Home Page>Cancer of the Vagina
Cancer of the VaginaDr Kingsley’s comments Cancer of the vagina tends to occur in women over the age of 50 years, and, when it occurs in older women, it tends to be fairly advanced when it is diagnosed, as they have often had the problem for some time and have not done anything about it. It counts for up to 2% of all gynaecological cancers, and one type, squamous cell carcinoma, is associated with long-term use of vaginal pessaries, especially ones that did not quite fit properly, so caused a slow inflammatory reaction. The other type, which is being seen less often nowadays, is called a clear cell adenocarcinoma. It occurred in young women whose mothers were treated with stilboestrol for a threatened miscarriage, when they were pregnant with them. In many ways it is astonishing that the connection was ever made between the condition and its cause. It also shows how harmful some unnatural chemicals, especially hormones, can be on the body, yet how long it can take before the effects show up. Similar observations are gradually coming to light over HRT. Soft tissue sarcomas are rarely found in young children, and malignant melanoma is also a rare possibility. Symptoms and Signs. The first symptom or sign is most commonly a bloodstained vaginal discharge. However, because the initial indications are often ignored, there may be urinary symptoms such as cystitis, or rectal ones including pain. In more advanced cases a fistula may develop. This is when the vaginal wall breaks down because of the cancer, and a direct connection is made with the neighbouring organ. The result is organisms from the vagina can infect the bladder, or faeces may enter the vagina itself. In some instances, the whole area can become a smelly, putrid mass. As usual in advanced cases, there may be any number of symptoms or signs of generalised ill health, such as weight loss, loss of appetite, anaemia, shortness of breath and pain, etc. Conventional Treatment. Surgery, if it is carried out, will remove the whole of the female anatomy in that part of the body, the vagina, cervix, uterus, tubes and ovaries. However, in older women, especially with advanced disease, that is quite impractical, so intravaginal radiotherapy is the treatment of choice. In such advanced cases, treatment is palliative, i.e. to make the woman as comfortable as possible. An Explanation by Dr Kingsley Before Your Consultation about your Vaginal Cancer Most consultations with doctors are fairly quick affairs, lasting perhaps five minutes, even if you are suspected of having cancer of your vagina. You may be lucky to have more time spent on you, but when you have your consultation with me, I will spend as much time as you want. There is no time limit. We will take as long as you want. Often when I see some people for the first time, they are in a state of panic. They haven’t a clue what it is all about. No one has explained anything to them. Perhaps in the past they have been admitted for an emergency operation, or they had simply been told to come into hospital on such-and-such a day when they were either operated on or started a course of chemotherapy or radiotherapy. Once in hospital some sort of explanation may have been given, and you were probably seen by a junior doctor who not only took a short history of any symptoms you had, but also examined you to look for any signs of your vaginal cancer, but, by then, you were already captive and didn’t really have much choice in the matter. To be fair to doctors, they assume that their advice is the best on offer. After all, they are the experts. Virtually all doctors would treat your condition in roughly the same way, so it seldom occurs to them that you just might not want to follow their advice. In any case, most patients have been frightened by their diagnosis and want to get on with the treatment, assuming that the doctor can deal with it for them. Most people put their faith in their doctor, assuming he knows what he is doing. There is absolutely no intention on my part to tell you whether to follow your doctor’s advice of not. That is a decision you have to make. No one can make it for you, but I will help you make up your mind. The Consultation The virtual consultation with me has been planned as though you are with me in my consulting room. I will go though your history, or the history that I come across so often, explaining the parts of it that give me clues to the cause of people’s problems. The chances are that, having taken a medical history from many thousands of patients over nearly forty years of medical practice, especially in the detail that I find so valuable, it is likely that much of it will be appropriate to you. The consultation is one of the longest parts of this programme, as you would imagine, and it is full of fascinating information. Periodically I lecture to medical colleagues on the subject of ‘What a clinical history and the clinical examination can tell me’. All this information is the result of my many years of listening to patients, letting them tell their stories, believing in their observations that have often been ignored, and learning by experience. So, enjoy yourself, feel enlightened, smile, be happy and radiate confidence in what you are going to do. Be positive and forget the doom and gloom merchants. If someone has given you a poor prognosis, forget it. You no longer fit into their statistics. You are going to do something for yourself. You are now in charge. ---------------------------------------- What you do now is in your own hands. We would like you to take advantage of all the benefits of becoming a member of our Cancer Help Centre, which is free to join, so please look at the Members’ Area Overview, where you will find a summary of all that is on offer. |
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