[MOL] Re: Pink Res. 2 [00326] Medicine On Line


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[MOL] Re: Pink Res. 2






Welcome to your mol cancer forum, pls. know that we hope you will allow us to
walk with you through your cancer journey.  Should you need anything, just ask,
that is what what we are here for.  Your friend, Lillian

What is cancer of the vagina?

Cancer of the vagina, a rare kind of cancer in women, is a disease in which
cancer (malignant) cells
are found in the tissues of the vagina. The vagina is the passageway through
which fluid passes out of
the body during menstrual periods and through which a woman has babies. It is
also called the "birth
canal." The vagina connects the cervix (the opening of the womb or uterus) and
the vulva (the folds
of skin around the opening to the vagina).

There are two types of cancer of the vagina: squamous cell cancer (squamous
carcinoma) and
adenocarcinoma. Squamous carcinoma is usually found in women between the ages of
60 and 80.
Adenocarcinoma is more often found in women between the ages of 12 and 30.

Young women whose mothers took DES (diethylstilbestrol) are at risk for getting
tumors in their
vaginas. Some of them get a rare form of cancer called clear cell
adenocarcinoma. The drug DES
was given to pregnant women between 1945 and 1970 to keep them from losing their
babies
(miscarriage).

A doctor should be seen if there are any of the following: bleeding or discharge
not related to
menstrual periods, difficult or painful urination, and pain during intercourse
or in the pelvic area. Also,
there is still a chance of developing vaginal cancer in women who have had a
hysterectomy.

A doctor may use several tests to see if there is cancer. The doctor will
usually begin by giving the
patient an internal (pelvic) examination. The doctor will feel for lumps and
will then do a Pap smear.
Using a piece of cotton, a brush, or a small wooden stick, the doctor will
gently scrape the outside of
the cervix and vagina in order to pick up cells. Some pressure may be felt, but
usually with no pain.

If cells that are not normal are found, the doctor will need to cut a small
sample of tissue (called a
biopsy) out of the vagina and look at it under a microscope to see if there are
any cancer cells. The
doctor should look not only at the vagina, but also at the other organs in the
pelvis to see where the
cancer started and where it may have spread. The doctor may take an x-ray of the
chest to make
sure the cancer has not spread to the lungs.

The chance of recovery (prognosis) and choice of treatment depend on the stage
of the cancer
(whether it is just in the vagina or has spread to other places) and the
patient's general state of health.



STAGE EXPLANATION


Stages of cancer of the vagina

Once cancer of the vagina has been found (diagnosed), more tests will be done to
find out if the
cancer has spread from the vagina to other parts of the body (staging). A doctor
needs to know the
stage of the disease to plan treatment. The following stages are used for cancer
of the vagina:


Stage 0 or carcinoma in situ

Stage 0 cancer of the vagina is a very early cancer. The cancer is found inside
the vagina only and is
in only a few layers of cells.


Stage I

Cancer is found in the vagina, but has not spread outside of it.


Stage II

Cancer has spread to the tissues just outside the vagina, but has not gone to
the bones of the pelvis.


Stage III

Cancer has spread to the bones of the pelvis. Cancer cells may also have spread
to other organs and
the lymph nodes in the pelvis. (Lymph nodes are small bean-shaped structures
that are found
throughout the body. They produce and store cells that fight infection.)


Stage IVA

Cancer has spread into the bladder or rectum.


Stage IVB

Cancer has spread to other parts of the body, such as the lungs.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may
come back in the vagina or in another place.



TREATMENT OPTION OVERVIEW


How cancer of the vagina is treated

Treatments are available for all patients with cancer of the vagina. There are
three kinds of treatment:

     surgery (taking out the cancer in an operation)
     radiation therapy (using high-dose x-rays or other high-energy rays to kill
cancer cells and
     shrink tumors)
     chemotherapy (using drugs to kill cancer cells)

Surgery is the most common treatment of all stages of cancer of the vagina. A
doctor may take out
the cancer using one of the following:

     Laser surgery uses a narrow beam of light to kill cancer cells and is
useful for stage 0 cancer.
     Wide local excision takes out the cancer and some of the tissue around it.
A patient may need
     to have skin taken from another part of the body (grafted) to repair the
vagina after the cancer
     has been taken out.
     An operation in which the vagina is removed (vaginectomy) is sometimes
done. When the
     cancer has spread outside the vagina, vaginectomy may be combined with
surgery to take out
     the uterus, ovaries, and fallopian tubes (radical hysterectomy). During
these operations, lymph
     nodes in the pelvis may also be removed (lymph node dissection).
     If the cancer has spread outside the vagina and the other female organs,
the doctor may take
     out the lower colon, rectum, or bladder (depending on where the cancer has
spread) along
     with the cervix, uterus, and vagina (exenteration).
     A patient may need skin grafts and plastic surgery to make an artificial
vagina after these
     operations.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and
shrink tumors.
Radiation may come from a machine outside the body (external radiation) or from
putting materials
that produce radiation (radioisotopes) through thin plastic tubes into the area
where the cancer cells
are found (internal radiation). Radiation may be used alone or after surgery.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill,
or it may be put
into the body by a needle in a vein. Chemotherapy is called a systemic treatment
because the drugs
enter the bloodstream, travel through the body, and can kill cancer cells
outside the vagina. In
treating vaginal cancer, chemotherapy may also be put directly into the vagina
itself, which is called
intravaginal chemotherapy.


