Vaginal Cancer Treatment in Mumbai, India

Vaginal cancer is a rare type of cancer affecting women. It involves the growth of cancerous cells inside the birth canal, which we refer to as the vagina.

Associated Anatomy

Vagina or birth canal

Vaginal Cancer Symptoms

• Vaginal Bleeding- Post-menopausal vaginal bleeding or bleeding during menopause
• Vaginal Discharge- Foul-smelling discharge with traces of blood
• Pain During Intercourse- There may be pain and bleeding during intercourse.
• Lump- A lump in the vagina may indicate vaginal cancer.
• Painful Urination- Pain or discomfort during urination
• Changes in Vaginal Skin Structure- Presence of ulceration or other skin changes
• Pelvic Pain- Pain in the pelvic area
• Pain in Legs- There may be swelling and pain in the legs and back.
• Change in Bowel Habits- Irregular bowel habits may hint at vaginal cancer.

Vaginal Cancer Causes

• Removal of the uterus-Hysterectomy may expose the women to vaginal intraepithelial neoplasia (VAIN), a precancerous condition.
• VAIN- The occurrence of VAIN involves abnormal cells that may become cancerous over time.
• Comorbidity- Human Immunodeficiency Virus infection or Human Papillomavirus (HPV) infection.
• Smoking habit- Smoking can become one of the causes of cervical cancer.

Vaginal Cancer Stages

• Stage I- Cancer is present in the vaginal wall.
• Stage II- Slow spread of vaginal cancer to the surrounding tissues.
• Stage III- Cancer is spreading further thereby affecting the pelvic wall.
• Stage IV - an Involvement of the rectal lining and a portion of the pelvis.
• Stage IV b- Metastasis which involves lungs, bones, etc.

Vaginal Cancer Possible Treatment

• Surgery- Surgery may be a suitable treatment for small vaginal cancers. It involves the removal of the tumor and nearby tissues. Advanced vaginal cancers may require the removal of the vagina, uterus, and other reproductive organs.
• Radiation Therapy- involves the use of high-energy radiation. Radiation therapy arrests the progress of cancer by killing the cancerous cells.
• Chemotherapy- Treatment of vaginal cancer includes chemotherapy to destroy cancer cells by using oral or intravenous medicines.

Vaginal Cancer Risk Factors

• Age- Women over 60 years are more prone to suffer from vaginal cancer.
• Medication- Past exposure to a drug DES may be a significant risk factor. Women whose mothers may have used the drug are likely to suffer from vaginal cancer.
• HPV Infection- There is a strong link between vaginal cancer and HPV infection.
• History of Hysterectomy- Uterus removal exposes the woman to vaginal cancers.

Vaginal Cancer Possible Complications

The most severe complication of vaginal cancer is the possible spread of cancer to distant organs like the liver, bones, and lungs. Cancer can also spread to other reproductive organs like the cervix and ovaries. Vaginal cancer can also cause hydronephrosis if it blocks the urine. Abnormal bleeding between periods or after menopause is a common complication of vaginal cancer.

Typical Tests for Vaginal Cancer

There are several diagnostic measures for the detection of vaginal cancer. The type of test depends upon the cancer stage, symptoms, and health parameters of the individual. Pap smear test and pelvic examination study abnormalities in the vagina and pelvic region. Colposcopy may further provide insight in case of any unusual findings. Doctors use biopsy, ultrasound, MRI, and CT scans for more precise detection of vaginal cancer.

Vaginal Cancer Prevention

Primary Prevention

• Vaccination- The use of the HPV vaccine may help prevent vaginal cancer.
• Periodic Examinations- Routine gynaecological examinations like PAP smear and pelvic examinations help detect precancerous lesions. Doctors can recommend measures to check further progress.
• Safe Sex- Avoid sexual intercourse before maturity. Use a condom and other safety measures to prevent HPV infection (HPI). Avoid sex with multiple partners or with a partner who has multiple partners.
• Avoid Smoking- Smoking is a proven cancer hazard. Avoiding smoking can help minimize the risk of vaginal cancer.

Secondary Prevention

• Follow-Up -Strictly adhere to the follow-up schedule post-treatment.
• Regular Examination- Do not miss periodic vaginal exams.
• Diet- Follow a healthy diet as per the recommendation of nutritionists.
• Supplements- Health supplements may play a beneficial role in preventing a relapse. Follow the advice of a physician regarding the use of dietary supplements.
• Exercise- Maintain good health by performing regular exercises.

Vaginal Cancer Prognosis

Expected Prognosis

Vaginal cancer is a treatable condition. The outlook is better if vaginal cancer is detected in the early stage. Detection of vaginal cancer during the first and second stages may ensure a complete cure. Over 67 percent of women with vaginal cancer survive more than five years after diagnosis during the first and second stages.

Natural Progression

• Vaginal cancer affects the small portion of the vaginal wall
• Cancer grows to become more than 2 cm
• The growth of vaginal cancer extends through the vaginal wall
• Vaginal cancer spreads to the pelvis
• Blockage of urine as vaginal cancer grows into the pelvic wall
• The cancer spreads into the rectum or bladder
• The continuous spread of vaginal cancer can finally involve the lungs, bones, and liver

Epidemiology

• Incidence of vaginal cancer is rare.
• One in a hundred cases of gynaecological cancer may be vaginal cancer.
• Squamous cell carcinoma accounts for 85 percent of cases of vaginal cancer.
• Women above the age of sixty are more prone to suffer from vaginal cancer.
• The majority of vaginal cancers are secondary cancers, originating outside the vagina.

Pathophysiology

Squamous cell carcinoma is a type of vaginal cancer that affects the flat cells that line the inner vaginal wall. It can involve distant organs like the liver or lungs. This cancer continues to spread from the vagina to the surrounding organs. Another type of vaginal cancer, Adenocarcinoma involves glandular cells in the initial stage.

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