When a woman experiences any signs of vaginal cancer, she should immediately report them to her physician.  The doctor will perform a thorough examination of her cervix and vagina with the help of a device called colposcopy. If the colposcopy reveals any abnormality in the region, the doctor will recommend a biopsy. Biopsy is a procedure, in which tissues are taken out from the suspected cancer site and tested under the microscope to find out whether it contains cancer cells. If cancer cells are detected in the vagina, the doctor will perform a detailed pelvic exam to find out how much the cancer has spread. The patient might also need to undergo one or more of the following diagnostic procedures.

MRI: This test helps creating extremely detailed images of the tumors.

CT scan: A patient is asked to undergo CT scans when the doctor needs to have a look at 2-dimensinal images of organs of your body. In case of vaginal cancer, CT scan helps in determining whether or not the cancer has spread beyond the vagina.

PET: This is a scanning procedure that helps in identifying the body parts having altered supply of blood. Presence of tumors may lead to altered supply of blood; thus PET helps in locating the site of tumors.

Proctoscopy or cystoscopy: During this procedure, the doctor looks into the surrounding organs of the vagina for instance the rectum and bladder using a device called cystoscope for checking whether the cancer has invaded those organs.

Here are various risk factors that could augment a female’s risk of getting cancer of the vagina:

• Squamous cell cancer commonly arises in females amid fifty & seventy years of age; around fifty percent of females having cancer of the vagina are in their sixties.
• Studies suggest that being infected with human papillomavirus virus (HPV) is a risk factor for developing cancer of the vagina. The common transmission is between individuals who engage in sexual intercourse. Several forms of HPV exist & several of them having more stronger links to particular cancer forms. Numerous kinds of cancer arising due to HPV are linked to pre-malignant conditions developing prior to the cancer.
• Women who smoke augment their risk for vaginal cancer.
• Females with mothers who used diethylstilbestrol or DES during their gestational period amid later part of forties & early part of the seventies have an augmented risk for RCC (or clear cell carcinoma). The avg. age of being diagnosed is nineteen years of age. Since majority of the females of moms that were DES takers are at present anywhere amid forty to seventy years of age, the numbers of cases has dipped. But, the long-standing risks for being exposed to DES are still unknown.
• Females that had cancer of the cervix or cervical pre-malignant conditions have an augmented risk for cancer of the vagina.
• Females that have been through radiotherapy done on the vagina have an augmented risk for vaginal cancer.
• Those who have been through hysterectomies (excision of partial or total area of the uterine area) have an augmented risk for cancer of vagina.
• Long-standing irritations to the vagina by the use of pessaries (devices utilized for keeping a flaccid uterine region in position) could augment a female’s risk for the cancer.

• Squamous Cell Cancer: The most prevalent form generally affecting women in the age bracket of 50-70years and detected in the upper section of the vagina.
• Adenocarcinoma: The second widespread form normally affecting women in the ages of 12-30 years, though it could seldom occur among women from all ages.
• Malignant Melanomas Sarcomas: The exceptionally rare types of the cancer.

It is vital to comprehend that despite having undergone a hysterectomy in the past, vaginal cancer could still occur among such women.

Risk Factors :

As is the case with several cancerous forms, the precise reason leading to vaginal cancer is still unsure. But, certain factors might raise the woman’s likelihood of developing the disease. These include:

• Those women who smoked.
• Squamous cell vaginal cancer is mostly observed in elderly women past fifty years of age.
• Those women who have earlier developed cervical cancer.
• Women that had previously undergone hysterectomy.
• Women that have had a history of human papilloma virus or HPV- induced genital warts.
• Women that had earlier undergone radiation therapy in the pelvic region.
• Additionally, research has revealed that those women in the young-age bracket whose mothers had taken the drug called as DES or diethylstilbestrol are at an increased risk of getting vaginal cancer. During the years 1945-1970, DES used to be issued to women during their pregnancy for averting miscarriages.

Vaginal Cancer Symptoms:

In few cases, vaginal cancer could be asymptomatic and is diagnosed through an abnormally occurring outcome of the Pap smear test. But, the widely prevalent signs of the cancer comprise of:

• Vaginal Blood loss or discharge that is unrelated to the monthly menstrual cycles.
• Having difficulty or pain while urinating.
• Pain and discomfort experienced at the time of intercourse or in the pelvic region.