Treatment by stage

Treatment of cancer of the vagina depends on the stage of the disease, the type
of disease, and the
patient's age and overall condition.

Standard treatment may be considered because of its effectiveness in patients in
past studies, or
participation in a clinical trial may be considered. Not all patients are cured
with standard therapy
and some standard treatments may have more side effects than are desired. For
these reasons,
clinical trials are designed to find better ways to treat cancer patients and
are based on the most
up-to-date information. Clinical trials are ongoing in most parts of the country
for most stages of
cancer of the vagina. To learn more about clinical trials, call the Cancer
Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.



STAGE 0 VAGINAL CANCER

Treatment may be one of the following:

     1. Surgery to remove all or part of the vagina (vaginectomy). This may be
followed by skin
     grafting to repair damage done to the vagina.

     2. Internal radiation therapy.

     3. Laser surgery.

     4. Intravaginal chemotherapy.



STAGE I VAGINAL CANCER

Treatment of stage I cancer of the vagina depends on whether a patient has
squamous cell cancer or
adenocarcinoma.

If squamous cancer is found, treatment may be one of the following:

     1. Internal radiation therapy with or without external beam radiation
therapy.

     2. Wide local excision. This may be followed by the rebuilding of the
vagina. Radiation
     therapy following surgery may also be performed in some cases.

     3. Surgery to remove the vagina with or without lymph nodes in the pelvic
area (vaginectomy
     and lymph node dissection).

If adenocarcinoma is found, treatment may be one of the following:

     1. Surgery to remove the vagina (vaginectomy) and the uterus, ovaries, and
fallopian tubes
     (hysterectomy). The lymph nodes in the pelvis are also removed (lymph node
dissection). This
     may be followed by the rebuilding of the vagina. Radiation therapy
following surgery may also
     be performed in some cases.

     2. Internal radiation therapy with or without external beam radiation
therapy.

     3. In selected patients, wide local excision and removal of some of the
lymph nodes in the
     pelvis followed by internal radiation.



STAGE II VAGINAL CANCER

Treatment of stage II cancer of the vagina is the same whether a patient has
squamous cell cancer or
adenocarcinoma.

Treatment may be one of the following:

     1. Combined internal and external radiation therapy.

     2. Surgery, which may be followed by radiation therapy.



STAGE III VAGINAL CANCER

Treatment of stage III cancer of the vagina is the same whether a patient has
squamous cell cancer
or adenocarcinoma.

Treatment may be one of the following:

     1. Combined internal and external radiation therapy.

     2. Surgery may sometimes be combined with radiation therapy.



STAGE IVA VAGINAL CANCER

Treatment of stage IVA cancer of the vagina is the same whether a patient has
squamous cell cancer
or adenocarcinoma.

Treatment may be one of the following:

     1. Combined internal and external radiation therapy.

     2. Surgery may sometimes be combined with radiation therapy.



STAGE IVB VAGINAL CANCER

If stage IVB cancer of the vagina is found, treatment may be radiation to
relieve symptoms such as
pain, nausea, vomiting, or abnormal bowel function. Chemotherapy may also be
performed. A
patient may also choose to participate in a clinical trial.



RECURRENT VAGINAL CANCER

If the cancer has come back (recurred) and spread past the female organs, a
doctor may take out
the cervix, uterus, lower colon, rectum, or bladder (exenteration), depending on
where the cancer
has spread. The doctor may give the patient radiation therapy or chemotherapy.

A patient may also choose to participate in a clinical trial of chemotherapy or
radiation therapy.



TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the vagina, call the National Cancer Institute's
Cancer Information
Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing
this
toll-free number, you can speak with a trained information specialist who can
answer your questions.

The Cancer Information Service also has booklets about cancer that are available
to the public and
can be sent on request. The following general booklets on questions related to
cancer may be
helpful:

     Taking Time: Support for People with Cancer and the People Who Care About
          Them
     What Are Clinical Trials All About?
     Chemotherapy and You: A Guide to Self-Help During Treatment
     Radiation Therapy and You: A Guide to Self-Help During Treatment
     Eating Hints for Cancer Patients
     Advanced Cancer: Living Each Day
     When Cancer Recurs: Meeting the Challenge Again
     What You Need To Know About Cancer

There are many other places where people can get information about cancer
treatment and services.
The social service office at a hospital can be checked for local and national
agencies that help with
getting information about finances, getting to and from treatment, getting care
at home, and dealing
with problems.

For more information from the National Cancer Institute, please write to this
address:

     National Cancer Institute
     Office of Cancer Communications
     31 Center Drive, MSC 2580
     Bethesda, MD 20892-2580

pink wrote:

> I WOULD LIKE TO SPEAK TO ANY PATIENTS WHO HAVE HAD UTERINE CANCER WHICH HAS
> SPREAD TO THE VAGINAL APEX REGION AND THE TREATMENTS THEY HAVE
> RECEIVED.....I HAD MY UTERUS REMOVED...HAD 25 RADIATION TREATMENTS AND 7
> MOS. LATER FOUND OUT I HAD ANOTHER TUMOR IN THE VAGINAL APEX...THEY ARE
> RECOMMENDING A EXENTERATION AND WOULD LIKE TO KNOW IF THERE ARE ANY
> SURGEONS OUT THERE WHO HAVE EVER REMOVED THE TUMOR WITH OUT REMOVING THE
> BLADDER AND INTESTINES, ETC....MRS. GARCIA
>
> ------------------------------------------------------------------------
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