Vaginal carcinoma, vulvar carcinoma
English: vaginal carcinoma
The vaginal cancer (Vaginal carcinoma Vaginal carcinoma) is a very rare malignant change in the vaginal epithelium. Due to the rarity and the difficulty of detecting vaginal carcinoma early, the chances of a cure are rather poor.
All information given here is only of a general nature, tumor therapy always belongs in the hands of an experienced oncologist (tumor specialist)!
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In the early stages, vaginal cancer often causes no symptoms and therefore remains undetected for a long time. Typical signs of vaginal cancer may include bleeding outside of your period, unusual discharge, unpleasant smell, pain when urinating or during intercourse. Women who are affected by one or more of these symptoms must urgently consult a gynecologist and clarify the symptoms with him.
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Primary vaginal carcinomas are very rare. The frequency will be on 0.5 out of 100,000 women estimated. Squamous cell carcinomas (starting from the epithelium of the skin / mucous membrane) most common in older women. You come in 90% of the cases in front. Followed by light cell adenocarcinoma (arising from glandular tissue). Even rarer than these are Sarcomas (starting from the connective tissue) or Melanoma (Pigment cell tumor) of the vagina. About half of these carcinomas are located in the upper third of the vagina, the other half on the back wall of the vagina.
Much more often the vagina is considered to be the place of the Secondary spread of a tumor. Often the tumors spread uterus, of the Ovaries, of Rectum or the bladder on the vagina and lead to there Metastasis.
The Squamous cell carcinoma (Vaginal cancer) can originate in any cell in the vagina. Most often, however, it develops in the posterior vaginal vault.
In the past, mothers were used to avoid one Premature birth treated with diethylstilbestrol. 1% of girls born fell ill with one in childhood light cell adenocarcinoma of the vagina. The vast majority of cases were observed in the United States. None of these incidents are known in Germany. This shows that high-dose estrogen treatment can be carcinogenic in the embryonic period.
Another Risk factor for vaginal cancer are the Human papillomavirus (HPV) from Type 16 and 18. They lead to wart-like changes in the mucous membrane and can degenerate.
The vaginal cancer grows very quickly into the surrounding connective tissue. So it picks up aggressively Bladder, rectum and uterus (where appropriate Polyps may have occurred as a preliminary stage). over. Due to the pronounced supply of lymph nodes in the vagina, metastases rapidly spread to the vagina Lymph nodes and thus to spread to other organs.
The stages of vaginal cancer (vaginal cancer) are after FIGO or the TNM classification divided. A distinction is made between how many organs are affected or whether the carcinoma is only limited to the vagina. On the other hand, the Lymph node involvement specified and Metastasis in more distant organs. FIGO distinguishes 6 stages. The division is based on the spread of the carcinoma into the surrounding area. Stage 1 means thereby "Carcinoma in situ" (so-called surface carcinoma). Stage 6 means a spread to distant organs.
Depending on the stage, they are Chances of recovery are very poor. Therapy becomes more difficult and futile when the tumor has spread to the lymph nodes and has already affected other organs.
The great danger of vaginal cancer (Vaginal cancer) lies in the lack of symptoms. Patients often do not notice changes in discharge or bleeding (menstrual bleeding) until the surface has ulcerated. Then, especially after sexual intercourse, bloody, watery or foul-smelling discharge can become noticeable. If the vaginal cancer is even more advanced, fistulas can form between the vagina and the bladder or rectum. If the tumor has spread to the surrounding tissue, abdominal pain or functional organ disorders can occur.
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$config[ads_text3] not foundRead more about this under Pain in the labia / clitoris
Vaginal cancer does not cause pain at the beginning and pain in the lower abdomen occurs only in advanced stages. The pain becomes worse when you urinate or during intercourse and may be accompanied by bleeding or discharge.
Read more about this under: Pain in the abdomen and Painful urination in woman
Vaginal cancer results in watery, brownish discharge from the vagina that can smell foul. The tumor in the vaginal wall can form small bleeding ulcers. These open areas can then be colonized by bacteria and secrete secretions through the infection. Unusual discharge is a warning sign of vaginal cancer and should be checked with a doctor immediately.
Bleeding outside of your normal period can be a sign of vaginal cancer. The bleeding is reddish-brown and often occurs after intercourse. In vaginal cancer, a tumor grows in the wall of the vagina and invades the tissue. Cancer sores typically grow very quickly and are well supplied with blood because the tumor cells need a lot of oxygen and nutrients from the blood. Small injuries to the vaginal wall cause bloody ulcers and the characteristic bleeding from the vagina.
