Cancer of the Vagina Diagnosis (Tests, Scans, Biopsy), Prevention

Diagnosis of Vaginal Cancer

The diagnosis of vaginal cancer is often missed or delayed because this type of malignancy is rare and is often asymptomatic in the early stages. The symptoms when present, are non-specific for vaginal cancer and many other more common gynecological conditions are first excluded. Vaginal cancer is more often diagnosed during routine pelvic examination and a pap smear. Therefore screening for vaginal cancer is advocated for women who are at high risk as discussed under causes of vaginal cancer.

Clinical History

Assessment of the symptoms is an important first step in arriving at a diagnosis Abnormal vaginal bleeding and discharge may often be the first symptoms of vaginal cancer but this does not mean that it will be evident from the early stages. Other factors to be taken into consideration is the history of past illnesses and related treatments, such as hysterectomy done for previous cancerous or pre-cancerous conditions. Risk factors should be noted and therefore long term screening is essential.

Physical Examination

A routine physical examination will determine the general health condition of the patient as well as any abnormal findings. This includes signs of a malignancy that are not isolated to the vagina or pelvic area, like unintentional weight loss.

A pelvic examination, including a speculum examination of the vagina, will look for any localized signs of disease. A pap smear is done during a pelvic examination and a rectal examination may also be considered due to close proximity and high chance of spread to the rectum.

Pap Test

To conduct a Pap smear or Pap test, cells from the surface of the cervix or vagina are scraped off and examined under a microscope. Abnormal cells may be cancerous or pre-cancerous and warrants further investigation like a biopsy.

Colposcopy

In this procedure, an instrument with a magnifying lens (colposcope) is passed through the vagina to view the vagina and cervix to look for any abnormal areas. Tissue samples for biopsy may be taken during a colposcopy.

Biopsy

If there is a suspicion of cancer following a pap test, a biopsy may be done during a colposcopy. Small bits of tissue are scraped out by means of a curette and examined under the microscope for any cancerous changes. A biopsy can rule out or confirm the diagnosis of vaginal cancer.

On confirmation of vaginal cancer, several other tests may be done to determine the stage of the disease. These may include :

• Chest x-ray
• Cystoscopy
• Ureteroscopy
• Proctoscopy
• CT scan
• MRI
• Lymphangiogram

Prevention of Vaginal Cancer

Vaginal cancer may not be entirely preventable, but certain steps can help to reduce the risk for developing it. This may include :

• Detecting and treating the disease in its pre-cancerous stage.
• Routine screening of women, especially those at risk of vaginal cancer, by yearly pelvic examination and Pap test.
• Avoiding known risk factors for any cancer like smoking.
• Avoiding infection with HPV, which is a sexually transmitted virus. Limiting the number of sexual partners and the use of condoms by the male partner may provide some protection and reduce the risk of infection by HPV. Vaccination against HPV can also help protect against infection.