Vaginal Cancer

Symptoms do not always occur with early vaginal cancers. As the tumors grow, they may produce a discharge or start to bleed. A lump may be present in the vagina, and there may be pain or fullness in the pelvis or lower abdomen. You may experience pain during intercourse. As the cancer continues to advance, it may interfere with your bowel or bladder function.

Although Pap smears do not screen for vaginal cancer, it may be noticed during the routine pelvic exam that accompanies Pap testing.

Vaginal cancer can cause a variety of symptoms, and any of them can be severe at times. These symptoms include:

• Bleeding after intercourse

• Blood-streaked stools

• Bloody or pink-colored urine (hematuria)

• Constipation

• Difficult or painful urination or bladder pain

• Frequent urination or bowel movements

• Lump in the vagina

• Pain during sexual intercourse (dyspareunia)

• Pelvic or abdominal pain or fullness

• Rectal pain or fullness

• Vaginal bleeding

• Vaginal discharge

• Vaginal itching or discomfort

In some cases, vaginal cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Inability to have bowel movements or pass gas

• Not producing any urine

• Rectal bleeding or blood in the stool

• Severe abdominal or pelvic pain

• Uncontrolled or heavy bleeding, hemorrhage

The cause of vaginal cancer is not known. Squamous cell carcinomas occur most commonly in women age 60 or older, while the average age at diagnosis of adenocarcinomas is 19. You may have a higher risk of vaginal cancer if you have had cervical cancer or if you have a human papilloma virus (HPV) infection. Prenatal exposure to diethylstilbestrol, a drug that was used in the 1950s to prevent miscarriage, also seems to increase the risk of vaginal cancer.

A number of factors increase the risk of developing vaginal cancer. Not all women with risk factors will get vaginal cancer. Risk factors for vaginal cancer include:

• Adolescent age (for adenocarcinomas)

• Age 60 or older (for squamous cell carcinomas)

• Early age of first sexual intercourse

• Exposure to diethylstilbestrol (DES) while in the womb

• Human papilloma virus (HPV) infection

• Multiple sexual partners

• Personal history of abnormal cervical cells

• Personal history of cervical cancer

• Vaginal adenosis

• Smoking

The goal of vaginal cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in your body, although it may recur later.

Vaginal cancer is often treated with surgery, which may be followed by radiation therapy. Your health care professional may use topically applied chemotherapy if your vaginal cancer is very early stage. Chemotherapy may also be used systemically for advanced stage vaginal cancer. Your health care professional may also recommend that you participate in a clinical trial.

Common treatments for vaginal cancer include:

• Chemotherapy to attack cancer cells

• Participation in a clinical trial that is testing promising new therapies and targeted treatments for vaginal cancer

• Radiation therapy to attack cancer cells

• Surgery to remove the cancer and evaluate the extent of any spread

Other therapies may be added to help bolster your general state of health and to help offset any side effects of treatment. These include:

• Antinausea medications

• Blood cell growth factors to increase the number of healthy blood cells

• Blood transfusions to temporarily replace blood components, such as red blood cells, that have been reduced or lost

• Dietary counseling to help you maintain strength and nutritional status

• Pain medications as needed

• Reconstructive surgery to restore structures that have been removed

Some complementary treatments may help some women to better deal with vaginal cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

• Acupuncture

• Massage therapy

• Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

• Yoga

In cases in which vaginal cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift from curing the disease to focusing on measures to keep you comfortable and maximize your quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support your family members.

Complications of untreated vaginal cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by carefully following the treatment plan you and your health care professional design specifically for you. Complications of vaginal cancer include:

• Adverse effects of treatment (surgery, chemotherapy, radiation)

• Bladder obstruction

• Bowel obstruction

• Diminished sexual activity

• Hemorrhage

• Spread of cancer