Vaginal Cancer Treatments
Different types of treatments are available for patients with vaginal cancer. Surgery is the most common treatment of vaginal cancer. The following surgical procedures may be used:
- 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.
Different types of treatments are available for patients with 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. One of the following types of surgery may be done:
- 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.
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 are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy refers to the use of high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. With external radiation therapy, a machine outside your body directs radiation at your cancer. With internal radiation therapy, a radioactive substance sealed in needles, seeds, wires, or catheters is placed inside your body in or near your cancer. Whether you receive internal or external radiation depends on the type and stage of your cancer. Some women instead undergo intraperitoneal radiation therapy, in which radioactive liquid is injected directly in their abdomen through a catheter to kill the cancer or keep it from spreading.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by keeping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Delivering anticancer drugs directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube is called intraperitoneal chemotherapy. Whether you receive regional, systemic, or intraperitoneal chemotherapy depends on the type and stage of your cancer.
Treatments in Development
New cancer treatments in development include:
- Biologic therapy: This treatment uses your immune system to fight cancer. The idea is to use substances made by your bodyor replicated in a lab to boost, direct, or restore your body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
- Targeted therapy: This treatment uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are conducted to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Your participation may help improve the way cancer is treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or that reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. To learn more about the clinical trials that Mount Sinai is participating in, visit our clinical trials page. Type in "ovarian cancer" and hit "Search Clinical Trials."
Some of the tests you underwent to diagnose your condition or to determine the stage of your cancer may have to be repeated. Other tests will be repeated to see how well your treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Even after you have completed treatment, your doctor may order tests from time to time to see if your condition has changed or if your cancer has come back. These tests are sometimes called follow-up tests or check-ups.
Mount Sinai has earned a reputation of being able to successfully treat women who have survived gynecologic cancer with fertility sparing (non hysterectomy) treatment, while providing support for their individual journey to parenthood. For women who are about to undergo chemotherapy or radiation to treat cancer, preserving eggs opens up the possibility of using their own genetic material to have a child once the disease is treated.
We achieve high success rates in both low-tech and high-tech infertility treatments by individualizing protocols, maintaining strict quality control procedures and by emphasizing compassionate and patient-friendly care.
The Mount Sinai In Vitro Fertilization ( IVF) Program was among the very first help women conceive using previously frozen eggs from donors – and we continue to advance this emerging field. Our caring and dedicated physicians, in conjunction with a Complementary Care Team of therapists and nutritionists are all part of Mount Sinai's multi-disciplinary team approach.
To make an appointment with a Mount Sinai gynecologic oncologist, please call us at 212-427-9898 or 212-241-1111.