Colposcopy: A diagnostic procedure in which a device called a colposcope is used to carefully examine the vagina, vulva, and cervix for signs of cancer. Your oncologist may recommend this procedure if your Pap test shows abnormal results.
Biopsy: If the Pap test result shows anything suspicious, a biopsy can be carried out during a colposcopy to collect tissues from the cervix and vagina for later analysis under a microscope. If the gynecologist suspects cancer, they may request further images to be done, such as an MRI or a PET scan to find out if cancer has spread beyond the vagina.
Staging is the process to find out if cancer has spread within the vagina or to other parts of the body. From the information gathered, the gynecologic oncologist can determine the current stage of the disease and come up with an appropriate cancer treatment plan. The following is one way of determining the stage and, therefore, the types of treatment needed.
Stage I: This is the initial stage in which cancer is found within the vaginal wall. Stage II: In this stage, cancer has spread through the vaginal wall to the tissues around the vagina. Stage III: Cancer has spread to the wall of the pelvis. Stage IV: This stage is further divided into two sub-stages: Stage IVA: Cancer has spread to one or more of the surrounding areas: the uterus, ovaries, cervix, bladder, or the lining of the rectum. Stage IVB: Cancer has spread to other parts of the body, such as the bone or lung. Types of Treatment for Vaginal Cancer Your choice of treatment options may depend on the stage and type of cancer, your current health condition, and your care goals. Currently, three standard treatment methods are being used to treat vaginal cancer patients:
Surgery Surgery is used to remove all cancer that can be seen from the vagina. Depending on the severity of the condition, patients may undergo surgeries that remove only the affected tissues or have their uterus, ovaries, and vagina removed entirely. Radiation Therapy During radiation therapy, high energy x-rays are used to kill cancerous cells or prevent them from growing. If needed, the gynecologic oncologist will usually recommend a combination of external beam radiation and brachytherapy.
External radiation therapy: A machine is used outside the body to send radiation to the intended area.
Internal radiation therapy involves placing hollow tubes in the vagina next to the tumor so that a precise dose of radiation can be inserted into the tubes and directly applied to the cancer. The radioactive substance is left in place in the vagina for several minutes, and patients must stay in bed during this time. These are most often done as outpatient procedures.
In chemotherapy, drugs are used to stop the growth of cancer. Chemo is often given to vaginal cancer patients, along with radiation after surgery is complete. Depending on the type and stage of cancer, either systemic or regional chemotherapy, will be administered. Regional chemotherapy affects only the infected areas. Systemic chemotherapy is often injected into the muscle or taken orally. This way, the drug enters the bloodstream and works its effect on cancer cells throughout the body.
Vaginal cancer can come back to the vagina or other parts of the body after it has been treated; therefore, it's important to carry out regular follow-up tests after cancer treatments conclude.
Does Vaginal Cancer Cause BleedingVaginal cancer is the rarest of gynecologic cancers. It begins in the vagina, the muscular tube that connects the outer genitalia to the uterus (also called the “birth canal”).
Vaginal cancer patients find comfort in our personalized, holistic, and warm approach to care at Weill Cornell Medicine. In addition to access to experts at a leading academic medical center, our patients also benefit from greater access to their attending physician, video visits, e-message, flexible scheduling, and collaborative care with a wide range of specialists.
Vaginal Cancer Prevention and Screening Vaginal Cancer Risk Factors Women who are over 50 years old, took diethylstilbestrol (DES), use tobacco, or have the human papillomavirus (HPV) have a greater risk of developing vaginal cancer. Prevention Strategies The HPV vaccine protects against the HPV virus that can cause vaginal cancer. Typically, the HPV vaccine is given to preteens. In addition, quitting tobacco use and using condoms can help prevent vaginal cancer. Vaginal Cancer Screening There is no recommended screen for vaginal cancer. Precancerous cells of the vagina can at times be detected by Pap smears performed for cervical cancer screening.
Vaginal Cancer Symptoms The most common signs for vaginal cancer include: Abnormal vaginal bleeding Watery vaginal discharge Lump or mass in vagina Painful or frequent urination Changes in bowel movements Pelvic pain How We Diagnose Vaginal Cancer Diagnostic Tests Your physician will first conduct a physical and pelvic exam. A biopsy is the best way to confirm the diagnosis, so a small sample of cells is removed from the vaginal wall and examined under a microscope.
Imaging and Staging If vaginal cancer is confirmed, it is critical to determine where the cancer is and the extent of disease. Our team of expert gynecologic oncologists carefully evaluate each patient to determine the stage of vaginal cancer and develop a personalized treatment plan. Imaging tests may include a CT, MRI, or PET scan. Stage I: Cancerous cells are found in the vaginal wall. Stage II: The cancer has spread to the tissue next to the vagina. Stage III: The cancer has spread to the nearby lymph nodes or elsewhere in the pelvis. Stage IV: The cancer has spread beyond the pelvis to other parts of the body. Illustration explaining the staging of vaginal cancer
Vaginal Cancer Treatment Options at Weill Cornell Medicine Our team of gynecologic oncologists personalize treatment depending on many factors, including the extent of disease. Individual treatment plans may include a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and other treatment options. Our physicians work closely with patients to minimize side effects and promote greater comfort throughout treatment. Precancerous Growth Removal If precancerous cells are detected, our gynecologic oncologists can surgically remove them with laser ablation. Precancerous cells can also be treated with topical therapy (a cream or ointment that is put directly on the cancer).
Surgical Approaches There are several surgical options to treat vaginal cancer, all of which include removing cancerous tissue (excision). A gynecologic oncologist will evaluate your specific condition and present the most appropriate options. Your physician may recommend: Partial vaginectomy (removal of part of the vagina) Radical vaginectomy (removal of the entire vagina) Hysterectomy (removal of uterus and ovaries) Pelvic exenteration (removal of the majority of the pelvic organs) Sentinel lymph node biopsy is a procedure in which the sentinel lymph node is removed and biopsied for cancer cells. Cancer typically spreads to these nodes first. This procedure helps physicians determine the extent of disease, as well as prevent the need for a full pelvic lymph node dissection.
Since several important organs are located in close proximity to the vagina, it is important to seek a highly trained surgeon who specializes in gynecologic cancers. Radiation Therapy Our gynecologic oncologists work closely with expert radiation oncologists at Weill Cornell Medicine to treat appropriate vaginal cancer patients with radiation therapy. Chemotherapy Chemotherapy is the use of drugs to kill cancerous cells. To limit side effects and damage to healthy cells, vaginal cancer patients are usually given chemotherapy in cycles with several rest periods.
Most women receive intravenous chemotherapy in combination with radiation to increase the effectiveness of radiation. Our expert gynecologic oncologists determine the most effective combination of therapies for each patient depending on a variety of factors. Our patients benefit from Weill Cornell Medicine's state-of-the-art chemotherapy treatment center, which provides unique support and resources. Immunotherapy Immunotherapy is the use of medications to stimulate your immune system to recognize and destroy cancer cells more effectively. Your physician determines the best immunotherapy medications and timing for taking them. With care from a highly trained gynecologic oncologist, immunotherapy can be an integral part of your vaginal cancer treatment.
The majority of vaginal cancers are caused by high-risk strains of the human papillomavirus (HPV). Having cervical precancer or cervical cancer also raises the risk of developing vaginal cancer.
If you have been diagnosed with HPV, cervical precancer or cervical cancer, talk to your gynecologist about your vaginal cancer risk.
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