Vaginal Cancer: Difference between revisions
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The vagina is an elastic fibromuscular canal connecting the cervix with the vulva. It acts as a birth canal, an outlet for the menstrual blood flow, and a cavity for sexual intercourse. | The vagina is an elastic fibromuscular canal connecting the cervix with the vulva. It acts as a birth canal, an outlet for the menstrual blood flow, and a cavity for sexual intercourse. | ||
== Epidimology == | |||
Primary vaginal cancer is more common in postmenopausal and elderly women about 50% of patients diagnosed with vaginal cancer are above seventy, and about 20% above eighty. In USA about 2890 are diagnosed with primary vaginal carcinoma every year<ref>Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians. 2016 Jan;66(1):7-30.</ref>. | |||
== Etiology == | == Etiology == | ||
Vaginal cancer like [[Cervical Cancer|cervical cancer]] is strongly associated with HPV infection, it may be caused by any skin-to-skin contact of the genital area, and vaginal, anal, or oral sex. In countries with a high prevalence of HPV, there is a high risk for [[Human Immunodeficiency Virus (HIV)|HIV]] infection and there are reported cases of primary vaginal cancer in young women<ref name=":0" />. | Vaginal cancer like [[Cervical Cancer|cervical cancer]] is strongly associated with HPV infection, it may be caused by any skin-to-skin contact of the genital area, and vaginal, anal, or oral sex. In countries with a high prevalence of HPV, there is a high risk for [[Human Immunodeficiency Virus (HIV)|HIV]] infection and there are reported cases of primary vaginal cancer in young women<ref name=":0" />. | ||
Co-factors such as smoking, immunosuppression, and high-grade squamous intraepithelial lesion HSIL are considered risk factors for vaginal cancer. | Co-factors such as smoking, immunosuppression, multiple sexual partners, history with a previous cervicla cancer or intraepithelial neoplasia<ref>Strander B, Hällgren J, Sparén P. Effect of ageing on cervical or vaginal cancer in Swedish women previously treated for cervical intraepithelial neoplasia grade 3: population based cohort study of long term incidence and mortality. Bmj. 2014 Jan 14;348.</ref>, and high-grade squamous intraepithelial lesion HSIL are considered risk factors for vaginal cancer. | ||
== Symptoms == | == Symptoms == | ||
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== FIGO Staging of Primary Vaginal Cancer == | == FIGO Staging of Primary Vaginal Cancer == | ||
Internaltional federation of gynacelogy and obstertrics FIGO classified the vaginal cancer according to the size of the tumor if it is in situ or reached any nearby sites in the pelvis '''T''', the spread of the tumor to nearby lymph nodes '''N''', and spread to distant sites '''M''' (organs or lymph nodes)<ref>Gardner CS, Sunil J, Klopp AH, Devine CE, Sagebiel T, Viswanathan C, Bhosale PR. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651370/#b2 Primary vaginal cancer: role of MRI in diagnosis, staging and treatment.] The British journal of radiology. 2015 Aug;88(1052):20150033.</ref>. | |||
{| class="wikitable" | |||
! colspan="1" rowspan="1" |Stage | |||
! colspan="1" rowspan="1" |Description | |||
|- | |||
| colspan="1" rowspan="1" |Stage 0 | |||
| colspan="1" rowspan="1" |Carcinoma in situ, intraepithelial carcinomaa | |||
|- | |||
| colspan="1" rowspan="1" |Stage I | |||
| colspan="1" rowspan="1" |Confined to the vagina | |||
|- | |||
| colspan="1" rowspan="1" |Stage II | |||
| colspan="1" rowspan="1" |Involvement of paravaginal tissue but not pelvic sidewall | |||
|- | |||
| colspan="1" rowspan="1" |Stage III | |||
| colspan="1" rowspan="1" |Extension to pelvic sidewall | |||
|- | |||
| colspan="1" rowspan="1" |Stage IV | |||
| colspan="1" rowspan="1" |Extension beyond true pelvis or bladder and/or rectal involvement | |||
|- | |||
| colspan="1" rowspan="1" | IVa | |||
| colspan="1" rowspan="1" |Extension beyond pelvis, bladder or rectal invasion | |||
|- | |||
| colspan="1" rowspan="1" | IVb | |||
| colspan="1" rowspan="1" |Distant organ metastases | |||
|} | |||
== Management == | == Management == | ||
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Introduction[edit | edit source]
Vaginal cancer is a rare primary vaginal cancer and does not include those with a history of vulvar or cervix cancer in the last 5 years, the most vaginal tumors are metastatic from other primary sites like cervical or vulvar cancer. It is more common in postmenopausal and elderly women than women under 40 years. It grows very slowly and the prognosis depends on the size, spread, and the patient's general health. Primary vaginal cancer represents about 1-2% of all female genital tract malignancies[1]and 10% of all vaginal malignant neoplasms[2]. Cervical screening helps to identify the abnormality and find the treatment early.
