Cancer of the vagina - Causes, symptoms and treatment. MF.
Among all oncogynecologic diseases, vaginal tumors occupy one of the last places in the frequency of occurrence in the population. Most often this is a squamous cell carcinoma of the vagina. It is necessary to distinguish strictly the cancer of the vagina, which is of a primary nature and that which appeared as a result of the transition from the cervix.
Causes of vaginal cancer
The cause of this pathology is still unclear. It is assumed that he, like cervical cancer, can be associated with human papillomavirus. It is often combined with cervical cancer.
The average age of patients with squamous cell carcinoma of the vagina is 60 years. According to the frequency of occurrence after squamous cell carcinoma, adenoma, carcinoma and various sarcomas of the vagina are also isolated, but their incidence is much lower.
Symptoms of vaginal cancer
The most common manifestation of vaginal cancer is bloody or other discharge from the genital tract. In later stages, urinary retention, frequent urination, hematuria may occur. When the posterior wall of the vagina is damaged, constipation, tenesmus, and blood excretion with feces are possible. Most often, the tumor is located in the upper third of the vagina, along its back wall.
Examination for suspected vaginal cancer
It is possible to suspect vaginal cancer when examining the vagina or when detecting tumor cells in cervical smears from the cervix. The main methods of diagnosis include:
• Bimanual examination and examination of the cervix in the mirrors, with inspection of the vagina
• Taking a smear for cytology. With a negative result, it is possible to perform a targeted biopsy.
• Colposcopy - you can identify lesions in the upper third of the vagina.
• Ultrasound - for diagnosis of lesions of lymph nodes and liver
• CT for the diagnosis of distant metastases
Vaginal cancer stages
Malignant vaginal infection is staged as follows:
• Stage 0 - In situ cancer
• Stage I - tumor is confined to the vaginal walls
•Stage II - extends to soft tissue, but does not pass to the pelvic wall
• Stage III - the tumor passes to the pelvic wall
• Stage IV - spreads beyond the pelvic area or sprouts the mucosa of the bladderor rectum. At the same time, a tumor is isolated - A - a bladder and a rectum;B - there are distant metastases.
The spread of vaginal cancer occurs with a transition directly to the soft tissues of a number of located organs( bladder, rectum), less often, in later stages, lymphogenically. Metastases to distant organs( lungs, liver) appear in the late stages of the disease.
Treatment of vaginal cancer
Treatment usually depends on the stage of the disease, the condition of the patient, and the laboratory-instrumental methods of examination.
Surgical treatment is not often used. In case of vaginal cancer of the 1st stage it is possible:
- expanded uterine extirpation( removal of the uterus with the neck, regional lymph nodes);
- in case this operation was already in the patient - removal of the upper third of the vagina.
In the absence of tumor cells at the edges of resection and metastases to the lymph nodes, further treatment is not indicated.
In advanced stages, surgery is possible - pelvic exenteration with pelvic and lumbar lymphadenectomy.
To date, radiotherapy is actively used. With small superficially located tumors, intracavitary radiotherapy is used. In other cases, first remote radiation therapy, followed by intracavitary and interstitial radiation therapy.
Prognosis for tumors of the vagina
Prognosis for tumors of the vagina during early diagnosis is relatively favorable. However, given the late detection and untimely initiation of treatment, the five-year survival rate currently does not exceed 43%.Since vaginal cancer is extremely rare, patients with this pathology should be referred to a specialized hospital as early as possible.
Doctor gynecologist Kupatadze D.D.