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Vaginal cancer is a disease in which malignant (cancer) cells form in the tissues of the vagina (birth canal). The vagina leads from the cervix (the opening of the uterus) to the outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which starts in the thin, flat cells lining the vagina. Another type of vaginal cancer is adenocarcinoma, cancer that begins in glandular cells in the lining of the vagina.
Estimated new cases and deaths from vaginal (and other female genital) cancer in the United States in 2007:
- New cases: 2,140
- Deaths: 790
Symptoms and Diagnosis
Vaginal cancer often does not cause early symptoms and may be found during a routine Pap test. When symptoms occur they may be caused by vaginal cancer or by other conditions. A doctor should be consulted if any of the following problems occur:
- Bleeding or discharge not related to menstrual periods.
- Pain during sexual intercourse.
- Pain in the pelvic area.
- A lump in the vagina.
The following tests and procedures may be used to diagnose vaginal cancer:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
- Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
- Pap smear: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap test.
- Biopsy: The removal of cells or tissues from the vagina and cervix so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a Pap smear shows abnormal cells in the vagina, a biopsy may be done during a
colposcopy.
- Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) and checked under a microscope for signs of disease.
Causes
All cancers are caused by dysfunctions of proteins involved in cell division, apoptosis, or DNA repair (see general characteristics). Dysfunctional proteins may arise from gene mutations or protein interactions with
environments such as viral proteins. The following
factors may increase the risk of developing vaginal cancer:
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Being aged 30 or younger or aged 60 or older.
- Being exposed to DES (Diethylstilbestrol, a synthetic form of the
hormone estrogen) while in the mother's womb. In the 1950s, the drug DES was given to some pregnant women to prevent miscarriage (premature birth of a fetus that cannot survive). Women who were exposed to DES before birth have an increased risk of developing vaginal cancer. Some of these women develop a rare form of cancer called clear cell
adenocarcinoma.
- Having human papilloma virus (HPV) infection.
- Using a vaginal pessary to keep the uterus from sliding into the vagina.
Reference:
National Cancer Institute, USA.
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