What Is a Vaginal Neoplasm?
A neoplasm is another name for cancer. Cancer is a disease characterized by the uncontrollable multiplication of abnormal cells. It can occur in many parts of the body, including the vagina.
Also called the birth canal, the vagina is a tubular part of the female genital tract that connects the cervix, at the bottom of the uterus, to the vulva, which is part of the external female genitalia.
Vaginal cancer is rare and comprises less than 3 percent of female reproductive cancers, according to the University of California, San Francisco (UCSF) Medical Center.
There are four main types of vaginal cancer:
Squamous Cell Cancer
Squamous cell cancer is the most common type of vaginal cancer. It develops from squamous cells in the lining of your vagina. Usually, it’s a slow-growing cancer, and it’s often discovered in its precancerous stages. Vaginal intraepithelial neoplasia (VAIN) is a precancerous condition that occurs when squamous cells start to display abnormal changes that can lead to cancer.
Adenocarcinoma is a type of vaginal cancer that starts in the gland cells. It’s the second most common type of vaginal cancer.
Melanoma of the skin is fairly common. It can also affect the vagina, but this is rare. Melanoma develops from skin cells that produce pigment.
Sarcomas are cancers that originate in bone, muscle, or connective tissue.
Some women may not have any symptoms. When symptoms are present, they can include:
- vaginal bleeding after intercourse
- abnormal vaginal discharge or bleeding
- pelvic pain
- vaginal pain
Sometimes, this cancer is found during a routine gynecologic checkup even if you don’t have symptoms.
It’s often difficult to know the cause of vaginal cancer. However, some factors may increase your risk. Women who are at an increased risk of developing vaginal cancer include:
- women over 70 years of age
- women whose mothers took the drug diethylstilbestrol (DES) while pregnant with them
- women infected with the human papillomavirus (HPV)
- women infected with HIV
- women who smoke cigarettes and drink alcohol
Talk with your doctor if you’re worried about your risk of vaginal cancer. They can review your health history and give you more information about your specific risk for this cancer. Even if you have one or more risk factors, you won’t necessarily get vaginal cancer.
Vaginal cancer may be found unexpectedly during a yearly pelvic exam or Pap smear. As part of every pelvic exam, your doctor will insert a gloved finger into your vagina while pressing down on your abdomen to look for unusual growths, pain, and tenderness.
During a Pap smear, your doctor will take a swab of cells from your cervix and vagina, to be tested for abnormalities. Unusual pain, tenderness, growths, or abnormal cells are all cause for concern, as they may be symptoms of vaginal cancer.
If your doctor suspects you have cancer, they may take a biopsy, which is a small sample of tissue, from your vagina to see if cancer cells are present. Your doctor may also order a vaginoscopy. The endoscope, or small microscope, used in this procedure will allow your doctor to examine your vagina in greater detail. CT scans and MRIs of the area may also be performed.
If your doctor diagnoses vaginal cancer, they’ll determine its stage. The staging system classifies cancers based on how far they’ve spread in your body. According to the Mayo Clinic, the following are the stages of vaginal cancer:
- Stage 1 vaginal cancer is limited to the vaginal wall.
- Stage 2 vaginal cancer has spread to tissue next to the vagina.
- Stage 3 vaginal cancer has spread to the lymph nodes in the area, the pelvis, or both.
- Stage 4A vaginal cancer has spread to the lymph nodes in the area and the bladder, rectum, or pelvis.
- Stage 4B vaginal cancer has spread to other areas of the body.
Your doctor will order a CT scan or MRI to view your surrounding organs and to see if the cancer has spread.
Like other cancers, vaginal cancer is treated based on type, location, and stage. One or more treatments may be used, including surgery, radiation, or chemotherapy.
Surgery is the most common treatment, regardless of the stage of the cancer, according to the UCSF Medical Center. Laser surgery or a simple excision may be done. If you have a more severe case, your surgeon may need to remove the vagina or organs to which the cancer has spread.
Radiation therapy uses high-energy rays to kill cancer cells. External radiation uses a machine outside the body to aim rays at the affected area. Internal radiation involves placing radioactive tubes or pellets into the cancerous tissues or area.
Chemotherapy involves using drugs to kill cancer cells. Depending on the specific drug, it may be administered intravenously or orally. The drug can then travel throughout your body, attempting to kill any cancer that has spread to distant organs.
Vaginal cancer often occurs without any symptoms, so it’s often diagnosed in its later stages. Having a yearly Pap smear and pelvic exam increases your likelihood of finding this cancer in its early stages.
According to the ACS:
- Fifty-four percent of women with squamous cell carcinoma of the vagina live five years or more after being diagnosed with vaginal cancer.
- Sixty percent of women with have adenocarcinoma of the vagina live five years or more after being diagnosed with vaginal cancer.
- Thirteen percent of women with vaginal melanoma live five years or more after being diagnosed with vaginal cancer.
Research is ongoing, and there are many new developments and studies underway. These include gene therapy and research into the connection between HPV vaccines, such as Gardasil, and a reduction in the risk of vaginal cancer.
It’s important to follow up with your doctor. Regular checkups help your doctor monitor any complications of cancer and the side effects from the drugs used to treat the cancer. They also allow your doctor a chance to help make sure the cancer doesn’t return.
Having cancer and undergoing treatment for it can be both physically and emotionally trying, but you don’t have experience it alone. A support group, counselor, or your treatment team can help you cope with any problems and help you feel less alone.
The American Cancer Society (ACS) website lists a number of organizations that can provide support to those with vaginal cancer.