Vaginal cancer begins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the outside of the body. Cancer of the vagina is related to cancer of vulva that is the area of skin that surrounds the vaginal opening, including the clitoris and labia. Vaginal and vulvar cancers are the least common of gynecologic cancers. Vulvar cancer begins in the vulva, the outer part of the female genital organs. Treatment is most effective when vaginal and vulvar cancers are found early. Together, vaginal and vulvar cancers account for only six to seven percent of all gynecologic cancers diagnosed in the United States, and most cases are diagnosed in women over 50.
Early on, most vaginal cancers do not cause signs and symptoms, so it is important for you to pay attention to your body and know what is normal for you. If you have any of the listed symptoms, it does not mean you have vaginal or vulva cancer. The same symptoms may be caused by something other than cancer. It is essential that you see a doctor if you experience any of the following symptoms:
- Vaginal discharge or bleeding that is not normal for you
- A change in bathroom habits, such as having blood in the stool or urine; going to the bathroom more often than usual; or feeling constipated
- Pain in your pelvis, the area below your stomach and in between your hip bones, especially when you pass urine or have sex
- Itching, burning, or bleeding on the vulva that does not go away
- Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you or has a rash or warts
- Sores, lumps, or ulcers on the vulva that do not go away
There is no way to know for sure if you will get vaginal or vulvar cancer. Some women get these cancers without being at high risk.
Factors that May Increase Risk
These factors may increase the chance that you will get vaginal or vulvar cancer, including:
- The human papillomavirus (HPV), a common sexually transmitted virus, most of which go away on their own, but for some, cause cell changes and increase the risk of cancer
- Cervical cancer
- A condition that weakens your immune system (such as HIV, the virus that can lead to AIDS), making it hard for your body to fight off health problems
Factors that May Reduce Risk
Since almost all cervical cancers and some vaginal and vulvar cancers are caused by HPV, it is wise to take preventative measures against HPV. Fortunately, Gardasil and Cervaris vaccinations can prevent certain types of HPV that most often cause cervical, vaginal, and vulvar cancers. The vaccine is recommended for 11 and 12 year old girls, and females who are aged 13 through 26 who did not get any or all of the shots when they were younger. Girls beginning age nine can also be vaccinated.
If you have been diagnosed with vaginal or vulvar cancer, your doctor can refer you to a gynecologic oncologist, a doctor who has been trained to treat cancers of the female reproductive system. Different types of treatments are available for patients with vaginal cancer, including surgery, and even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may have chemotherapy or radiation therapy after surgery to kill any cancer cells that remain. Your doctor will work with you to create a treatment plan that may include surgery, radiation therapy, chemotherapy or a combination of these treatments.
Surgery for Vaginal Cancer
Surgery is the most common treatment of vaginal cancer, including the following procedures:
- Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
- Wide local excision: A surgical procedure that takes out the cancer and some of the healthy tissue around it.
- Vaginectomy: Surgery to remove all or part of the vagina.
- Total hysterectomy: Surgery to remove the uterus and cervix.
Surgery for Vulvar Cancer
Surgery is the most common treatment for cancer of the vulva. The goal of surgery is to remove all the cancer without any loss of the woman's sexual function using one of the following surgical procedures:
- Wide local excision: A surgical procedure to remove the cancer and some of the normal tissue around the cancer.
- Radical local excision: A surgical procedure to remove the cancer and a large amount of normal tissue around it. Nearby lymph nodes in the groin may also be removed.
- Vulvectomy: A surgical procedure to remove part or all of the vulva.
- Skinning vulvectomy: The top layer of vulvar skin where the cancer is found is removed. Skin grafts from other parts of the body may be needed to cover the area.
- Simple vulvectomy: The entire vulva is removed.
- Modified radical vulvectomy: The part of the vulva that contains cancer and some of the normal tissue around it are removed.
- Radical vulvectomy: The entire vulva, including the clitoris, and nearby tissue are removed. Nearby lymph nodes may also be removed.
- Pelvic exenteration: A surgical procedure to remove the lower colon, rectum, and bladder. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.