Anatomy Background[edit | edit source]
The internal female reproductive system consists of ovaries, fallopian tubes, uterus, and vagina.
The vagina is an elastic fibromuscular canal connecting the cervix with the vulva. It acts as a birth canal, an outlet for the menstrual blood flow, and a cavity for sexual intercourse.
Epidimology[edit | edit source]
Primary vaginal cancer is more common in postmenopausal and elderly women about 50% of patients diagnosed with vaginal cancer are above seventy, and about 20% above eighty. In USA about 2890 are diagnosed with primary vaginal carcinoma every year[3].
Etiology[edit | edit source]
Vaginal cancer like cervical cancer is strongly associated with HPV infection, it may be caused by any skin-to-skin contact of the genital area, and vaginal, anal, or oral sex. In countries with a high prevalence of HPV, there is a high risk for HIV infection and there are reported cases of primary vaginal cancer in young women[1].
Co-factors such as smoking, immunosuppression, multiple sexual partners, history with a previous cervicla cancer or intraepithelial neoplasia[4], and high-grade squamous intraepithelial lesion HSIL are considered risk factors for vaginal cancer.
Symptoms[edit | edit source]
A woman with vaginal cancer may complain of the following symptoms but it does not necessarily mean it is vaginal cancer, it can also be caused by many different conditions/ impairments.
- Lump in the vagina and can be felt.
- Pain during sex or abnormal vaginal bleeding after sex.
- Abnormal vaginal discharge.
- Bleeding between periods.
- Itching sensation in the vagina that does not go away.
- Ulcer and skin changes.
FIGO Staging of Primary Vaginal Cancer[edit | edit source]
Internaltional federation of gynacelogy and obstertrics FIGO classified the vaginal cancer according to the size of the tumor if it is in situ or reached any nearby sites in the pelvis T, the spread of the tumor to nearby lymph nodes N, and spread to distant sites M (organs or lymph nodes)[5].
| Stage | Description |
|---|---|
| Stage 0 | Carcinoma in situ, intraepithelial carcinomaa |
| Stage I | Confined to the vagina |
| Stage II | Involvement of paravaginal tissue but not pelvic sidewall |
| Stage III | Extension to pelvic sidewall |
| Stage IV | Extension beyond true pelvis or bladder and/or rectal involvement |
| IVa | Extension beyond pelvis, bladder or rectal invasion |
| IVb | Distant organ metastases |
Management[edit | edit source]
Resources[edit | edit source]
NHS.
References[edit | edit source]
- ↑ 1.0 1.1 Adams TS, Rogers LJ, Cuello MA. Cancer of the vagina: 2021 update. International Journal of Gynecology & Obstetrics. 2021 Oct;155:19-27.
- ↑ Adhikari P, Vietje P, Mount S. Premalignant and malignant lesions of the vagina. Diagnostic Histopathology. 2017 Jan 1;23(1):28-34.
- ↑ Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians. 2016 Jan;66(1):7-30.
- ↑ Strander B, Hällgren J, Sparén P. Effect of ageing on cervical or vaginal cancer in Swedish women previously treated for cervical intraepithelial neoplasia grade 3: population based cohort study of long term incidence and mortality. Bmj. 2014 Jan 14;348.
- ↑ Gardner CS, Sunil J, Klopp AH, Devine CE, Sagebiel T, Viswanathan C, Bhosale PR. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment. The British journal of radiology. 2015 Aug;88(1052):20150033.
