What Is Vaginal Cancer?

Vaginal cancer is a type of cancer that first appeared in the vagina, not from other organs such as cervix, uterus, or ovaries that spread to the vagina. The vagina is the channel that connects the cervix to the outside of the body and the way out of the baby during normal labor.

Vaginal cancer can be divided into several types based on the type of cell where cancer starts:

• Vaginal squamous cell carcinoma. Vaginal cancer starts in thin and flat cells that line the vaginal surface. This type is the most common type, although vaginal cancer itself is a rare cancer.
• Vaginal adenocarcinoma. Vaginal cancer starts in the gland cells on the vaginal surface.
• Vaginal melanoma. The cancer develops in the cells producing pigments (melanocytes) in the vagina.
• Vaginal sarcoma. Vaginal cancer develops in connective tissue cells or muscle cells in the vaginal wall.

Vaginal cancer can appear without symptoms or signs, therefore it is necessary to check the area of ​​the womb and pap smear regularly in accordance with the recommendations of doctors.

Symptoms of Vaginal Cancer

Some common signs and symptoms of vaginal cancer are:

• Bleeding from the vagina. This bleeding occurs between menstrual periods, after sexual intercourse, or after menopause .
• Appears an itch or there is a lump in the vagina.
• Whitish that contains blood and smells.
• Difficult bowel movements.
• Pain during intercourse and urination.
• Frequent urination.
• Urine mixed with blood.
• Pain in the pelvic cavity.

Causes and Risk Factors of Vaginal Cancer

The cause of the appearance of cancer in the vagina is still not known with certainty. In general, cancer occurs when cells in the body change or mutate, which makes the cell divide and multiply too quickly and uncontrollably.

Some of the factors suspected to be at risk of triggering normal cells in the mutated vagina and becoming cancer are:

• Women exposed to the synthetic hormone estrogen diethylstilbestrol (DES) during pregnancy.
• Aged over 60 years.
• Infected with HPV (human papilloma virus) .
• Having sex at an early age.
• Diagnosed abnormal vaginal intraepithelial neoplasia (VAIN), ie abnormal vaginal cell changes. Usually this is caused by HPV infection.
• Smoke.
• Switching sexual partners.
• Never had a hysterectomy procedure.

Diagnosis of Vaginal Cancer

Vaginal cancer is sometimes found when performing routine content checks before symptoms develop. To diagnose vaginal cancer, the first step a doctor does is to ask for symptoms and signs that the patient feels. Then the doctor will run a physical examination on the outside and inside the patient's vagina to see if there are any abnormalities. Internal examination is done by examining the vaginal plug and using a device called a speculum to open the vaginal canal.

After performing a physical examination, the doctor may ask the patient to undergo several other checks, such as:

• P ap smear. In addition to cervical cancer , pap smears can also be done for early detection of vaginal cancer. Pap smears are done using a cotton swab and a small brush to take a sample of mucus and slightly erode the cells in several areas on the surface of the vagina and cervix. The cell will then be examined under a microscope. Ask your obstetrics and gynecologist how regularly you should do a pap smear to detect cervical and vaginal cancer early.
• Colposcopy. This is an examination action using a special instrument called a colposcope. Colposcopes shaped like a microscope or magnifying glass and equipped with lights that can see the condition of the vagina and cervix more detail.
• Biopsy . If during the colposcopy examination found there are abnormalities, the doctor will take the tissue samples for examination under a microscope. In contrast to pap smears, more specific biopsies directly take the tissue that is experiencing abnormalities, not just erode the surface of the tissue.

If the biopsy results show that the cell is a malignant cell, the doctor will determine the stage of vaginal cancer. Vaginal cancer is divided into 4 stages, as follows:

• Stage 1 . Cancer is confined to the vaginal wall.
• Stage 2 . The cancer spreads to the tissues around the vagina.
• Stage 3 . The cancer spreads to the pelvic cavity.
• Stage 4A . The cancer spreads to other organs near the vagina, such as the gut or bladder.
• Stage 4B . The cancer spreads to other organs far from the vagina, like the liver.

To determine the stages, the doctor may perform additional tests, such as X-rays, CT scans, MRIs, or PET scans, as well as endoscopic examination, ie a camera hose for hollow organs, such as cystoscopy and end or rectal proctoscopy ).

Treatment of Vaginal Cancer

The choice of vaginal cancer treatment depends on how far the spread is. Here are three types of vaginal cancer treatment:

Radiotherapy

This is the main way of handling for vaginal cancer. There are two types of radiotherapy , namely:

• External radiotherapy. The radiotherapy machine will fire high-energy rays to the vagina and pelvis.
• Internal radiotherapy. Radioactive material will be planted temporarily in the vaginal area. Internal radiotherapy can only be performed on early-stage vaginal cancer.

Surgery

There are four types of surgery to treat vaginal cancer, namely:

• Lifting the tumor. This action is done by simply removing the tumor and part of the healthy vaginal tissue.
• Partial vaginectomy. This is a surgery to remove part of the vagina.
• Radical vaginectomy. This is a surgery to remove the entire vagina.
• Vaginectomy and radical hysterectomy . This is a surgery to remove the entire vagina, uterus, ovaries, ovaries, and pelvic lymph nodes.
• Pelvic exenteration . This is a combined surgical hysterectomy to remove the surrounding tissues, including the bladder and lower intestine. Artificial hole (stoma) will be made as a place to dispose of urine and feces.

Chemotherapy

Not yet clear the benefits of chemotherapy for vaginal cancer, but usually chemotherapy is used as a combination with radiotherapy to strengthen the effects of radiotherapy. In addition, chemotherapy is also used to kill cancer cells that have spread to other areas.

Prevention of Vaginal Cancer

To prevent vaginal cancer, there is no definite way. But there are several things you can do to reduce the risk of vaginal cancer, namely:

• Do not smoke. Smoking increases the risk of developing vaginal cancer.
• Examination of contents and pap smears on a regular basis . Routine checks are done so that the cancer can be diagnosed as early as possible.
• HPV vaccination. Getting HPV vaccination may reduce the risk of HPV-related cancers, one of which is vaginal cancer.

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