Vaginal Cancer Treatment in Delhi, India

Vaginal cancer is a cancer of the vagina. It occurs when cancerous cells grow in the vagina. It is a rare type of cancer that affects women. It generally occurs in women above the age of 60.

Associated Anatomy of Vaginal Cancer

The vagina or the birth canal is a tube that links the uterus with the external genitals.

Types of Vaginal Cancer

The types of vaginal cancer are categorised based on the involvement of different cells in the vagina. These are:

Squamous cell carcinoma

Squamous cell carcinoma, a common vaginal cancer that occurs when the cells that line the vagina are involved. 70% of vaginal cancer is squamous cell carcinoma.

Adenocarcinoma

Adenocarcinoma occurs in gland cells of vagina.

Sarcoma

Sarcoma occurs in the vaginal connective tissue cells or muscle cells. Its type include rhabdomyosarcoma, leiomyosarcoma, and more.

Melanoma

Melanoma originates from pigmented melanoma cells of vagina.

Vaginal Cancer Causes

• Human papillomavirus (HPV): It is the most common virus causing sexually transmitted disease (STD). Most vaginal cancers are caused due to an HPV infection.
• Vaginal intraepithelial neoplasia: Abnormal vaginal cells.
• Women born from mothers who were administered the hormonal drug diethylstilbestrol (DES) during pregnancy.
• Radiotherapy for uterus cancer.

Vaginal Cancer Symptoms

The initial stage of vaginal cancer can be asymptomatic. However, symptoms that may develop as the cancer progress are:

• Vaginal bleeding after intercourse in the absence of menstruation.
• Noticeable swelling or mass can be felt in the vagina.
• Pain during sexual intercourse.
• Abnormal discharge from the vagina.
• Intense pain during urination.
• Increased frequency in urination.
• Pain in the pelvic region.

Stages of Vaginal Cancer

Vaginal cancer is divided into the following four stages based on the spread of cancer:

Stage I: The initial stage, the spread is only in the vaginal wall.

Stage II: When the cancer has spread to the tissues around the vagina.

Stage III: When the pelvis is partially affected.

Stage IVa: The cancer has spread to the bladder and rectum linings and around the entire pelvis.

Stage IVb: When cancer reaches the farther body parts, lungs and bones.

Vaginal Cancer Diagnosis

Pelvic Examination

Pelvic examination for the examination of your vagina, bladder, and rectum to check for any abnormalities.

Pap Test

Pap test for obtaining cells from the external surface of your cervix and vagina, which are examined for the presence of cancer cells.

Minimally Invasive Procedures

Minimally invasive procedures such as colonoscopy and endoscopy can be performed to rule out any abnormalities in the vagina and cervix.

Biopsy

A biopsy is performed as a confirmatory test for cancer and also for the removal of a minor amount of suspected tissue.

Imaging Techniques

Imaging techniques such as CT scan and Magnetic resonance imaging (MRI) are used to create internal images of organs for better treatment.

Vaginal Cancer Treatment

The various treatment modalities for vaginal cancer include:

Radiotherapy

Radiotherapy is mostly recommended in the initial stage of vaginal cancer. High-energy radiation is used to destroy cancer cells. It can be given both externally or internally. Internal radiotherapy is known as brachytherapy.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. The medication is induced through the blood. It is used either separately or along with radiotherapy. It helps to shrink the tumour size.

Surgeries for vaginal cancer

Surgery is recommended if the radiotherapy is unsuccessful ro advance disease. The following types of surgery are performed for vaginal cancer:

• Vaginectomy: it is the surgical removal of either the affected part of the entire vagina. After the recovery, you can choose reconstructive surgery to create a new vagina. It is performed with the tissue grafts of skin and muscle from other parts of your body.
• Radical Hysterectomy: Surgical removal of the uterus is called hysterectomy. In some instances of vaginal cancer, the uterus may also be removed. Moreover, the ovaries, fallopian tubes, and lymph nodes may also be removed.

Possible Complication of Vaginal Cancer

Possible complications can occur post-treatment. You may experience painful urination, nausea and vomiting, diarrhoea, and unusual vaginal discharge. Bladder and rectum can be damaged during treatment. Radiotherapy can make the vagina narrower and uncomfortable for sex.

Vaginal Cancer Prevention

Primary Prevention of Vaginal Cancer

Preventions for vaginal cancer include:

• Vaccination – HPV Vaccination reduces the incidence of vaginal cancer.
• Maintain vaginal hygiene: To reduce chances of microbial infection.
• Avoid sex with multiple partners: It increases the risk of STDs.
• Avoid having intercourse at a young age: Avoid unprotected sex and an unhygienic approach.
• Avoid drinking and smoking.
• Maintain a healthy lifestyle: Eat healthy, do exercise, keep yourself hydrated, and go for routine health checkups.

Secondary Prevention of Vaginal Cancer

Secondary prevention includes:

• Go for routine pelvic examinations.
• Pap test: Cervical screening used to detect precancerous and cancerous cells.
• Human papillomavirus (HPV) vaccination: Prevents infection and reduces the risk of vaginal cancers.

Epidemiology of Vaginal Cancer

• Vaginal cancer is very rare, the survival rate is dependent on the stage of cancer.
• It is common in women who have never undergone cervical screening.
• Vaginal cancer is more common in women aged 60 and above.
• 50% of cases are in women above 70 years of age.

Expected Prognosis of Vaginal Cancer

• Prognosis depends upon the stage at which cancer is diagnosed.
• Early-stage cancer is likely to be successfully treated.
• Later stage cancers are difficult to treat and have less survival rate.

Natural Progression of Vaginal Cancer

If cancer is not diagnosed at the correct time, in the initial stages, it will spread all over the body, making it almost impossible to cure.

Pathophysiology of Vaginal Cancer

Pathophysiology of vaginal cancer includes growth of abnormal cancerous cells. These cells multiply uncontrollably and form a mass of cells called tumours. In advanced stages these masses of cells can break off and invade nearby tissues, spreading cancer in nearby organs as well. This stage is called metastasis. Hair is lost due to high radiation therapies and chemotherapies.

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