Cancer is caused when the normal mechanisms that control cell growth become disturbed, causing cells to grow and divide without stopping. This is usually the result of damage to the genetic material of the cell (deoxyribonucleic acid, or DNA). The cause of vaginal cancer is not known.
Symptoms of vaginal cancer appear when the cancer has become more advanced. Approximately 20% of vaginal cancer cases are asymptomatic (produce no symptoms) and are diagnosed following an abnormal Pap test. Symptoms of vaginal cancer include:
abnormal vaginal bleeding or discharge
pain during intercourse
pain in the pelvic area
difficult or painful urination
The diagnosis of vaginal cancer is made by physical examination and laboratory analysis of tissue samples. During the physical examination, the physician will place one or two fingers into the vagina and press down on the lower abdomen with his or her free hand to feel (palpate) the reproductive organs and any masses. During a routine speculum examination, the physician will obtain a sample of cervical and vaginal cells (using a swab, brush, or wooden applicator) for laboratory analysis (Pap test).
A special magnifying instrument, called a colpo-scope, may be used to view the vagina. Additionally, the surface of the vagina may be treated with a dilute solution of acetic acid, which causes some abnormal areas to turn white. Squamous carcinoma and adenocarcinoma usually appear as a growth on the surface of the vagina. Squamous carcinoma may present as an open sore (ulcer). Adenocarcinoma may lie deeper so that it is not visible and detected only by palpation. Vaginal melanoma appears as a brown or black skin tag (polypoid), growth attached to the vaginal wall by a stem (pedunculated), nipple-like growth (papillary), or fungus-like growth (fungating). Sarcomas often appear as a grape-like mass.
If any area appears abnormal, a tissue sample (biopsy) will be taken. The biopsy can be performed in the doctor's office with the use of local anesthetic. A small piece of tissue, which contains the suspect lesion with some surrounding normal skin and the underlying skin layers and connective tissue, will be removed. Small lesions will be removed in their entirety (excisional biopsy). The diagnosis of cancer depends on a microscopic analysis of this tissue by a pathologist.