Vaginal Cancer Treatments
The best treatment of vaginal cancer requires a multidisciplinary team approach. Aurora cancer patients benefit from multidisciplinary case reviews, which can include specialists from various disciplines.
- Cancer Nurse Navigator: a registered nurse with special training who can help answer questions and provide information on resources and support services.
- Gynecologic oncologist: an obstetrician/gynecologist with additional fellowship training in the study and treatment of cancers of the reproductive system.
- Pathologist: a physician who examines tissues and cells under a microscope to determine if they are normal or abnormal.
- Radiation oncologist: a physician specializing in treating cancer with radiation therapy.
- Radiologist: a physician who uses X-rays and other imaging tests to diagnose disease.
Vaginal cancer treatment plans are customized for each patient by our team of experts and may include cancer surgery, radiation therapy and/or chemotherapy.
Your diagnosis, cancer staging, general health and child-bearing preferences may play a role in deciding the appropriate treatments. Most vaginal cancers begin with cell mutations called vaginal intraepithelial neoplasia (VAIN). Sometimes the neoplasia can be removed or destroyed before they become cancerous.
A very thin strip of tissue may be removed with laser therapy (a narrow beam of energy to cut or destroy cells) or a loop electrosurgical excision procedure (LEEP). LEEP utilizes a thin heated loop and electrical current. Topical chemotherapy or other procedures may also be used to treat neoplasia.
Surgery is a common treatment for some neoplasia and invasive cancers. The type and extent of surgery depends on the type and stage of the cancer. For more advanced or invasive cancers, reproductive organs or lymph nodes may be removed.
Some surgeries are performed through one long open incision in your abdomen; or through a small incision in the top of the vagina; or laparoscopically through a series of small incisions in your abdomen.
- Laser surgery: focused beam of energy is used like a scalpel to remove cancerous tissue. It's used for early cancers on the surface lining of the vagina.
- Excision: wide local excision uses a scalpel to remove the cancer and a "margin" of healthy tissue around it. Skin grafting or reconstructive surgery may then be performed.
- Vaginectomy: part or all of the vagina is surgically removed. Then skin grafting or reconstructive surgery may be performed.
- Vaginal hysterectomy: a vaginal hysterectomy (surgical removal of the uterus) requires a small incision at the top of your vagina to remove the uterus and sometimes other reproductive organs.
- Radical hysterectomy: a radical hysterectomy removes your uterus, cervix, fallopian tubes, ovaries and tissue around the uterus such as lymph nodes.
- Lymphadenectomy: lymph nodes in the groin or pelvis are removed and examined to see if the cancer has spread.
- Pelvic exenteration: very rarely, more extensive surgery may be necessary. This may include removing some or all of your reproductive organs as well as other organs such as the rectum, bladder or part of the colon. Additional surgery may be performed to provide substitutes for organs that are removed.
- Robotic surgery: this minimally invasive procedure is similar to a laparoscopy but uses the precision of robotics coupled with magnified views and the surgeon's skills to perform a hysterectomy (removal of the uterus).
Surgery may be followed by chemotherapy and/or radiation therapy to kill additional cancer cells. In some cases, chemotherapy or radiation is used to shrink the tumor before surgery.
External beam radiation uses a special machine outside the body to send beams of high-energy X-rays through the skin to target and kill cancer cells. Sometimes it is combined with low-dose chemotherapy. A course of external beam radiation treatment may be done five days per week for several weeks. Side effects may include nausea, diarrhea, cramping, loss of appetite, skin irritation and fatigue.
Another radiation treatment, Brachytherapy, places small amounts of radioactive material inside your body. Intracavitary radiation inserts a container containing a radioactive substance into the vaginal cavity. Interstitial radiation temporarily implants radioactive material into and around the tumor site.
In general, Brachytherapy is more targeted, affecting less healthy tissue than external beam radiation. It may use a higher radiation dosage so fewer treatments may be required. Side effects may include fatigue, vaginal irritation, abdominal cramping and diarrhea.
Clinical trials offer additional treatment options for some patients. Some promising new treatments may be available only in a research setting. Aurora offers access to these clinical trials of therapies that might not be widely available elsewhere.
Aurora offers other treatments and palliative care to maintain your quality of life during and after cervical cancer treatments. Reducing disease symptoms, managing treatment side effects, maximizing comfort and taking advantage of complementary therapies are part of the mission of the Cancer Counseling Center.