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Vaginal Cancer
By peace | June 16, 2006
The vagina is a 3 to 4 inch (7 1/2 -10 cm) tube that at one end joins the cervix, the lower part of the uterus (womb), and at the other end opens onto the vulva, the external genitalia. The vagina is also called the birth canal. The vagina is usually in a collapsed state with its walls touching each other. The vaginal walls have many folds that help the vagina to open and expand during sexual intercourse or birth of a baby. Glands in the cervix secrete mucus to keep the vaginal lining moist.
Vaginal cancer is the uncontrolled growth of abnormal cells in the vagina, which is also called the birth canal. Cancer that starts in the vagina is called primary vaginal cancer. Primary vaginal cancer is rare, accounting for only about 2% of cancers affecting the female reproductive system. It is more common that cancer cells found in the vagina came from cancer that started elsewhere, such as the cervix. Vaginal cancer accounts for about 3% of cancers of the female reproductive system. There are two main types of primary vaginal cancer:
1. Squamous cell carcinoma — Cancer cells grow from the surface layer of the vagina’s lining. This cancer usually develops slowly. It commonly develops in the upper part of the vagina near the cervix. According to the National Cancer Institute, this type of cancer usually occurs in women between ages 50 and 70. According to the American Cancer Society, squamous cell carcinomas account for 85% to 90% of vaginal cancers.
2. Adenocarcinomas — Cancer cells form in the glands in the vaginal wall. According to the American Cancer Society, this type of cancer is more often diagnosed in younger women. A subtype, called clear cell adenocarcinoma, is the most common. Daughters of mothers who took the drug diethylstilbestrol (DES) while pregnant have a higher risk of developing this rare form of cancer. DES, which was introduced in the 1940s to help prevent miscarriages, was banned from use in the United States in 1971.
The American Cancer Society estimates that approximately 5% to 10% of vaginal cancers are adenocarcinomas. Other, less common types of vaginal cancer include malignant melanomas and sarcomas. Melanoma tends to affect the lower or outer part of the vagina. Sarcomas develop deep in the vaginal wall.
Risk Factors Of Vaginal Cancer
Some of the risk factors for developing vaginal cancer are: prescription of diethylstilbestrol, and already being diagnosed with cervical cancer and age.
Age is a risk factor for squamous cell carcinoma. Most of the women who are diagnosed with squamous cell carcinoma are diagnosed while the women are between the ages of 50 and 70. Diethylstilbestrol is a hormonal drug that was prescribed between 1940 to 1971 for some women thought to be at increased risk for miscarriages.
A person who has cervical cancer has a high risk of developing vaginal squamous cell cancer. This is because cervical and vaginal cancer have similar risk factors.
Symptoms of vaginal cancer can include:
- Abnormal vaginal bleeding, often after intercourse, that is not related to your period;
- Unusual vaginal discharge
- A mass that can be felt
- Pain during intercourse
- Pain in the pelvic region
- Painful urination and constipation
Keep in mind that these symptoms more commonly occur in a number of less dangerous conditions, such as infections of the reproductive organs. These symptoms should always be evaluated by a health care professional.
What causes Vagina Cancer
Like any other cancer, the precise reason why one woman gets vagina cancer and another does not is unknown. There are however “risk factors” that seem to predispose a woman to the disease. There are different risk factors for different types of vaginal cancer.
Many pregnant women between 1945 and 1970 were given a drug called “diethylstilbestrol ” or DES . Young women whose mothers took DES are at risk for getting tumors in their vaginas, at an average age of 20 years old.
Some get a rare form of cancer called “clear cell adenocarcinoma”. The risk of an exposed fetus to develop clear cell carcinoma of the vagina later in life is 1:1000. This type of cancer more commonly starts in the cervix than vagina. DES may be a factor for the young.
For the more common patient with squamous cell cancer, risk factors include:
- Being Female is obviously the biggest risk factor for vaginal cancer.
- Lots of Male Sexual Partners and having children by different men, and starting to have sex at a young age dramatically increases risk. In contrast, vaginal cancer is extremely rare in women who never were pregnant (”nulliparous”) and nuns. One-quarter of the American adult female population have never had children.
- Uncircumcised Sexual Partners - vaginal cancer is very rare in the wives of circumcised Jewish men, as is cervical cancer.
- Sexually Transmitted Viruses like the “Human Papilloma Virus” (HPV), especially types 16, 18, and 33. These are found in about 50% of patients. They cause genital warts and predispose to various cancers.
- Low Social and Financial Status may reflect more sexual promiscuity or inability to get proper screening and treatment for the disease.
- Immune Deficiency Diseases like AIDS. In fact, the development of vaginal cancer in a HIV positive patient is sufficient to reclassify them as full-blown AIDS. Furthermore, getting immune-system suppressing drugs (to avoid rejecting a newly transplanted organ) also increases the risk, especially in patients with HPV.
- Having had a hysterectomy could mean that you still have a chance of developing vaginal cancer, or cancer of the remaining “cervical cuff”
Alcohol and tobacco use is not linked to getting vaginal cancer!
Screening for Vaginal Cancer
The Papaniculaou (”Pap”) smear, done since 1940, is of proven value in the early detection of vaginal cancer. It is also useful after treatment to help monitor the success of therapy.
A pap smear is done at the time of a pelvic examination, it involves taking a brush and a small “spatula” (Ayer’s) to get some cells from the “squamocolumnar junction” of the cervix and the vagina, and also any abnormal areas. The scraping often causes slight bleeding. Too much blood in the specimen can distort the Pap smear, so it is not advised during a menstrual period.
The American Cancer Society recommends a cancer “checkup” every three years for women over age 20, or starting younger if she is sexually active. This includes a pelvic exam with a Pap test every 3 years (after 2 initial “negative” tests one year apart). Those at higher risk should get more frequent (i.e. annual) screening.
The cells collected from the Pap test are examined by a Pathologist (and often also checked by a computerized reading machine) to look for abnormal changes. If cells are found that are not normal you will need to have a sample taken called a biopsy.
The Pathologist will look not only at cells of the vagina, but also at the other cells taken from a scraping inside the cervix. If cancer is detected, he will state the specific type. The vagina is an amazing stretchable tube which functions to receive sperm and transmit it up into the womb, helps in protecting a developing baby, and acts as the birth canal for delivery. Common vaginal problems include irritation, mild infections and sexually transmitted diseases. Rarely, cancer can develop in the vagina, making up just 2% of “female” cancers.
While cervix, uterus and ovarian cancer are much more common, great strides have still been made in researching vaginal cancer. If a person develops vaginal cancer, it is crucial to get prompt diagnosis and effective treatment; this can literally make the difference between life and death.
Understanding your options will give you the peace-of-mind of knowing that you’ve done everything possible to ensure a successful outcome for yourself or a loved one.
Topics: All Posts, Diseases, Woman's Health |
