Vaginal cancer is a rare cancer that affects the vagina of the woman. It mainly affects older women and occurs in almost a third of cases with cervical cancer (cervical cancer). Infection with human papillomavirus (HPV) is one of the risk factors for vaginal carcinoma.
Vaginal cancer is by definition one malignant tumor the vagina. Doctors also speak of vaginal carcinoma (lat. Vagina = Scabbard; Greek. Karkinos = Cancer).
In 90 out of 100 cases, vaginal cancer arises from the uppermost cell layer of the vaginal mucosa, the so-called squamous epithelium. Consequently, these forms of vaginal cancer are one squamous cell carcinoma. The remaining vaginal cancer tumors originated from other cell types. It is then predominantly adenocarcinomas or a malignant melanoma (black skin cancer) of the vagina. In childhood, a malignant tumor in the vaginal area also a so-called rhabdomyosarcoma his.
If a vaginal cancer develops directly from cells of the vagina, physicians use the term primary vaginal cancer.
Generally, many malignant tumors of the vagina but also arise from cancer of the adjacent organs and tissues (eg. vulva or the bladder). One then speaks of one secondary vaginal carcinoma. For example, cervical cancer (cervical carcinoma) is present in almost one third of all women with cervical cancer.
Malignant tumors of the vagina are rare. Only about 1 to 2 out of 100 malignant tumors of the female genitalia are vaginal cancer. Of the 100,000 women, on average less than one woman suffers from a cancer each year. Above all, older women are affected: the mean age of onset is between 60 and 65 years. If the vaginal cancer occurs in younger women, this is usually due to an infection with human papilloma viruses (HPV).
The causes of vaginal cancer (vaginal carcinoma) are not fully understood. However, it is known risk factors that favor formation of this tumor. These include infections with the human papilloma viruses (HPV) especially type 16.
Human papilloma viruses are the most common pathogens of sexually transmitted viral diseases worldwide. They lead to wart-like changes of the skin and the mucous membrane - including in the vagina.
On another risk factor for vaginal cancer is the intake of Diethylstilbestrol (DES) during the pregnancy. This is an artificial estrogen administered to pregnant women until it was banned in 1971 for a miscarriage to avoid. Since it can take several years for a vaginal carcinoma to be late effect developed the DES treatment, affected women only with a time delay at an older age.
Like many others cancers Symptoms also occur in a vaginal carcinoma only when the cancer is already in one advanced stage located. First symptom is often one bleeding from the sheath, especially after the sexual intercourse. In some patients it may also be increased or bloody discharge to get out of the vagina.
Broader tumors can too pain in the abdomen as well as disorders of the urinary bladder or bowel function.
In case of vaginal cancer (vaginal carcinoma), the doctor usually diagnoses in the context of routine gynecological examination - so rather fortuitously and not because the person concerned visited him for complaints.
At check-ups, the gynecologist takes the so-called cell swab (Pap test) single cells from the mucous membrane of the vagina and lets them examine microscopically. If the cells are abnormally altered to indicate that they have a cancer of the vagina, the doctor can diagnose it using a tissue sample secure (biopsy).
An important tool in the diagnosis of vaginal cancer is the so-called colposcope. It is a magnifying instrument that allows the doctor not only to look more closely at the mucosa, but also to take tissue samples from suspicious areas.
If there is a cancer of the vagina, the doctor must assess the extent to which the tumor has already spread (so-called staging). So he can do the exact thing stage of the disease. This is important as the treatment options, depending on the stage at which a vaginal carcinoma is located.
Imaging procedures play an important role in staging. They allow the doctor to look at internal organs. So he can see whether the tumor has grown into neighboring organs or in distant body regions (eg. in the Lungs) has already formed secondary tumors (metastases). Imaging procedures for vaginal carcinoma are:
- ultrasounds (Sonography) of the
- pelvic organs
- X-ray the lung
- Computed Tomography (CT) and magnetic resonance imaging (MRI) of the pelvic organs
In addition, a reflection of the urinary tract (urethrocystoscopy) and the Rectal (rectoscopy) often makes sense.