Depending on the extent of the vaginal cancer in the body, it is divided into four stages:
Stage 0: This is a very early stage when vaginal cancer has not yet spread. The tumor is still relatively small and has only affected the vagina.
Stage 1: At this stage, only the vaginal wall is affected by the tumor.
Stage 2: The tumor cells have spread to the tissues surrounding the vagina.
Stage 3: The tumor has spread to the pelvis and affected pelvic organs and lymph nodes located there.
Stage 4-A: Cancer affects the rectum or bladder.
Stage 4-B: The tumor cells have spread to other regions of the body and e.g. Metastases formed in the lungs.
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Vaginal cancer does not initially cause pain, which allows it to grow for a long time before it is finally noticed. In the early stages, the most common symptoms are reddish-brown intermenstrual bleeding and discharge.
In the early stages of cancer, there are changes in the lining of the vagina. The tumor cells grow in the uppermost layers of the vaginal wall, whereby the carcinoma is only a few cell layers thick and is referred to as surface carcinoma. The doctor calls this stage stage 0 or "carcinoma in situ". This means that the cancer is still at its place of origin and has not metastasized. In addition, in the early stages of vaginal cancer, the lymph nodes in the pelvic area are not yet affected. As the tumor progresses, it grows deeper into the tissue of the vagina and finally reaches the pelvic wall and affects other organs.
In the advanced stage, vaginal cancer forms daughter tumors (Metastases) and can penetrate other organs. Often the organs of the pelvic area, especially the urinary bladder and rectum, are affected first. The metastases later spread through the lymph nodes and bloodstream to the liver and lungs.
The doctor uses an ultrasound scan or computed tomography (CT) scan of the pelvis and abdomen and an X-ray of the chest to determine whether the vaginal cancer has already metastasized.
The Diagnosis of vaginal cancer is often an incidental finding during routine gynecological examinations.
The advanced carcinoma is accompanied by disintegration of the epithelial surface and bleeds when touched light. This makes it easier for the gynecologist to identify and localize.
With small cancers, however, there is a risk of being overlooked. A thorough examination using the Colposcope. Also should a cytological examination of the vaginal epithelium every year be performed. The Schiller iodine sample: By dabbing the vaginal epithelium with iodine the healthy, glycogen-containing epithelia stain brown-red.
If abnormalities occurred during these diagnostic procedures, further examinations are carried out. This usually includes a biopsy and Sonography to be able to assess the surrounding organs. To clarify whether Urinary tract or the rectum are infested, becomes one Rectoscopy (Rectoscopy) and a Urethrocystoscopy (Urinary tract mirroring) carried out. In exceptional cases, a Computed Tomography (CT) or one Magnetic resonance imaging (MRI) for specific diagnostics. This will open up the entire abdomen Metastases and Tumor formations examined.
A focal dysplasia, a Carcinoma in situ or very small vaginal cancer (vaginal cancer) can be treated by removing the affected area generously. In some cases, these cancers can be treated with a laser.
The invasive vaginal cancer however, requires individually planned therapy. In the case of limited carcinomas, radical surgery is carried out with removal of all organs that are at risk or affected. If the carcinoma has spread too far, the Radiotherapy in the first place. The problem is that due to the radiation too Urethra, bladder and rectum are also treated. This often leads to the formation of fistulas and is a major problem for the radiation treatment of vaginal cancer Radiation treatment are two options to disposal. On the one hand, radiation from the immediate vicinity of the tumor (Brachytherapy). This can either be applied directly from the inside or through the skin (percutaneous). Another possibility is irradiation from a distant radiation source (Teletherapy). The chemotherapy is usually only used at Metastasis and tumor formation applied in other organs.
Vaginal cancer is an extremely rare disease and the chances of recovery depend largely on the size and spread of the tumor. If the cancer is discovered at an early stage (stage 0 or 1) and surgically removed or treated with radiation therapy, treatment is successful. In general, vaginal cancer is easy to treat, although the chances of recovery decrease as the stage progresses. It is therefore important that the cancer is discovered at an early stage as part of a gynecological preventive examination.
Since the Vaginal cancer remains symptom-free for a long time, therapy is often started very late. At the time of therapy, the carcinoma has often already been in place Neighboring organs and the Lymph nodes scattered. The radiation therapy that comes into question is very difficult and is associated with many undesirable side effects. One still reckons with one today 5 year survival rate of 47%. The rare ones Sarcomas and Melanoma the vagina have a significantly worse prognosis.
However, if the treatment is carried out very early and successfully, healing is possible.
