To determine the most appropriate treatment, your doctor will base on the location of the tumor in your vagina and its stage. Overall, vaginal cancer treatment typically involves surgery, radiation therapy and sometimes chemotherapy.
There are several types of surgery that your surgeon can perform. Surgery performed depends on your age, your health in general, the location and stage of the cancer. In general, surgeries that can be performed in vaginal cancer treatment include:
- Laser Surgery – this surgical intervention is reserved for cancers limited to the surface of the vagina. During the procedure, your surgeon will use a narrow beam of light to destroy the cancer cells in the vagina.
- Wide local excision (WLE) – WLE is a surgical procedure performed to remove the tumor and surrounding healthy tissue. In most cases, after the surgery, the surgeon takes pieces of skin or flaps of muscle from other areas of your body to repair your vagina.
- Vaginectomy – this is a surgical removal of part or the entire vagina. In general, vaginectomy is performed in cases of invasive vaginal cancer. During the surgical intervention, your surgeon can also remove the lymph nodes (lymphadenectomy) nearby. In certain cases, the vaginectomy may be accompanied by a hysterectomy, removal of the uterus, ovaries and fallopian tubes. Vaginectomy is often followed by brachytherapy and chemotherapy.
- Pelvic exenteration (or pelvic evisceration) – other surgical intervention above may not be suitable for recurrent vaginal cancer or cancer that has spread throughout your pelvic area. In this case, your surgeon will perform a pelvic exenteration to remove your lower colon, bladder, ovaries, uterus, vagina, and rectum. After which, your surgeon will make a urostomy to allow urination, and colostomy to allow feces leave your body.
Radiation Therapy (Radiotherapy)
If you have a stage II, III or IV vaginal cancer, the surgery must be followed by radiation therapy to destroy locally the remaining cancerous cells and reduce the risk of recurrence or metastasis. In rare cases, however, radiotherapy can be administered before surgery in order to reduce the size of the tumor to facilitate its excision.
- External beam radiation therapy – this method involves projecting high-dose of X-rays to the tumor to eliminate or shrink it. External radiation therapy is usually administered on an outpatient basis, five days a week for several weeks.
- Internal Radiotherapy – during this procedure, small tube containing radioactive material are inserted into your vagina for several hours to several days. Unlike external radiation therapy, internal radiation therapy requires hospital stay.
Chemotherapy can be included in the treatment. In general, you will be given powerful chemicals to stop or slow reproduction of cancer cells. You will be recommended chemotherapy if you have a very aggressive vaginal cancer: a cancer that spreads very quickly, or has spread beyond the vagina. In the treatment of vaginal cancer, chemotherapy drugs are usually taken intravenously.
However, the chemotherapy drugs attack both the cancer cells and healthy cells, which often cause side effects. Side effects vary from one person to another, from one drug to another. Most common side effects of chemotherapy include:
- low blood cells count
- stomach pain
- loss of appetite
- temporary hair loss
- increased vulnerability to infections