Understanding the vagina

The vagina is part of the female reproductive system. It extends from the cervix (the opening of the uterus) to the outside of the body at the vulva. Blood from a menstrual period flows through the vagina. And babies are born through the vagina.

There are different cells within the vagina. They include:

• Squamous cells. They're also called the epithelium. They make up the lining of the vagina.
• The vaginal wall. It's made up of connective tissue, muscle, lymph vessels, and nerves.
• Glands. They're near the opening of the vagina. They keep everything moist.

When vaginal cancer forms

There are different types of vaginal cancer.

• Vaginal intraepithelial neoplasia (VAIN). It's also called vaginal precancer. Abnormal cells are found in the epithelium. VAIN could become cancer over time.
• Squamous cell carcinoma. This is the most common type. It starts near the cervix.
• Adenocarcinoma. This type begins in gland cells of the vagina.
• Other, rare types such as:
  • Melanoma.
  • Sarcoma.

Symptoms can include:

• Irregular vaginal bleeding (bleeding between periods).
• Abnormal vaginal discharge.
• Pain during or after sex.
• Pelvic pain.
• A vaginal mass.
• Pain when urinating.
• Constipation.

Like most cancers, vaginal cancer can spread. It can spread to other parts of the reproductive system. It can also spread to nearby organs and other parts of the body. It's called metastasis when cancer spreads outside the vagina. The more that cancer spreads, the harder it is to treat.

Treatment choices for vaginal cancer

You and your doctor will decide on a treatment plan that's best for you. You may have one or a combination of treatments. They may include:

• Laser therapy. This uses a beam of high-energy light to destroy abnormal tissue. It's used for precancer treatment only.
• Topical therapy. This places drugs right at the affected area. It's used for precancer treatment only.
• Surgery. The affected parts of the vagina are removed. Sometimes the entire vagina is taken out (vaginectomy). Nearby lymph nodes in the groin may also be taken out (lymphadenectomy).
• Radiation therapy. This uses focused beams of high energy to kill cancer cells. It may be used alone or with chemotherapy. There are two types:
  • External beam radiation therapy. It's delivered to the vagina from outside the body.
  • Intracavity brachytherapy. It's delivered inside the vagina with a cylinder-shaped container. There are two types: low dose rate (LDR) and high dose rate (HDR).
• Chemotherapy. This uses strong medicines to kill cancer cells. It may be used alone, with radiation, or before surgery.
• Immunotherapy. This uses medicines that help your body's own immune system better fight cancer.
• Targeted drug therapy. This uses medicines that kill cancer cells or slow their growth.

After treatment, you'll be checked regularly for signs and symptoms of the cancer coming back (recurrence).