Diagnosis & Tests:

In case one is sensing any signs of vaginal cancer or other vaginal problems, then it is imperative to seek prompt medical assistance for gaining a specific diagnosis. The doctor would delve in detail about the varied symptoms appearing alongside reassessing the medical history and carrying out a detailed physical examination. For ascertaining the reasons behind the symptoms, the below stated tests could be conducted:

• Pelvic Examination
  During this exam, the uterus, vagina, ovaries, fallopian tubes, urinary bladder and rectum are palpated to detect any irregularity in their form or size.
• Pap smear Test
  The Pap smear test would be conducted during the course of the pelvic examination. During the Pap smear test, a small section of tissue sample is picked up from the cervical and vaginal area with the assistance of a small-sized spatula and brush, to be sent for microscopic analysis for any kind of anomalies. There might be a certain level of pressure experienced during the test, but is generally painless.
• Coloscopy
  In case anomalous cells are detected during the Pap smear test, the doctor would suggest undergoing a coloscopy wherein employing a small-sized microscope known as a colposcope, the vagina is carefully examined in further detail. A near-fifteen minutes, outpatient procedure generally does not cause pain, but could get slightly uncomfortable.
• Biopsy
  In case any anomalous cells are detected during the Pap smear, the doctor would suggest undergoing a biopsy procedure wherein a tiny tissue sample is taken from the vagina to be microscopically analysed for any malignant cells.
• CT or Computed tomography Scan
  During the imaging test, a sequence of comprehensive images of the interiors of the body are taken with the help of a computer connected to an X-ray device. An intravenous injection of a specialised dye is administered or is ingested for assisting in enhanced viewing of the organs or tissues.
• MRI or Magnetic Resonance Imaging
  A pain-free, non-invasive method employing strong magnets and radio signals for building images of the body. The projection of the slices or imaging planes could be saved on a computer or made into film prints. MRI could be conducted with ease through clothes and bones.

Vaginal Cancer Treatment:

Vaginal cancer treatment usually comprises of surgical intervention, radiation therapy and probably chemotherapy. Along with surgical intervention, the patient might require skin grafting and plastic surgery for creating a synthetic vagina. Few patients might require a combination of treatments comprising of more than one type.

The team of cancer experts and plastic surgeons would work in unison to chart out the most effectual course of treatment for the particular condition.

Surgery

All vaginal cancer stages are treated with the widely accepted surgical procedure wherein the cancer is removed employing the below stated methods:

• Laser Surgery
  A narrow shaft of light is employed for killing the cancer cells that are still in the preliminary stages, being restricted to the place where it originated also called as the in situ cancer stage.
• Wide Local Excision
  A form of surgery wherein the cancer and a small section of the adjacent tissue are removed. A section of the skin from another area of the body would be grafted for repairing the vagina, following the removal of the malignant cells.
• Vaginectomy
  In few cases, the removal of the vagina might be suggested. When the cancer has metastasized or spread beyond the vagina, then vaginectomy might be coalesced with surgery for the removal of the uterus, ovaries and fallopian tubes. This procedure is known as radical hysterectomy. During the course of these surgeries, the excision of the lymph nodes present in the pelvis is also done.
• Exenteration
  In case the cancer has metastasized beyond the parameters of the vagina and the other organs, then on the basis of the extent of spread, a decision could be taken for removal of the lower colon, rectum or bladder along with the cervix, uterus and vagina.

Radiation Therapy

Radiation Therapy utilizes X-rays or other forms of high power energy beams emanating from a machine located outside the body for obliterating cancer cells and shrinking tumors. This form of radiation is known as external beam radiation therapy. In another kind of radiation therapy known as internal radiation, fine plastic tubes function as placing agents for radiation-producing radioisotopes into the malignant area. Radiation could be employed by itself or be combined with chemotherapy or following surgery.

Chemotherapy

Chemotherapy involves the orally consumed pill version or the intravenous administration of cancer-combatant drugs that move through the body and could annihilate cancer cells outside the vagina. Chemotherapy is hence known as systemic therapy and could be used in combination with radiation treatment or by itself.