Vaginal Cancer

Various types of radiation therapy may be used, including external-beam radiation, internal radiation or a combination. External-beam radiation involves carefully targeting a beam of radiation at the cancer from a machine outside of the body. In internal radiation therapy, called brachytherapy, radioactive materials are placed inside the vagina. While external-beam radiation can harm nearby healthy tissues, brachytherapy can cause greater local side effects and scarring of the vaginal tissue.

There are two other types of internal radiation therapy. Low-dose brachytherapy involves placing radioactive material inside a cylindrical container, which is placed in the vagina for one to two days. Interstitial therapy involves placing radioactive materials directly into the cancer through needles.

Surgery is the treatment of choice only for a small group of vaginal cancers because vaginal cancer tends to involve more extensive, radical surgery than other cancers and may not be any more effective than radiation therapy. One exception includes treating stage I adenocarcinomas, which may be treated with a combination of limited surgery of the tumor and surrounding tissue, removal of lymph nodes and radiation to help to preserve fertility. Preserving fertility is important because these cancers are more common in younger women. Another exception is treatment of stage II squamous cancers for women who cannot have radiation therapy, usually because they already have received radiation therapy for another cancer in the past. The extent of surgery depends on the cancer's stage and size. Types of surgery include:

• Laser surgery - Using a narrow beam of light to kill cancer (useful in stage 0 cancers)

• Loop electroexcision - Using low-voltage, high-frequency radio waves through a thin loop of wire as a cutting device to remove superficial (stage 0) cancers

• Radical vaginectomy - Removing the vagina and adjacent tissues

• Vaginectomy combined with radical hysterectomy - Removing the vagina, the uterus and adjacent tissues

• Lymphadenectomy - Removing of the lymph nodes in the groin or inside the pelvis

• Pelvic exenteration - Radical hysterectomy, vaginectomy and removal of the bladder, rectum and part of the colon.

If all or part of the vagina must be removed, the vagina can be reconstructed with tissue from another part of the body.