Vaginal cancer

Overview

Vaginal cancer is a rare cancer that occurs in your vagina — the muscular tube that connects your uterus with your outer genitals. Vaginal cancer most commonly occurs in the cells that line the surface of your vagina, which is sometimes called the birth canal.

While several types of cancer can spread to your vagina from other places in your body, cancer that begins in your vagina (primary vaginal cancer) is rare.

A diagnosis of early-stage vaginal cancer has the best chance for a cure. Vaginal cancer that spreads beyond the vagina is much more difficult to treat.

Symptoms

Early vaginal cancer may not cause any signs and symptoms. As it progresses, vaginal cancer may cause signs and symptoms such as:

• Unusual vaginal bleeding, for example, after intercourse or after menopause
• Watery vaginal discharge
• A lump or mass in your vagina
• Painful urination
• Frequent urination
• Constipation
• Pelvic pain

When to see a doctor

See your doctor if you have any signs and symptoms related to vaginal cancer, such as abnormal vaginal bleeding. Since vaginal cancer doesn't always cause signs and symptoms, follow your doctor's recommendations about when you should have routine pelvic exams.

Causes

It's not clear what causes vaginal cancer. In general, cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal cells.

Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor).

Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).

Types of vaginal cancer

Vaginal cancer is divided into different types based on the type of cell where the cancer began. Vaginal cancer types include:

• Vaginal squamous cell carcinoma, which begins in the thin, flat cells (squamous cells) that line the surface of the vagina, and is the most common type
• Vaginal adenocarcinoma, which begins in the glandular cells on the surface of your vagina
• Vaginal melanoma, which develops in the pigment-producing cells (melanocytes) of your vagina
• Vaginal sarcoma, which develops in the connective tissue cells or muscles cells in the walls of your vagina

Risk factors

Factors that may increase your risk of vaginal cancer include:

• Increasing age. Your risk of vaginal cancer increases as you age. Most people who are diagnosed with vaginal cancer are older than 60.

• Atypical cells in the vagina called vaginal intraepithelial neoplasia. Being diagnosed with vaginal intraepithelial neoplasia (VAIN) increases your risk of vaginal cancer.

  With VAIN, cells in the vagina appear different from normal cells, but not different enough to be considered cancer. A small number of those with VAIN will eventually develop vaginal cancer, though doctors aren't sure what causes some cases to develop into cancer and others to remain benign.

  VAIN is frequently caused by the sexually transmitted human papillomavirus (HPV), which can cause cervical, vaginal and vulvar cancers, among others. Vaccines that prevent some types of HPV infection are available.

• Exposure to miscarriage prevention drug. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s you may have an increased risk of a certain type of vaginal cancer called clear cell adenocarcinoma.

Other risk factors that have been linked to an increased risk of vaginal cancer include:

• Multiple sexual partners
• Early age at first intercourse
• Smoking
• HIV infection

Complications

Vaginal cancer may spread (metastasize) to distant areas of your body, such as your lungs, liver and bones.

Prevention

There is no sure way to prevent vaginal cancer. However, you may reduce your risk if you:

• Undergo regular pelvic exams and Pap tests. You can increase the chance that vaginal cancer is discovered early by having routine pelvic exams and Pap tests. When discovered in its earliest stages, vaginal cancer is more likely to be cured. Discuss with your doctor when to begin these tests and how often to repeat them.
• Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of vaginal cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
• Don't smoke. If you smoke, quit. If you don't smoke, don't start. Smoking increases the risk of vaginal cancer.

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