Vaginal Cancer

There are two main types of vaginal cancer:

• Those that start in the vagina itself (primary vaginal cancer)
• Those that spread into the vagina from another part of the body (secondary vaginal cancer).

The two main primary vaginal cancers are named after the cells from which they develop:

• Squamous cell: The most common type of vaginal cancer is called squamous cell carcinoma, which means the cancer originated from the skin-like cells on the vaginal wall. This is usually found in the upper part of the vagina, and most commonly affects women between the ages of 50 and 70.
• Adenocarcinoma: This type of vaginal cancer begins in the glandular cells in the lining of the vagina. It is harder to diagnose than squamous cell cancer because it is more likely to be hidden inside the vaginal canal. This type of vaginal cancer occurs more often in young women in their 20’s.

Other, rarer, vaginal cancer types include:

• Vaginal Sarcoma: Sarcomas are cancers that start in the tissues that structure the organ body, such as bone, muscle, fat and cartilage. Sarcomas of the vagina are extremely rare and account for only 3% of all vaginal cancers. These cancers tend to grow quite quickly.
• Embryonal rhabdomyosarcoma: Also called sarcoma botryoides, it is a very rare type of vaginal sarcoma which only develops in girls up to the age of 6 years. This is a very fast growing cancer and is difficult to treat.
• Vaginal Melanoma: Only about 3% of vaginal cancers are melanomas. Melanomas develop from the cells in the skin that produce pigment, which gives the skin its colour. Melanoma is most likely to develop in the lower third of the vagina and in women in their 50’s.
• Small cell vaginal cancer: Small cell cancers are also called oat cell carcinomas due to the cancer cell’s distinctive oat shape. They are very, very rare.

Symptoms of vaginal cancer can include:

• Irregular bleeding – this is the most common symptom
• Vaginal discharge that smells or is blood stained
• Pain during sexual intercourse
• A lump or growth in the vagina that you or your doctor can feel
• A vaginal itch that won’t go away
• Constipation
• Pain when passing urine
• Swelling in the legs
• Pain in the pelvic area that won’t go away

Please remember that cancer of the vagina is rare so if you have any of these symptoms, they are likely to stem from another health condition. However, it is important to consult a doctor if you are concerned.

The best treatment depends on:

• Type of vaginal cancer
• Stage of vaginal cancer
• The patient’s general health

The two main ways of treating cancer of the vagina are radiotherapy and surgery. Chemotherapy might be used alongside radiotherapy. Having chemotherapy on its own for vaginal cancer is not likely, but the oncologist may suggest it depending on the situation.

There are several different surgery options for vaginal cancer. These include:

• Vaginectomy: removal of the vagina along with surrounding tissues.
• Radical hysterectomy: removal of the womb, cervix, upper part of your vagina, and the surrounding tissues.
• Pelvic exenteration: this involves a hysterectomy plus removal of the vagina, bladder, rectum and part of the bowel.
  The surgical option that is most suitable will depend mostly on the size and position of the cancer.