In case of vaginal cancer (vaginal carcinoma), the therapy especially after the stage of the tumor - that is, how far the tumor has already spread, for example, into adjacent tissue. Depending on what stage the vaginal cancer has reached, the treating doctors are following different therapy approaches.
Possible are both
- the surgical removal of the tumor as well
- a irradiation.
However, these procedures are closing not but they can also be combined. For example, in some cases it may be useful to first remove the vaginal carcinoma and then to irradiate the vagina afterwards.
In contrast to others cancers as leukemia (Blood cancer) or breast cancer plays the chemotherapy no significant role in the treatment of vaginal carcinoma.
The scope the procedure depends on the procedure size of the tumor: at small tumors at an early stage, the physician completely removes the tissue and can receive the vagina. At broad vagina cancer it may be necessary to remove the vagina completely.
In individual cases the surgeon must also have a part of the bladder and/or the intestine and remove regional lymph nodes.
Goal of radiotherapy is to kill the malignantly altered cells. Depending on that at the stage where the cancer of the vagina is located, the treating physicians can communicate with them two different methods to the affected area:
- In the so-called afterloading radiant material is introduced directly into the vagina (irradiation from inside).
- When irradiated by the skin (percutaneous irradiation), special accelerators direct the rays from the outside to the diseased body region.
Malignant tumors the vagina like the vaginal cancer (vaginal carcinoma) may progress to too complications to lead. You can, for example, grow into the neighboring organs. Affected are then for example:
- external genitals (vulva)
In addition, sheath cancer spreads over the preferred lymphatics and forms daughter tumors (metastases) in the lymph nodes of the pelvis. Less common are such settlements in other organs
- the Liver,
- the lung or
- the bone to find.
When the vaginal cancer is in the pool he can substitute other organs. For example, the vaginal carcinoma presses the ureter from, the urine can poorly - in the worst case, not more – drain. The urine builds up to the kidney back, which in turn is severe kidney damage can cause.
In case of vaginal cancer, the hang forecast depending on how much the tumor has already spread at the beginning of the treatment. Will the vaginal carcinoma recognized early, before it has grown into adjacent organs or has spread to lymph nodes, very often complete healing is possible.
However, as vaginal cancer does not show any clear early symptoms, the disease is usually only discovered when it is already advanced. In addition, vaginal carcinomas tend to form recurrences, so reappear. Therefore, when looking at all vagina cancer patients, the overall outcome is a relatively poor prognosis.
To diagnose a possible vagina cancer as early as possible, you should regularly to the gynecological screening tests take part. You should also join complaints that may indicate a vaginal carcinoma or other disease of the genital organs should be examined as soon as possible by your gynecologist.
After successful treatment of a malignant tumor of the vagina are regular follow-up examinations necessary. These take place every three months for the first three years and twice a year for the following two years and then every year thereafter.
At the follow-up examination questioned the doctor first examines the patient in detail for any complaints or other abnormalities. Subsequently, a gynecological examination follows. The doctor scans the vagina and examines them with the help of a colonoscope and per Ultrasonic. In addition, he removes cells from the vagina with a smear. He then has them examined in a laboratory to see if the cells are healthy or malignantly altered.
If suspicious symptoms appear, affected women should not hesitate, but of course also go between the specified follow-up appointments to the doctor.
So far, no measures are known that can effectively prevent the development of vaginal cancer (vaginal carcinoma). In case of complaints women should not hesitate, but to see a gynecologist immediately. This is especially important as the prognosis the sooner a vagina cancer is detected, the better.
For that reason, women should too regularly to the gynecological screening tests take part. For women over the age of 30, the special examination of the vagina recommended in the context of this early detection.
Infection with human papillomavirus (HPV) is a risk factor fürKrebserkrankungen the female genitalia. For several years, vaccines have been against them virus to disposal. Such HPV vaccination is recommended for girls aged 9 to 14 years - notably, to reduce the risk of cervical cancer to lower. However, preventing HPV infection eliminates a risk factor for vaginal cancer.