Vaginal Cancer Health Article

Coping with cancer treatment

The patient should consult her treatment team regarding any side effects or complications of treatment. Vaginal stenosis can be prevented and treated by vaginal dilators, gentle douching, and sexual intercourse. A water-soluble lubricant may be used to make sexual intercourse more comfortable. Women with a reconstructed vagina will need to use a water-soluble lubricant during sexual intercourse. Many of the side effects of chemotherapy can be relieved by medications. Women may wish to consult a psychotherapist and/or join a support group to deal with the emotional consequences of cancer and vaginectomy.

Clinical trials

As of 2001, there are no clinical trials underway that were specific for vaginal cancer. Women should consult with their treatment team to determine if they are candidates for any ongoing studies.

Prevention

Risk factors for vaginal cancer include:

• Diethylstilbestrol (DES). Young women whose mothers took DES during pregnancy are at a higher risk of developing vaginal cancer, particularly clear cell carcinoma. Between 1945 and 1970, DES was prescribed to pregnant women who were at risk of miscarriage.
• Cervical cancer. Women with a history of cervical cancer have a high risk of developing vaginal cancer.
• Hysterectomy. Up to half of all patients with vaginal cancer have had a hysterectomy. Their vaginal cancer may actually represent an earlier spread from the cervix.
• Chronic irritant vaginitis. Chronic irritation to the vagina, particularly from use of a vaginal pessary, is associated with vaginal cancer. A pessary is an instrument that is placed into the vagina to support the uterus or prevent pregnancy (contraception).
• Vaginal adenosis. This condition, in which cells that resemble those of the uterus are found in the vaginal lining, places a woman at a higher risk of developing vaginal cancer.
• Human papilloma virus (HPV) infection. Infection by this sexually transmitted virus, the cause of genital warts, increases a woman's risk of developing squamous carcinoma.
• Smoking. There appears to be an association between tobacco use and vaginal cancer.

All women, even those who have had a hysterectomy or are past menopause, should get an annual pelvic examination and Pap test. Women who had a hysterectomy because of cancer may benefit from more frequent Pap tests. The earlier that precancerous abnormalities or vaginal cancer are detected, the better the prognosis. Women whose mothers took DES during pregnancy and those with vaginal adenosis should be screened regularly. Women can reduce the risk of contracting HPV by avoiding sexual intercourse with individuals who have had many sexual partners, limiting their number of sexual partners, and delaying first sexual activity until an older age. Avoiding tobacco products may reduce a woman's risk of developing vaginal cancer.

Special concerns

Of special concern to women undergoing treatment of vaginal cancer is the effect surgery and/or radiation therapy will have on sexual functioning. Women of childbearing age may worry about their fertility and whether or not they will be able to bear children. Depression, due to the affects of surgery on body image and sexuality, may occur. Complications, both short term and long term, following extensive surgical treatment of vaginal cancer are not uncommon.

See Also Cystoscopy; Fertility issues

Resources

BOOKS

Bruss, Katherine, Christina Salter, and Esmeralda Galan, eds. American Cancer Society's Guide to Complementary and Alternative Cancer Methods. Atlanta: American Cancer Society, 2000.

Eifel, Patricia, Jonathan Berrek, and James Thigpen. "Cancerof the Cervix, Vagina, and Vulva." In Cancer: Principles & Practice of Oncology. DeVita, Vincent T., Samuel Hellman, and Steven Rosenberg, eds. Philadelphia: Lippincott Williams & Wilkins, 2001.

Garcia, Agustin, and J. Tate Thigpen. "Tumors of the Vulva and Vagina." In Textbook of Uncommon Cancer. Raghavan, D., M. Brecher, D. Johnson, N. Meropol, P. Moots, and J.Thigpen, eds. Chichester, UK: John Wiley & Sons, 1999.

Primack, Aron. "Complementary/Alternative Therapies in the Prevention and Treatment of Cancer." In Complementary/Alternative Medicine: An Evidence-Based Approach. Spencer, John, and Joseph Jacobs, eds. St. Louis: Mosby, 1999.

PERIODICALS

Creasman, William, Jerri Phillips, and Herman Menck. "The National Cancer Data Base Report on Cancer of the Vagina." Cancer 83 (September 1998): 1033-40.

ORGANIZATIONS

American Cancer Society. 1599 Clifton Rd. NE, Atlanta, GA30329. (800) ACS-2345. <http://www.cancer.org>.

Cancer Research Institute. 681 Fifth Ave., New York, NY10022. (800) 992-2623. <http://www.cancerresearch.org>.

Gynecologic Cancer Foundation. 401 North Michigan Ave., Chicago, IL 60611. (800) 444-4441 or (312) 644-6610.<http://www.wcn.org/gcf>.

National Institutes of Health, National Cancer Institute. 9000Rockville Pike, Bethesda, MD 20982. (800) 4-CANCER.<http://cancernet.nci.nih.gov>.

Belinda Rowland, Ph.D.

Adjuvant therapy

—A treatment that is intended to aid the primary treatment. Adjuvant treatments for vaginal cancer are radiation therapy and chemotherapy.

Biopsy

—Removal of a small piece of tissue for microscopic examination. This is done under local anesthesia and removed by either using a scalpel or a punch, which removes a small cylindrical portion of tissue.