Cancer - vagina

Alternative names
Vaginal cancer; Vaginal tumors; Tumor - vaginal

Definition
Vaginal tumors are tissue growths that arise in the vagina.

Causes, incidence, and risk factors

The majority of cancer in the vagina is the result of the spread of a different cancer, such as cervical or endometrial cancer, into the vagina. Primary vaginal cancer is very rare and only makes up about 1% of all gynecologic malignancies.

The vast majority of primary vaginal cancers are squamous cell carcinoma (85%). The remainder are adenocarcinoma (6%), melanoma (3%), and sarcoma (3%).

The cause of squamous cell carcinoma of the vagina is unknown, but up to 30% of patients have a prior history of cervical cancer.

About 75% of patients with squamous cell cancer of the vagina are over 50. Adenocarcinomas of the vagina more commonly affect younger women. The average age of diagnosis for adenocarcinoma of the vagina is 19.

Women whose mothers took diethylstilbestrol (DES) during the first trimester of pregnancy are at increased risk for developing clear cell adenocarcinoma.

Sarcoma botryoides of the vagina is a rare type of cancer that mainly occurs in infancy and early childhood.

Symptoms

     
  • Painless vaginal bleeding and discharge  
  • Bleeding after sexual intercourse  
  • Pelvic or vaginal pain

About 5 - 10% of patients have no symptoms and have their cancer detected at the time of routine pelvic examination and Pap smear.

Signs and tests

Evaluation consists of pelvic examination and Pap smear. A biopsy may be performed, if suspicious lesions are seen.

If the Pap smear is abnormal and the vagina does not have any visible abnormalities, colposcopy (an examination of the vagina and cervix using a special microscope) may be performed to locate abnormal areas for biopsy.

CT scan of the abdomen and pelvis may be obtained as well, and possibly a chest x-ray.

Treatment

Treatment of vaginal cancer is individualized for each patient, and depends on the stage of the disease, the type of cancer, the area of vagina involved, and the age and health of the patient.

Surgery is sometimes used to remove the cancer, but most patients are treated with radiation. If the tumor is actually cervical cancer extending into the vagina, then radiation is given with chemotherapy at the same time. Sarcoma botryoides may be treated with a combination of chemotherapy, surgery, and radiation.

Support Groups
The stress of illness may be eased by joining a support group whose members share common experiences and problems. These support groups can be found by searching the Internet or contacting the American Cancer Society.

Expectations (prognosis)
The prognosis of vaginal cancer depends largely on the stage of disease and the type of tumor. The overall 5-year survival rate for squamous cell carcinoma is about 42%. The overall 5-year survival rate for patients with adenocarcinoma is about 78%.

Complications
Vaginal cancer may spread to other areas of the body. Other complications include complications of radiation, surgery, and chemotherapy.

Calling your health care provider

Call for an appointment with your health care provider if you notice bleeding after intercourse or have persistent vaginal bleeding or discharge.

Prevention
No certain preventative measures are known, but early detection can be maximized by regular yearly pelvic examinations and Pap smears.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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