancer treatments, and family history of cancer. If you've had previous Pap tests or gynecologic procedures, try to remember when and where they were done.

Write down questions you want to ask your doctor. Some important ones might include: What type of vaginal cancer do I have? What stage is it? What are my treatment options? What are the side effects of each treatment? How will treatment affect my daily life and relationships?

Consider bringing a trusted friend or family member with you to the appointment. They can help you remember information discussed and provide emotional support. Don't be afraid to ask your doctor to repeat information or explain things in simpler terms if needed.

What's the Key Takeaway About Vaginal Cancer?

The most important thing to remember about vaginal cancer is that while it's a serious condition, it's also relatively rare and often very treatable, especially when caught early. Many women go on to live full, healthy lives after treatment.

Regular gynecologic care and being aware of changes in your body are your best tools for early detection. Don't ignore persistent symptoms, even if they seem minor or embarrassing to discuss. Your healthcare provider is there to help, and early detection truly makes a difference in treatment outcomes.

If you're diagnosed with vaginal cancer, remember that you're not alone. Your healthcare team will work with you to develop the best treatment plan for your situation, and there are many resources available to support you through treatment and recovery.

Prevention strategies like HPV vaccination, regular screening, and maintaining a healthy lifestyle can significantly reduce your risk. Even if you have risk factors, it doesn't mean you'll develop cancer - these are just factors that might increase your chances.