Health Tips

Vagina Cancer:-
What is vaginal cancer?.

This is an abnormal growth of malignant cells (tumors, tumor) in the vagina. Vagina itself, sometimes referred to as the "birth canal", and for a period of 3 - 4 inch hollow tube that extends from the vulva (external genitalia) up to the cervix (the lower part of the uterus or womb). On the walls of the vagina often in the "closed" position or collapsed, but is able to expand significantly during sexual activity or delivery of the child.

What are the different types of vaginal cancer?.
The vast majority of cases of vaginal cancer (more than 90%) and squamous cell carcinomas, which grow in the skin, "" (epithelial lining) of the vagina. Usually occur in the upper part of the vagina near the cervix, and evolve over the years, many parts of the pre-cancer and called neoplasia vaginal intraepithelial (futility).

There is a much smaller proportion of vaginal cancer (5%) are adenocarcinomas which arise from glandular tissue. A sub-type of this cell Adenokarsinoma is clear, and which occurs in young women whose mothers took the old hormonal drug called diethylstilbestrol (DES), while they were pregnant with them. Diethylstilbestrol, which was scheduled from the 1940s to the early 1970s to prevent miscarriage.

Many of the rarest types of vaginal cancer and malignant tumors (2-3%), seen at the bottom or outside of the vagina, and sarcomas (2-3%). The most common cause of the masses in the vagina are metastases (spread of cancer from another site to the vagina). This can occur either by direct growth of the tumor in the vagina (for example, from the rectum and bladder) or from a remote location (for example, breast) through the blood stream or lymph nodes.
How common is cancer of the vagina?.
Which is a rare cancer, does not represent only about 2% of all tumors of the reproductive system of women. There are about 2,000 new cases reported each year in the United States with nearly 800 deaths attributed to the disease.

Cancer of the vagina that is happening?.
Normally, this is a condition affecting older women, and the average age of 65 - 70 years at diagnosis. The largest number of cases are diagnosed in women more than 70 years of age. Adenocarcinomas of the vagina, especially the choice is clear cell mentioned above, can be seen in younger women, and commonly before the age of 20.

What are the risk factors for cancer of the vagina?.
Squamous cell cancer of the vagina and is associated with aging and some high-risk strains of human papilloma virus (HPV). In fact, after being diagnosed with cervical cancer is in itself a major risk factor for cancer of the vagina. In addition to this, many of the risk factors for cervical cancer has been linked to cancer of the vagina as well. These risk factors include: smoking, young age at first intercourse, and a large number of sexual partners in his life. Chronic irritation of the vagina also been linked to some cases.

As mentioned above, clear cell Adenokarsinoma of the vagina associated with DES exposure in the womb.
What are the symptoms of vaginal cancer?.
Pain, vaginal bleeding, not related to menstrual periods, is the most common symptoms. Bleeding after sexual intercourse may also be a sign of cancer of the vagina. Vaginal bleeding woman in menopause and cancer until proven otherwise, should be evaluated promptly. Other symptoms can include vaginal discharge, and painful sexual intercourse. Vaginal cancer in more advanced, there may also be irritable bowel syndrome, such as blood in the stool, painful bowel movements or constipation, due to the invasion of the tumor in the rectum. Cancer of the vagina and can also spread locally to the bladder causing painful or difficult urination.

How is the diagnosis of cancer of the vagina?.
One of the most important steps in the evaluation of patients with gynecological complaint is a proper examination of the pelvis. Health care provider (HCP) should examine the uterus and ovaries, fallopian tubes and vagina. Vaginal cancer is diagnosed and staged clinically, and in the bladder and rectum should also be evaluated (with cystoscopy and proctoscopy, if necessary) for any abnormalities. Tomography and magnetic resonance imaging to scan the upper part of the abdomen and pelvis is not currently standard recommendations, but often done to look for enlarged lymph nodes, kidney / bladder problems, liver and tumor.

A Pap test should be performed, where the outside of the cervix and vagina, and is scraped samples are submitted for microscopic analysis and testing of HPV. Even if the suspected diagnosis of cancer of the vagina, cervix, and the anointing of particular importance to the exclusion of cervical cancer, which is more common than cancer of the vagina. Up to 20% of cases of vaginal cancer found by chance during the examination of cervical cancer, with a touch of the cervix.

A colposcopy is a place where agents include a magnifying lens of the microscope in the vagina to better visualize the cervix and inside the vagina. Any suspicious areas on the cervix and / or along the walls of the vagina should be biopsied and sent for microscopic analysis. Any suspicious areas are tested through the application of a dilute solution of acetic acid in the region, and areas not normally and usually turn white, making it easier to identify and biopsy.Once diagnosed, and how is vaginal cancer staged?

Staging helps doctors decide treatment options that may be best for each individual, as well as to speculate.

