Vaginal cancer is a relatively uncommon form of gynecological malignancy, particularly when it originates in the vagina rather than spreading from another site. A lack of awareness often exists because its symptoms can be subtle, vague, and easily mistaken for far more common, non-cancerous conditions like infections or hormonal changes. Understanding the specific nature of these potential signs is important, since early detection remains a significant factor in successful treatment. This overview addresses the physical findings and subjective sensations that may indicate the presence of this disease.
Primary Signs and Visible Changes
The most frequent initial indication of vaginal cancer is abnormal vaginal bleeding, which typically occurs without pain. This bleeding is unexpected, meaning it happens outside of a regular menstrual period in pre-menopausal individuals. For those who have gone through menopause, any new instance of vaginal bleeding or spotting should be reported immediately, as post-menopausal bleeding is never considered normal.
Bleeding may specifically be noticed after sexual intercourse, known as post-coital bleeding, suggesting the tumor is fragile and easily disrupted by friction. The tumor itself can present as a noticeable mass or lump within the vaginal canal, which may be felt during routine hygiene or a sexual encounter. Squamous cell carcinoma, the most common type, often appears as an ulcerating lesion or a raised mass on the vaginal wall, which can sometimes be seen during a physician’s examination.
A persistent and unusual vaginal discharge is another common sign that warrants medical attention. This discharge may be watery, blood-tinged, or possess a foul odor, reflecting the presence of abnormal tissue or secondary infection. These visible manifestations are often the findings that initially prompt an individual to seek professional medical advice.
Associated Pain and Pelvic Discomfort
While abnormal bleeding is usually the earliest sign, subjective sensations like pain and discomfort often signal a more locally advanced stage of the disease. Painful sexual intercourse, medically termed dyspareunia, can occur when the tumor mass is large or positioned to cause discomfort during penetration. This pain can range from mild to severe and typically persists beyond the time of intercourse.
The growth of a tumor can exert pressure on surrounding pelvic organs, leading to a feeling of unexplained pelvic fullness or pressure, similar to a constant deep ache. When the cancer involves the adjacent urinary tract, it can cause dysuria (pain or burning upon urination). Individuals may also experience increased frequency or urgency to urinate, as the tumor irritates or compresses the bladder.
If the tumor extends toward the back of the pelvis, it can interfere with normal bowel function, leading to changes in habits. This can manifest as persistent constipation or a feeling of incomplete bowel emptying. In more advanced instances, pressure on the rectum can cause tenesmus, which is the painful, persistent urge to defecate even when the bowel is empty.
Navigating Screening and Diagnosis
Any individual experiencing these signs and symptoms must seek a prompt medical evaluation. The process begins with a comprehensive pelvic examination, where the physician visually inspects the vagina and cervix and manually feels for any masses or tenderness. This physical assessment is the first step in identifying suspicious lesions that require further investigation.
While the Pap test is highly effective for screening cervical cancer, it is less reliable for detecting primary vaginal cancer in asymptomatic individuals. However, a Pap test or a vault smear may incidentally detect abnormal cells originating from the vaginal walls. If an abnormal area is identified during the pelvic exam, the next step is usually a procedure called colposcopy.
Colposcopy involves using a specialized magnifying instrument to closely examine the vaginal tissues under bright light. If abnormalities are seen, a biopsy is performed, which involves taking a small tissue sample for laboratory analysis. The biopsy is the definitive method for confirming the presence of cancerous cells and determining the specific type of vaginal cancer.
Once a diagnosis is confirmed, additional imaging tests, such as CT scans, MRI, or PET scans, are typically conducted to determine the extent of the cancer’s spread. This process, known as staging, assigns a numerical stage (I through IV) to the cancer. Staging guides treatment planning and defines whether the cancer is confined to the vagina or has spread to nearby tissues or distant organs.