Vaginal cancer is cancer that grows and develops in the vagina. Vaginal cancer is cancer that starts in the vagina, not from other organs around the vagina, such as the cervix, uterus or ovaries.
The vagina is a canal that connects the uterus and cervix (cervical) to the outside of the body. This channel functions as a way out of menstrual blood ( menstruation ) and a way out of the baby during normal delivery.
Vaginal cancer is a rare cancer and often causes no symptoms in its early stages. As a result, early-stage vaginal cancer is often diagnosed accidentally during routine health checks and Pap smears .
However, if vaginal cancer has entered an advanced stage, symptoms may occur in the form of itching and a lump in the vagina, pelvic pain, and pain when urinating.
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 starts in the thin, flat cells on the surface of the vagina
- Adenocarcinoma, which is vaginal cancer that starts in the gland cells on the surface of the vagina
- 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 with certainty. Cancer can appear when some of the body's cells change (mutate), then grow uncontrollably and attack the healthy cells around them. Cancer cells can also spread and invade other body tissues (metastasize).
Although the cause is unknown, most cases of vaginal cancer are related to infection with the human papillomavirus (HPV).
Risk factors for vaginal cancer
Several factors that are thought to be at risk of triggering normal cells in the vagina to mutate and turn into cancer are:
- Over 60 years old
- Using the synthetic estrogen hormone diethylstilbestrol (DES)
- Suffer from infection with HPV ( human papillomavirus )
- Have had a uterine removal procedure ( hysterectomy )
- Suffering from HIV infection
- Suffer from a precancerous disorder, such as vaginal intraepithelial neoplasia (VAIN)
- Have a smoking habit
- Having sex at an early age
- Multiple sexual partners
Vaginal Cancer Symptoms
At first, vaginal cancer does not cause certain signs or symptoms. 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 lump in the vagina that does not go away
- Discharge that is watery, smells or contains blood
- Pain when urinating
- Frequent urination
- Pelvic pain
When to see a doctor
Check with your doctor if you experience the symptoms mentioned above. Get regular pelvic exams if your doctor recommends that you do so. This is because vaginal cancer is sometimes asymptomatic.
Early examination can determine the cause of the complaint you are experiencing. If the symptoms experienced are caused by cancer, treatment can be done immediately.
Diagnosis of vaginal cancer
Vaginal cancer is sometimes found when patients carry out routine examinations of the female area before any symptoms or complaints arise.
To diagnose vaginal cancer, initially the doctor will ask about the patient's symptoms. After that, the doctor will examine the outside and inside of the patient's vagina to see any abnormalities.
Vaginal examination is carried out by digital vaginal examination and using a speculum to open the vaginal canal.
After that, the doctor may ask the patient to undergo several 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 tissue samples that have abnormalities, to ensure abnormal cell and tissue growth
- Scanning with X-rays, CT scans, MRI, PET scans, cystoscopy and proctoscopy ( rectal endoscopy ), to determine the presence and size of cancer, and how far the cancer has spread
Vaginal Cancer Stage
Based on the TNM classification (tumors, nodules, and metastases), vaginal cancer can be divided into 4 stages, namely:
At this stage, the spread of cancer is limited only to the vaginal wall.
At this stage, the cancer in the vaginal wall has spread, but has not reached the pelvic wall.
At this stage, the cancer has spread to the pelvic cavity and has blocked the flow of urine, causing hydronephrosis .
At this stage, the cancer has spread to other organs, such as the anus or bladder, but has not reached the lymph nodes in the pelvis or groin.
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 get rid of the cancer. However, the method used for each patient may be different, depending on the type of cancer and the stage of vaginal cancer. Here is the explanation:
Radiotherapy is the main method of treating vaginal cancer. There are two types of radiotherapy , namely:
- External radiotherapy, namely radiotherapy by shooting radiation beams into the vagina and pelvis to kill cancer cells
- Internal radiotherapy ( brachytherapy ) , namely radiotherapy by implanting radioactive material in the vagina or the area around it, to treat early-stage vaginal cancer or follow-up treatment after external radiotherapy
There are five types of surgery to treat vaginal cancer, namely:
- Tumor removal surgery, to remove the tumor and some of the healthy vaginal tissue around it
- 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 remove tissue from the vagina, rectum, ovaries, uterus, bladder, and lower colon
If radiotherapy and surgery cannot control or eliminate the cancer, your doctor may suggest chemotherapy . Chemotherapy is the administration of drugs to kill cancer cells and is usually combined with radiotherapy.
In addition to the treatment methods above, doctors may also recommend patients undergo palliative therapy. Palliative therapy is useful for relieving pain and symptoms suffered. This therapy can also provide encouragement and encouragement to patients to improve their quality of life.
Vaginal Cancer Complications
Vaginal cancer that is not treated immediately can enlarge 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 vaginal cancer. However, there are several efforts that can be made to reduce the risk of developing vaginal cancer, namely:
- Do not smoke
- Do not change sexual partners
- Undergo routine obstetrical and pap smear examinations
- Undergoing the HPV vaccination
- Do not have sex at an early age
- Using condoms during sexual intercourse