Treatment options for Vaginal Cancer

There are many treatment options for vaginal cancer. Treatment for any cancer aims to cure the disease, but if this is not possible, the focus shifts to preventing the tumour from growing or spreading thereby, increasing life expectancy and maintaining a good quality of life.

Treatment options for vaginal cancer include:

• Surgery.
• Chemotherapy.
• Radiation therapy.

Treatment is influenced by many factors such as:

• Stage of the cancer.
• Location, size and shape of the tumour.
• Whether the tumour cells are squamous cell or adenocarcinoma.
• If you had a past radiation treatment done to the pelvis.
• Your age and general health.
• Your preferences (such as your goals of treatment and the side effects you're willing to endure).

Most cases of vaginal cancer are treated by surgery and radiation.

Radiation therapy: Radiation therapy (also called radiotherapy) uses high-powered energy beams (x-rays or other types of radiation) to destroy cancer cells and shrink tumours. Radiation therapy is directed at the cancer cells. Radiotherapy, however, damages normal cells of the body and can cause several side effects such as fatigue, nausea and vomiting and erythema of skin. Your doctor will recommend a treatment based on the severity of the symptoms. The two types of radiation therapy used for treatment of vaginal cancer include:

• External beam radiation: in this process, radiation is given by a machine placed outside your body. The machine directs the beam of radiation to specific points on your body (radiation at your pelvis or abdomen or wherever the cancer has spread). Most women with vaginal cancer are treated with external beam radiation.
• Internal radiation (brachytherapy): In this technique, a radiation-filled device such as small seeds, wires or a cylinder is placed inside the vagina or the surrounding tissue for a short period of time. The device is removed after a pre-specified number of days. In the early-stage of vaginal cancer, only internal radiation may be given. Some women may be given internal radiation after external radiotherapy.

Chemotherapy: Chemotherapy is a mode of cancer treatment, which uses certain drugs to destroy or kill cancer cells. As the effectiveness of chemotherapy in women with vaginal cancer is not established, it is generally not used on its own to treat vaginal cancer. It is usually given along with radiation therapy (as chemotherapy can enhance the effectiveness of radiation).

Surgery: Surgery aims to remove (if possible) all the cancer. It is most often used for the treatment of early stage vaginal cancer i.e. when the cancer is limited to the vagina or is near the tissue.  As the pelvis has many important organs, surgery for larger tumours may necessitate the removal of these organs. In these cases, other treatment methods may be used to control the cancer before attempting a surgery. Different surgeries done in women with vaginal cancer include:

• Removal of the tumour or lesion if the tumor is small.
• Removal of a part of the vagina (partial vaginectomy) or the entire vagina (radical vaginectomy).
• Removal of a majority of the pelvic organs (pelvic exenteration).

Surgery that is done depends on the stage and extent of tumour. Your doctor will decide the type of surgery that is needed after repeated discussions with you and examination (including tests). In case the vagina is completely removed, your doctor may do a surgery to construct a new vagina.