Signs, Symptoms and Complications of Vaginal Cancer

In the early stages of the disease, vaginal cancer maybe asymptomatic. Even when symptoms are present, it may be non-specific for vaginal cancer and common to a number of other conditions. As a result, the diagnosis is frequently missed or delayed. Often vaginal cancer is detected during a routine pelvic examination or pap smear. The average duration of symptoms may be 6 to 12 months before a diagnosis of vaginal cancer is made, but it can range from 0 to 11 years.

Vaginal Cancer Signs and Symptoms

Abnormal vaginal bleeding occurs in most cases and includes :

• Painless vaginal bleeding – the most common symptom.
• Postmenopausal bleeding is a common feature since most vaginal cancers (squamous cell carcinoma) occur in women over 60 years of age.
• Heavy menstrual periods.
• Bleeding during or following sexual intercourse (post-coital bleeding).
• Bleeding in between periods (intermenstrual bleeding).
• Vaginal bleeding may not be related to menstrual periods.

Abnormal vaginal discharge may occur less frequently. The discharge may be watery and odorless, or it may be blood tinged or accompanied by a foul odor. Pain in the pelvic region may be constant or only noticed during sexual intercourse. Patienst may become aware of a lump or mass in the vagina or it is only found during gynecological examinations.

Urinary symptoms such as bladder pain, painful urination (dysuria), frequent urge to urinate (urgency), and blood in the urine (hematuria). Urinary symptoms are likely to develop when the bladder is involved, either due to direct compression by the vaginal tumor or by infiltration of cancer cells. Involvement of the rectum may result in painful defecation and constipation.

Vaginal Cancer Complications

• Fistulas (abnormal connections) may form between the vagina and the rectum (recto-vaginal fistula) and between the vagina and the bladder (vesico-vaginal fistula) in advanced stages of the cancer.
• Metastasis is the spread of cancer to other parts of the body, such as the lungs, liver, and pelvic bones.
• Depression may follow upon diagnosis of vaginal cancer or even after treatment.
• Recurrence of vaginal cancer after treatment. The outlook following recurrence is quite grave.
• Complications of treatment :
  • Complications of surgery, apart from the usual complications that may be expected with any surgical procedure,  will depend upon the type of surgery. Intercourse may become difficult or impossible after vaginal surgery but vaginal reconstruction can help. There may be problems faced after hysterectomy, including signs of early menopause. Total pelvic exenteration may cause a host of complications and may necessitate the use of urostomy and colostomy bags for passage of urine and stool.
  • Complications of radiotherapy may include dysuria, vaginal discharge, fatigue, nausea, redness and irritation of the skin. Signs of early menopause in premenopausal women, such as hot flashes, decreased libido, mood changes, and vaginal dryness may develop.
  • Complications of chemotherapy, such as nausea, vomiting, fatigue, and hair loss.
  • The emotional impact of treatment, especially in younger patients who may have to undergo a hysterectomy or radiation therapy, may  be related to the fact that future pregnancy will not be possible. Removal of the vagina may have an equally devastating effect, if not greater, as sexual intercourse is affected.