What Is Vaginal Cancer?

Vaginal cancer is a rare type of cancer that forms in the vaginal tissue in women. Not to be confused with the vulva, the vagina is the narrow, elastic canal that extends from the cervix to the outside of the body. It is about 2 to 4 inches long and is also referred to as the birth canal.

Causes and Risk Factors of Vaginal Cancer

Although researchers cannot pinpoint exactly what causes vaginal cancer, they have identified several known risk factors for the disease. A risk factor is something that increases the likelihood that you may develop a disease but is not a guarantee you will get it. Risk factors for vaginal cancer include:

• HPV infection
• DES exposure (synthetic estrogen given to women before 1971 during pregnancy to prevent miscarriage, but ultimately causing health risks to the expectant mother and daughters/son they carried)
• diagnosed with cervical cancer
• use of a vaginal pessary
• smoking
• HIV/AIDS infection

Vaginal Cancer Symptoms

In the early stages, vaginal cancer does not usually cause any noticeable symptoms. As the disease progresses, symptoms begin to appear. Symptoms of vaginal cancer include abnormal vaginal bleeding or discharge, pelvic pain, a lump, bump, or lesion in the vagina, and pain during sexual intercourse. These symptoms are not exclusive to vaginal cancer; in fact, they are symptoms of other, less serious conditions.

Diagnosing Vaginal Cancer

If vaginal cancer is suspected, further evaluation is necessary to confirm the absence or presence of cancer. Findings from a pelvic exam and/or Pap smear are usually the first evaluations to raise red flags. A colposcopy may then be done to allow the doctor to view the cervix and vaginal walls more closely. A colposcopy utilizes a microscope-like instrument called a colposcope to look for abnormalities. During the colposcopy, a vaginal biopsy may be done on any suspicious areas. A biopsy involves removing a sample of tissue to be studied under a microscope. A vaginal biopsy is done very quickly and usually does not require an anesthetic.

If the biopsy confirms cancer, the stage of the disease will be determined. Staging refers to a categorization of how far the cancer has spread to nearby tissues. If advanced cancer is suspected, further medical testing may be necessary to determine the stage of the cancer.

Treatment of Vaginal Cancer

Your treatment plan depends on the type of vaginal cancer, stage, and general health. The primary treatment methods for vaginal cancer are surgery and radiation therapy.

Vaginal cancer surgery varies among diagnosed women. The type of surgery chosen weighs heavily on the size and stage of the tumor. Smaller, early-stage vaginal cancer may only require laser or wide local excision surgery to remove cancerous tissue, while more advanced cases may require more aggressive surgical therapy, like a radical vaginectomy (surgical removal of part or all of the vagina). This may be in addition to a radical hysterectomy and lymphadenectomy (removal of nearby lymph nodes).

Radiation therapy is also an option for treating vaginal cancer. This type of treatment uses certain types of high-energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.

Two primary types of radiation therapy are external beam radiation therapy and internal beam radiation, also called brachytherapy. In vaginal cancer, external beam radiation is much more common than internal beam radiation.

Chemotherapy is a treatment option for some women with vaginal cancer, but it is much less commonly used than surgery and radiation. It is given to women who suffer from advanced-stage vaginal cancer and is often in conjunction with radiation therapy.

Prevention of Vaginal Cancer

Because we don't know the exact causes of vaginal cancer, the best defense we have against the disease is to avoid the risk factors. Keep in mind that some women with vaginal cancer do not have any risk factors for the disease, so it cannot be prevented in all cases.

To reduce your risk of developing vaginal cancer, you should avoid becoming infected with HPV. Limiting the number of sexual partners you have and ensuring your partner wears a condom during intercourse are excellent ways to limit your exposure to the virus. Another way to prevent HPV is to get vaccinated with Gardasil-9. This vaccine, which is only approved in the U.S., protects against 9 total strains of HPV and may also provide protection against HPV-related vaginal cancer. The vaccine is currently indicated for females and males ages 9 through 45.

Another way to reduce your risk of vaginal cancer is to avoid smoking. If you don't smoke, don't start and if you do smoke, remember that it is never too late to quit. Avoiding tobacco products not only will help you to prevent vaginal cancer, it will help you prevent many other types of diseases and conditions as well.
Finally, getting a regular Pap smear is vital to your gynecologic health. While the Pap smear is best known for detecting abnormal cervical changes, it may be able to detect changes in vaginal cells that could progress into vaginal cancer if left undetected. Unfortunately, this is not true for all types of vaginal cancer.​