Can all of America Joint Committee on Cancer stage (TNM model) and the International Federation for Gynecologie et d 'Obstetrique (generation) can be used.

And preferred by most gynecologists and obstetrics system, which includes 5 stages, from 0 (I) to stage 4 (most advanced).

They are as follows:

• Phase 0 - very early stages of cancer of the vagina, also known as carcinoma in situ (CIS), neoplasia vaginal intraepithelial (VAIN), or pre-cancer, because cancer cells are trapped in the skin and vagina were not been grown in tissue deep or spread away from the vagina

• Phase 1 - the cancer has started to grow deep into the tissues of the vagina, but did not spread outside the vagina

• Phase 2 - cancer has started to spread outside the vagina in the surrounding tissues, but did not reach the walls of the basin

• Phase 3 - the cancer has spread outside the vagina, which was reached nearby lymph nodes or pelvic side walls

• Phase 4 - advanced vaginal cancer, with spread to other organs of the body outside the vagina

For further reference, link detailed TNM / Obstetrics stages are shown below:
Primary tumor (T):-

* Texas: Primary tumor can not be evaluated
* T0: No evidence of primary tumor
* Tess / 0: Carcinoma in situ
* T1 / I: tumor confined to the vagina
* T2 / II: Tumor invades paravaginal tissues but not to pelvic wall *
* T3 / III: Tumor extends to pelvic wall
* T4 / exciting: tumor invades the mucous membrane of the bladder or rectum and / or extends beyond true pelvis

Regional lymph nodes (n):-

* NX: Regional nodes can not be evaluated
* N0: No regional lymph node metastases
* N1 / products: the pelvis or groin lymph node metastases

Distant metastases (M):-

* MX: distant metastasis can not be evaluated
* M0: No distant metastasis
* M1 / products: remote metastases

Adapted from the vagina. In: American Joint Committee on Cancer: AJCC Cancer Staging Manual. 6th ed. New York, United States: Springer, 2002, p. 251-257.

How is the treatment of cancer of the vagina?.
Surgery, radiation therapy and chemotherapy are the treatment options model, and can be used in treatments, one way or collectively.

The system should be optimal treatment ultimately be individualized as much as possible. Should take into account the stage of the patient's disease, and other medical history, and personal preference, among other things.

Surgery:-
Surgery can be done either to remove all or part of the vagina. In general, and minor cuts in the upper vagina are the best candidates for surgery. Surgical methods include the following:

• Laser surgery for the disease in the very early stage, using a tight pack of light to kill cancer cells

• Wide local excision to eradicate the cancer and some surrounding tissue

• Vaginectomy, where the surgeon to remove the vagina and usually some lymph nodes in the pelvis;

• Radical hysterectomy if the cancer has spread outside the vagina, with the removal of the uterus and ovaries and fallopian tubes, as well as the lymph nodes

• Exenteration pelvic disease was very advanced, especially if an abnormal connection (fistula) formed between the vagina and the bladder or rectum.

Radiotherapy:-
Radiotherapy uses high-energy rays to kill cancer cells. This is the treatment of choice for most patients with invasive vaginal cancer, especially stage 2 disease, and higher education. And can be shipped from the external radiation beam (from an external device), brachytherapy (using "seeds" of radioactive isotopes through thin plastic tubes directly into the cancerous area), or more often a combination of both. Sometimes, brachytherapy alone can be used in small cancers in the upper part of the vagina. In general, whether the patients had been renewed after the radiation, and surgery if the treatment is preferred.

Chemotherapy:-
Chemotherapy uses drugs to kill cancer cells. Given the relative rarity of this disease, there are no random data support the use of radiation along with chemotherapy for cancer vagina. However, based on multiple studies in cervical cancer show better results compared with a combination of radiation alone, many recommend to the High Contracting Parties to the use of radiation and concurrent cisplatin-based chemotherapy for patients with high cancer risk through the vagina. Chemotherapy can also be used to monitor (as opposed to treatment) or recurrent disease on a large scale, but the results have traditionally been poor.

Most of the side effects of surgery and radiation occurs due to the proximity of the bladder and rectum into the vagina. Because of this close proximity, can not be that these are damaged during surgery or radiation. Side effects of radiation can include bowel and bladder irritation with increased frequency of bowel movements or urination. Radiation can cause scar tissue to form in the vagina which can make intercourse painful. And expanded to maintain the permissible from the vagina and are often used to prevent this. Rarely, there can be no connection between the bladder or rectum and vagina form (also known as obstetric fistula), which allows the passage of stool or urine in the vagina.

What is the diagnosis?.
Cell carcinoma and Adenokarsinoma:-

Phase 5-year rate of survival


Phase 0 96%

Phase I 73%

Phase II 58%

Phase III / IV 36%