Causes and risk factors
The exact cause of vaginal cancer is not known. Genetic mutation causes abnormal production of cells of vagina. They grow out of control and accumulate to form tumor. They invade nearby tissues and spread to other organs [metastasis]
Clinical presentation
Vagina is a 3-4 inch long tube that connects the external female genitals to the uterus. The entrance to vagina is surrounded by external parts called as vulva. The vulva includes – labia majora [large lip folds], labia minora [small lip folds], clitoris, mons pubis, and perineum. Presence of red, swollen, non healing ulcer, that bleeds easily on touch. Foul smelling discharge from vagina, vaginismus are features of vaginal cancer. Other symptoms include unexplained vaginal bleeding especially after intercourse. There is watery discharge from vagina, sensation of lump in the vagina. Patient experiences pain while urinating, pain in lower abdomen, hard stools, constipation. The cancer is classified into 4 types according to the site of affection i.e. vaginal squamous cell carcinoma – beginning in thin , flat cells that line the wall of vagina; adenocarcinoma affecting glandular cells of vagina; vaginal melanoma that affect melanocytes [ pigment producing cells ] of vagina; vaginal sarcoma is developed into the connective tissue in the muscle wall of vagina.There are different stages of vaginal cancer:
Stage1: the carcinoma is in situ
Stage2: the cancer is restricted to the vaginal tissue and there is no involvement of the lymph nodes
Stage 3: The cancer spreads to the pelvis
Stage 4A: metastasis occurs to the nearby areas such as bladder or rectum
Stage 4B: metastasis occurs to the distant organs such as liver.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosiscolposcopy is the primary test for detecting cancer. Vaginal biopsy, biopsy of the lesion is recommended which confirms the diagnosis. To determine the stage and extent of cancer further investigations likeimaging studies such as CT scan, MRI, PET scan are useful. Proctoscopy, cystoscopy may be carried out to detect the extent of cancer in rectum or urinary bladder.
Treatment
Treatment depends upon the type and stage of vaginal cancer. Treatment for vaginal cancer includes surgery and radiation. Surgery involves removal of cancerous lesion, removal of vagina [partial or radical vaginectomy], and removal of other pelvic organs such as entire uterus, bladder or rectum where metastasis has occurred. After vaginectomy, vaginal reconstruction surgery may be done.Radiation therapy, chemotherapy willalso help in treating vaginal cancer. Regular monitoring may be required.
Other Modes of treatment
The other modes of treatment can also be effective in treating vaginal cancer. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating vaginal cancer.
