Vaginal cancer

Vaginal cancer

Vaginal cancer is cancer that grows and develops in the vagina. Vaginal cancer is cancer that starts from the vagina, not from other organs around the vagina, such as the cervix, uterus, or ovaries.

The vagina is the tube that connects the uterus and cervix with the outside of the body. This channel serves as the exit of menstrual blood ( menstruation ) and the exit of the baby during normal delivery.

Vaginal cancer is a rare cancer and often does not cause symptoms in the early stages. As a result, early stage vaginal cancer is often diagnosed accidentally during routine health checkups and pap smears .

However, if vaginal cancer has entered an advanced stage, symptoms such as itching and lumps in the vagina, pain in the pelvis, and pain when urinating can arise.

Types of Vaginal Cancer _

Vaginal cancer can be divided into several types based on the type of cell where the cancer starts, namely:

  • Squamous cell carcinoma , the most common type of vaginal cancer, which begins in the thin, flat cells on the surface of the vagina
  • Adenocarcinoma, which is vaginal cancer that begins in the glandular cells of the vaginal surface
  • Melanoma, which is cancer that develops in pigment-producing cells (melanocytes) in the vagina
  • Vaginal sarcoma, which is cancer that develops in connective tissue cells or muscle cells in the vaginal wall

Causes of Vaginal Cancer

The cause of vaginal cancer is still not known for sure. Cancer can appear when some of the body's cells change (mutate), then grow uncontrollably and attack the surrounding healthy cells. Cancer cells can also spread and attack other body tissues (metastasis).

Although the cause is not yet known, most cases of vaginal cancer are related to human papillomavirus (HPV) infection.

Risk factors for vaginal cancer

Some factors that are thought to be at risk of triggering normal cells in the vagina to mutate and turn into cancer are:

  • Aged more than 60 years
  • Using the synthetic estrogen hormone diethylstilbestrol (DES)
  • Suffering from HPV ( human papillomavirus ) infection
  • Ever undergone a procedure to remove the uterus ( hysterectomy )
  • Suffering from HIV infection
  • Suffering from precancerous abnormalities, such as vaginal intraepithelial neoplasia (VAIN)
  • Has a smoking habit
  • Having sex at an early age
  • Alternate sexual partners

Vaginal Cancer Symptoms

In the beginning, vaginal cancer does not cause any specific symptoms or signs. However, over time, vaginal cancer will cause the following signs and symptoms:

  • Abnormal bleeding from the vagina, for example during or after sexual intercourse, outside of menstruation, or after menopause
  • Itching or lumps in the vagina that do not go away
  • Discharge that is watery, smelly, or contains blood
  • Pain when urinating
  • Constipation
  • Frequent urination
  • Pelvic pain

When should you go to the doctor?

Check with your doctor if you experience any of the symptoms mentioned above. Have a routine pelvic exam if your doctor advises you to do so. This is because vaginal cancer sometimes has no symptoms.

An early examination can determine the cause of the complaints you are experiencing. If the symptoms experienced are caused by cancer, treatment can be done immediately.

Vaginal Cancer Diagnosis

Vaginal cancer is sometimes found when patients perform a routine examination of the feminine area before any symptoms or complaints arise.

To diagnose vaginal cancer, initially the doctor will ask about the symptoms experienced by the patient. After that, the doctor will examine the outside and inside of the patient's vagina to see if there are abnormalities.

Examination in the vagina is done by examining the vaginal plug and using a speculum to open the vaginal canal.

After that, the doctor can ask the patient to undergo some supporting examinations, such as:

  • Pap smear , to take a sample from the vagina
  • Colposcopy , to see the condition of the vagina and cervix in more detail
  • Biopsy by taking a sample of abnormal tissue, to ensure abnormal cell and tissue growth
  • Scanning with X-ray photo, CT scan, MRI, PET scan, cystoscopy and proctoscopy ( rectal endoscopy ), to find out the presence and size of cancer, as well as how far the cancer has spread

Stage of Vaginal Cancer

Based on the TNM classification (tumor, nodule, and metastasis), vaginal cancer can be divided into 4 stages, namely:

  • Stage 1
    In this stage, the spread of cancer is limited only to the vaginal wall.
  • Stage 2
    At this stage, the cancer in the vaginal wall has spread, but has not yet reached the pelvic wall.
  • Stage 3
    At this stage, the cancer has spread to the pelvic cavity and has blocked the flow of urine, causing hydronephrosis .
  • Stage 4A
    At this stage, the cancer has spread to other organs, such as the anus or bladder, but has not yet reached the lymph nodes in the pelvis or groin.
  • Stage 4B
    At this stage, the cancer has spread to other organs that are far from the vagina, such as the lungs, liver, or bones.

Vaginal Cancer Treatment

Treatment of vaginal cancer aims to eliminate the cancer. However, the method performed on each patient can be different, depending on the type of cancer and the stage of vaginal cancer. Here is the explanation:

Radiotherapy

Radiotherapy is the main method to deal with vaginal cancer. There are two types of radiotherapy , namely:

  • External radiotherapy, which is radiotherapy by shooting radiation into the vagina and pelvis to kill cancer cells
  • Internal radiotherapy ( brachytherapy ) , which is radiotherapy by implanting radioactive material in the vagina or the surrounding area, to deal with early stage vaginal cancer or advanced treatment after external radiotherapy

Operation

There are five types of surgery to deal with vaginal cancer, namely:

  • Tumor removal surgery, to remove the tumor and part of the surrounding healthy vaginal tissue
  • Partial vaginectomy, to remove the cancer and part of the vagina
  • Radical vaginectomy , to remove the entire vagina
  • Radical vaginectomy and hysterectomy, to remove the entire vagina, uterus, ovaries, fallopian tubes, and pelvic lymph nodes
  • Pelvic exenteration , to lift the vagina, rectum, ovaries, uterus, bladder, and lower colon

Chemotherapy

If radiotherapy and surgery cannot control or eliminate the cancer, the doctor may recommend chemotherapy . Chemotherapy is the administration of drugs to kill cancer cells and is usually combined with radiotherapy.

In addition to the above treatment methods, doctors can also recommend that patients undergo palliative therapy. Palliative therapy is useful to relieve the pain and symptoms suffered. This therapy can also provide enthusiasm and encouragement to the patient to improve the quality of life.

Complications of Vaginal Cancer

Vaginal cancer that is not treated immediately can grow and spread to the tissues around the vagina. In fact, vaginal cancer can also spread to distant organs, such as the lungs, liver, and bones.

Vaginal Cancer Prevention

There is no specific way that can really prevent the onset of vaginal cancer. However, there are several efforts that can be made to reduce the risk of vaginal cancer, namely:

  • No smoking
  • Do not alternate sexual partners
  • Carry out regular check-ups and pap smears
  • Undergo HPV vaccination
  • Not having sex at an early age
  • Use a condom when having sex
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