A. Vaginal Cancer

Definition and Risk Factors

• A rare cancer that forms in the vaginal lining.

• Less common for cancer to begin in the vagina than for cancer to spread there (from uterus or cervix).

• Higher risk groups: people above 60 or those having HPV.

• Regular pelvic exams and PAP smears are important for early detection, as it often doesn’t cause symptoms.

Types of Vaginal Cancer

Signs and Symptoms

• Vaginal bleeding unrelated to menstruation, especially after intercourse.

• Vaginal bleeding after menopause.

• Vaginal discharge that is watery, bloody, or foul-smelling.

• Pain during intercourse.

• A noticeable mass in the vagina.

• Painful urination and pelvic pain.

• Constipation or black-colored stools.

• Feeling the urge to poop when the bowels are empty.

Diagnostics

• History (based on symptoms).

• Pelvic exam and Pap smear (Pap) test.

• If abnormal cells: colposcopy and vaginal biopsy.

• Staging (TNM): Determined by imaging and procedures:

  • Imaging: X-rays, CT scans, MRI (details about tumor size), and PET scans (show abnormal lymph nodes).

  • Cystoscopy: To check for cancer spread into the bladder.

  • Proctoscopy: To check for cancer spread into the rectum/small intestine.

Management and Treatment

• Precancerous cells: Laser surgery and topical treatments.

• Invasive vaginal cancer: Combination of surgery, radiation, and chemotherapy.

  • Surgery: Wide local excision, Vaginectomy (partial or radical), and pelvic exenteration.

  • Radiation: External or internal radiation therapy.

  • Chemotherapy: Used in conjunction with radiation therapy.

Prevention

• Get regular pelvic exams and Pap tests.

• Get the HPV vaccine.

• Do not smoke.

B. Vulval Cancer