Vaginal Cancer
Vaginal cancer is a rare cancer of the female reproductive system. Only 3% of gynecologic cancers are vaginal. The vagina (birth canal) is the corridor through which menstrual fluid leaves the body and babies are born. It is connected to the cervix (the opening of the uterus or womb) and the vulva (folds of skin around its opening). The vaginal walls have a thin layer of cells called the epithelium, which contains cells called squamous epithelial cells. The vaginal wall, underneath the epithelium, consists of connective and involuntary muscle tissue, lymph vessels, and nerves. Usually, the vagina is in a collapsed position with its walls touching. The walls have many folds that allow the vagina to open and expand during sexual intercourse and vaginal childbirth. The vaginal lining is kept moist by mucus released by glands in the cervix. Vaginal cancer begins when cells in the vagina begin to change, grow uncontrollably, and eventually form a tumor. Tumors can be benign (noncancerous) or malignant (cancerous).
Types of vaginal cancer
There are four types of vaginal cancer:
- Squamous carcinoma. Squamous carcinoma begins in the epithelial lining of the vagina, most often in the area closest to the cervix. Squamous cell cancers make up 85% to 90% of vaginal cancers. It develops slowly through precancerous changes called vaginal intraepithelial neoplasia (VAIN).
- Adenocarcinoma. Adenocarcinoma begins in the tissues of vaginal glands. It accounts for 5% to 10% of vaginal cancers.
- Clear cell adenocarcinoma. This cancer occurs in young women whose mothers took the drug diethylstilbestrol (DES) during pregnancy between the late 1940s and 1971. It is estimated that one woman in 1,000 exposed to DES develops vaginal cancer.
- Melanoma. Melanoma is the most serious type of skin cancer. Melanoma is usually found on skin exposed to the sun, but it can begin on the skin of the vagina or other internal organs. Dark-colored tumors appear on the lower or outer parts of the vagina. Learn more in the PLWC Guide to Melanoma.
All women should have an annual gynecologic examination. The doctor will take a family medical history and perform a general physical examination. Research has shown that certain factors can help prevent vaginal cancer.
- Delaying first sexual intercourse until the late teens or older
- Avoiding sexual intercourse with multiple partners
- Avoiding sexual intercourse with someone who has had many partners
- Practicing safe sex
- Having regular Pap tests to detect and treat precancerous conditions
- Not starting to smoke
- Quitting smoking, if a smoker
Most vaginal cancers do not cause symptoms in the early stages, but cancer in more advanced stages can cause symptoms to occur. Even precancerous conditions, such as VAIN, may not cause symptoms. However, many cases of VAIN and early vaginal cancer, although asymptomatic, can be found through regular Pap tests. Women with vaginal cancer may experience the following symptoms. Sometimes, women with vaginal cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor. The most common symptom of vaginal cancer is abnormal vaginal bleeding. Vaginal bleeding during menopause is not normal and, therefore, always a sign of a problem. Other symptoms of vaginal cancer include:
- Unusual vaginal bleeding
- Abnormal vaginal discharge
- Difficulty or pain when urinating
- Pain during sexual intercourse
- Pain in the pelvic area (the lower part of the abdomen between the hip bones)
- Pain in the back or legs
- Edema (swelling in the legs)
Credit: National Institute of Health.