What to Know About Your Treatment Options for Vaginal Cancer
Treatment for vaginal cancer depends on the results of lab tests and the extent of your cancer. The extent of cancer is called its stage. Your doctor may also consider your age and general health. If having children is an issue for you, your cancer care team may consider this, too.
It’s normal to want to learn all you can about vaginal cancer and your treatment choices. You probably have many questions and concerns. Your doctor is the best person to answer your questions about your treatment. Your doctor can answer questions about how successful it is expected to be, and what the risks and side effects are.
Treatment for vaginal cancer is either local or systemic. Local treatments remove, destroy, or control the cancer cells in one certain area. The goal of systemic treatments is to kill or control cancer cells through your whole body. Chemotherapy is a systemic treatment. These are the three main treatments used for vaginal cancer:
- surgery
- radiation
- chemotherapy
Types and Goals of Treatment for Vaginal Cancer
Each type of treatment for vaginal cancer has a different goal. You may have more than one type of treatment. If you do, treatments may be either combined or sequential. Your doctors will take your individual situation into consideration when making treatment recommendations. Here is a list of the main treatments and their goals.
- Surgery. Small cancers in the vagina that have not spread may be treated with surgery. There are two goals of surgery. The first is to remove the cancer from the vagina. The second is to biopsy the lymph nodes in the groin. The nodes in the groin are the places vaginal cancer generally spreads. So, performing a biopsy on these nodes helps your doctor see if the cancer is spreading. The spread of cancer is called metastasizing. You may need to have other organs or tissue removed during surgery. That will depend upon the extent of the cancer’s spread.
- Radiation therapy. Advanced cancer in the vagina is usually first treated with radiation and small amounts of chemotherapy given at the same time. The goal of this treatment is to kill cancer cells by using high-energy radiation. Your doctor may use low-dose chemotherapy with radiation to make your treatment more effective. You may have this treatment after surgery to kill any remaining cancer cells. However, doctors often use radiation alone to cure vaginal cancers, especially smaller ones.
- Chemotherapy. This is the use of drugs to kill cancer cells. The goal of chemotherapy is to shrink the cancer while also reducing the chance that the cancer will spread to other parts of the body. You may have chemotherapy alone or along with radiation to increase the effectiveness of the radiation therapy.
Research is ongoing in the field of vaginal cancer. New medicines and treatments are tested in clinical trials. Before starting treatment, ask your doctor if there are any clinical trials you should check on.
Advances in Treating Vaginal Cancer
Vaginal cancer is not studied as much as some other cancers. But researchers are making advances with new ways to prevent and treat it.
Advances in Prevention
Scientists are learning how certain genes control cell growth. They are also studying how changes in these genes cause normal vaginal cells to become cancer. These special genes are called oncogenes and tumor suppressor genes. The goal of this research is to develop therapies that target and replace damaged genes in cancer cells with normal genes. This may help stop the abnormal behavior of these cells. Researchers are also using these same genes to be able to predict how a woman with precancerous cells progresses to cancer. Knowing the profile of genes needed to progress can help predict. Then patients who will benefit can receive more aggressive therapies.
Researchers are also working on vaccines. The goal is to prevent and treat vaginal and cervical cancer. Some vaccines are intended to protect women who are exposed to the human papillomavirus (HPV). That way they can prevent cervical and vaginal cancers. Other vaccines are being tested on women with chronic HPV infections. These help women’s immune systems destroy the virus and cure the infection before a cancer develops. Still other vaccines are targeted for women who have cancer that has spread or recurs. The goal of these vaccines is to produce an immune reaction in the parts of the virus that contribute to the abnormal growth of cancer cells.
Advances in Treatment
As with other rare cancers, progress in treatment can be frustratingly slow.
Photodynamic Therapy as New Treatment
Researchers are using a special kind of light, called photodynamic therapy, to kill vaginal cancer cells. First, they inject a chemical into a vein. That chemical is absorbed by cancer cells. This makes the cells sensitive to certain types and colors of light. Then the cancer cells are exposed to a special light. This exposure kills many of them.
Radiation Therapy’s Long-Term Success
Researchers have been investigating the long-term success of radiation for vaginal cancer. They studied a group of women with various stages of vaginal cancer. They checked to see which of the women were cancer-free for at least 5 years. Here’s what they learned at the 5-year mark:
- 85% of women in the study with stage I vaginal tumors were cancer-free
- About 78% of women with stage II tumors were cancer-free
- 58% of women with stage III and IV tumors were cancer-free
This showed promising results for radiation treatment at any stage.
Treatment Outcomes
A recent study looked at treatment outcomes for 110 women with vaginal cancer. The women were treated over 14 years, from 1990 to 2004. Most—73%—had a hysterectomy. More than 1/3 of women had combination therapy with radiation plus chemotherapy.
Here’s what researchers reported about survival after 3 years:
- 100% for Stage I
- 70% for Stage II
- 51% for Stages III and IV
The researchers reported that women had a poorer chance of survival if they were age 60 or older, had more advanced disease, or used tobacco.
