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Cancer in the vagina is very rare and, in most cases, it appears as a worsening of cancer in other parts of the body, such as the cervix or vulva, for example.
Symptoms of cancer in the vagina such as bleeding after intimate contact and smelly vaginal discharge usually appear between 50 and 70 years of age in women infected with the HPV virus, but they can also appear in younger women, especially if they are at risk behaviors how to have relationships with several partners and not use a condom.
Most of the time the cancerous tissues are located in the innermost part of the vagina, with no visible changes in the outer region and, therefore, the diagnosis can only be made based on imaging tests ordered by the gynecologist or oncologist.
Possible symptoms
When it is at an early stage, vaginal cancer does not cause any symptoms, however, as it develops, symptoms such as the ones below will appear. Check the symptoms you may be experiencing:
- 1. Smelly or very liquid discharge No Yes
- 2. Redness and swelling in the genital area No Yes
- 3. Vaginal bleeding outside the menstrual period No Yes
- 4. Pain during intimate contact No Yes
- 5. Bleeding after intimate contact No Yes
- 6. Frequent desire to urinate No Yes
- 7. Constant abdominal or pelvic pain No Yes
- 8. Pain or burning when urinating No Yes
Symptoms of cancer in the vagina are also present in numerous other diseases that affect the region and, therefore, it is important to go to routine gynecological consultations and periodically do the preventive exam, also called pap smear, to identify changes at an early stage, ensuring better chances of cure.
See more about the Pap smear and how to understand the test result.
To make the diagnosis of the disease, the gynecologist scrapes the surface tissue inside the vagina for biopsy. However, it is possible to observe a suspicious wound or area with a naked eye during a routine gynecological consultation.
What causes vaginal cancer
There is no specific cause for vaginal cancer, however, these cases are usually related to HPV virus infection. This is because some types of the virus are able to produce proteins that alter the way the tumor suppressor gene works. Thus, cancer cells are easier to appear and multiply, causing cancer.
Who is most at risk
The risk of developing some type of cancer in the genital region is higher in women with HPV infection, however, there are other factors that may also be the cause of vaginal cancer, which include:
- Be over 60 years old;
- Have a diagnosis of intraepithelial vaginal neoplasia;
- Being a smoker;
- Having HIV infection
Since this type of cancer is more common in women who have HPV infection, preventive behaviors such as avoiding having multiple sexual partners, using condoms and vaccinating against the virus, which can be done free of charge at SUS in girls between 9 and 14 years old. Find out more about this vaccine and when to get vaccinated.
In addition, women who were born after their mother was treated with DES, or diethylstilbestrol, during pregnancy may also be at increased risk for developing cancer in the vagina.
How the treatment is done
Treatment for cancer in the vagina can be done with surgery, chemotherapy, radiation therapy or topical therapy, depending on the type and size of the cancer, stage of the disease and the patient's general health:
1. Radiotherapy
Radiation therapy uses radiation to destroy or reduce the growth of cancer cells and can be done in conjunction with low doses of chemotherapy.
Radiotherapy can be applied by external radiation, through a machine that emits beams of radiation over the vagina, and must be performed 5 times a week, for a few weeks or months. But radiotherapy can also be done by brachytherapy, where the radioactive material is placed close to the cancer and can be administered at home, 3 to 4 times a week, 1 or 2 weeks apart.
Some of the side effects of this therapy include:
- Tiredness;
- Diarrhea;
- Nausea;
- Vomiting;
- Weakening of the pelvis bones;
- Vaginal dryness;
- Narrowing of the vagina.
Generally, the side effects disappear within a few weeks after finishing treatment. If radiation therapy is given in conjunction with chemotherapy, adverse reactions to treatment are more intense.
2. Chemotherapy
Chemotherapy uses drugs orally or directly into the vein, which can be cisplatin, fluorouracil or docetaxel, which help to destroy cancer cells located in the vagina or spread throughout the body. It can be performed before surgery to reduce the size of the tumor and is the main treatment used to treat more developed vagina cancer.
Chemotherapy not only attacks cancer cells, but also normal cells in the body, so side effects such as:
- Hair loss;
- Mouth sores;
- Lack of appetite;
- Nausea and vomiting;
- Diarrhea;
- Infections;
- Changes in the menstrual cycle;
- Infertility.
The severity of the side effects depends on the medication used and the dosage, and they usually disappear within a few days after treatment.
3. Surgery
The surgery aims to remove the tumor located in the vagina so that it does not increase in size and does not spread to the rest of the body. There are several surgical procedures that can be performed such as:
- Local excision: consists of the removal of the tumor and a part of the healthy tissue of the vagina;
- Vaginectomy: consists of the total or partial removal of the vagina and is indicated for large tumors.
Sometimes it may also be necessary to remove the uterus to prevent cancer from developing in this organ. Lymph nodes in the pelvis should also be removed to prevent cancer cells from spreading.
The recovery time from surgery varies from woman to woman, but it is important to rest and avoid having intimate contact during the healing time. In cases where there is total removal of the vagina, it can be reconstructed with skin excerpts from another part of the body, which will allow the woman to have intercourse.
4. Topical therapy
Topical therapy consists of applying creams or gels directly to the tumor located in the vagina, in order to prevent cancer growth and eliminate cancer cells.
One of the drugs used in topical therapy is Fluorouracil, which can be applied directly to the vagina, once a week for about 10 weeks, or at night, for 1 or 2 weeks. Imiquimod is another medicine that can be used, but both need to be indicated by the gynecologist or oncologist, since they are not over-the-counter.
Side effects of this therapy can include severe irritation to the vagina and vulva, dryness and redness. Although it is effective in some types of vagina cancer, topical therapy does not have as good results compared to surgery, and is therefore less used.