Materiały źródłowe

• #1 Vaginal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559126/

  The pathways of carcinogenesis for vaginal cancer can be divided into human papillomavirus (HPV) induced and non-HPV induced. As with cervical cancer, the HPV 16 virus strain accounts for most HPV-positive patients. Within the HPV DNA, the activity of the viral reading frames E6 and E7 create proteins that interfere with critical cell cycle points. E6 interferes with suppressive tumor protein p53 and E7 with retinoblastoma protein. These are significant factors in HPV-related neoplasia, including primary vaginal cancer. The E5 protein may also play a role in immune evasion. […] Like the premalignant cervical lesions and carcinoma of the cervix, continual HPV infection, especially the HPV 16 subtype, is associated with the long-term development of high-grade squamous intraepithelial lesions (HSIL) and carcinoma of the vagina. The squamous cells of the vaginal mucosa are similar to the cells of the ectocervix. Recently, the terminology for precancerous lesions has changed from the vaginal intraepithelial lesion (VAIN) 1 to the low-grade squamous intraepithelial lesion and VAIN 2-3 to the high-grade squamous intraepithelial lesion. Because the vaginal epithelium does not transform via squamous metaplasia, vaginal tissue less commonly undergoes malignant transformation from HPV infection. Primary melanomas arising from the female reproductive system are uncommon and aggressive cancers. The vulva is the most frequent site (70%), followed by the vagina and, more rarely, the cervix. Tumors that involve the vagina or cervix are strongly associated with high-risk clinicopathologic features, including increased tumor thickness, ulceration, positive surgical margins, lymph node metastasis, and poor long-term clinical outcomes, including death.

• #2 Vaginal Cancer – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/vaginal-cancer

  Most vaginal cancers are caused by persistent human papillomavirus (HPV) infection. […] Vaginal cancer is caused by HPV infection or in utero exposure to diethylstilbestrol. […] Risk factors include cervical or vulvar precancer or cancer.

• #3 What Causes Vaginal Cancer? | Causes of Vaginal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/vaginal-cancer/causes-risks-prevention/what-causes.html

  The exact cause of most vaginal cancers is not known. But scientists have found that it is linked to a number of conditions described in Risk Factors for Vaginal Cancer Research is being done to learn more about how these risk factors cause cells of the vagina to become cancer. […] About 75% of vaginal cancers are caused by the human papillomavirus (HPV). Research has shown that normal cells make substances called tumor suppressor gene products to keep from growing too rapidly and becoming cancers. High-risk HPV (human papillomavirus) types (like HPV 16 and HPV 18) produce 2 proteins (E6 and E7) that can change the way tumor suppressor gene products work. When this happens, the tumor suppressor gene products are no longer able to control growth of normal cells into cancer cells. […] Women who were exposed to diethylstilbestrol (DES) as a fetus (that is, their mothers took DES during pregnancy) are at increased risk for developing vaginal clear cell carcinoma. DES also increases the likelihood of vaginal adenosis (gland-type cells in the vaginal lining rather than the usual squamous cells). Most women with vaginal adenosis never develop vaginal clear cell carcinoma. Still, those with a rare type of adenosis called atypical tuboendometrial adenosis do have a higher risk of developing this cancer.

• #4 HPV and Cancer – NCI

  https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer

  HPV can cause six types of cancer: These include anal cancer, cervical cancer, oropharyngeal cancer, penile cancer, vaginal cancer, and vulvar cancer. […] Most vaginal cancer (75%) is caused by HPV. […] HPV infection causes cells to undergo changes. If not treated these cells can, over time, become cancer cells. […] Once high-risk HPV infects cervical cells, it interferes with the ways in which these cells replicate, divide, and communicate with one another, causing infected cells to multiply in an uncontrolled manner. […] Research has found that it can take 5 to 10 years for HPV-infected cervical cells to develop into precancers and about 20 years to develop into cancer. […] Although research has focused on how high-risk HPV causes cancer in the cervix, HPV-caused cancers at other sites are likely to arise through similar mechanisms.

• #5 Vaginal Cancer | Concise Medical Knowledge

  https://www.lecturio.com/concepts/vaginal-cancer/

  The pathogenesis of SCC is usually related to HPV. […] HPV infection LSIL/VaIN-I HSIL/VaIN-II/III carcinoma in situ invasion through the basement membrane is invasive cancer. […] Most commonly due to HPV-16. […] HPV has 2 major oncoproteins: E6 inactivates p53 tumor suppressor protein and E7 inactivates Rb tumor suppressor protein. […] After cells lose tumor suppressor proteins, unregulated proliferation occurs leading to HSIL.

• #6 Vaginal cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20352447

  Vaginal cancer begins when cells in the vagina develop changes in their DNA. A cell’s DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] Most DNA changes that lead to vaginal cancers are thought to be caused by human papillomavirus, also called HPV. HPV is a common virus that’s passed through sexual contact. For most people, the virus never causes problems. It usually goes away on its own. For some, though, the virus can cause changes in the cells that may lead to cancer.

• #7 Therapeutic Mechanisms of Treatment in Cervical and Vaginal Cancer – touchONCOLOGY

  https://touchoncology.com/gynaecological-cancers/journal-articles/therapeutic-mechanisms-of-treatment-in-cervical-and-vaginal-cancer/

  Cervical and vaginal cancers remain serious health problems. […] Randomized clinical trials have indicated that radiochemotherapy strategies that disrupt the repair of damaged DNA are key to the management of advanced stage cervical and vaginal cancers. […] A primary cause of cervical and vaginal cancers is human papillomavirus (HPV), a virus often acquired by sexual activity. […] HPV interrupts host-cell mechanisms of cell-cycle termination. […] The far-reaching effects of HPV proteins that supersede cell-cycle checkpoints increase the tendency to oncogenic phenotypes. […] Current HPV biology, therefore, entices investigators to exploit pharmacologic means of limiting 2-deoxyribonucleoside diphosphate (dNDP) production by RNR (maybe its M1-M2 form specifically) through either transcriptional or protein-protein regulation.

• #8 Vaginal Cancer: Overview, Risk Factors, Pathogenesis

  https://emedicine.medscape.com/article/269188-overview

  The presence of different stages of histologic differentiation in vaginal cancer VAIN, carcinoma in situ, possible microinvasive carcinoma, and invasive cancer suggests a continuum of transformation from less malignant to more invasive; this is similar to the continuum described for cervical cancer. […] On the other hand, the significant association of vaginal cancer with a history of cervical or vulvar cancer suggests that the entire genital tract is at risk for squamous cell carcinoma once malignancy has occurred anywhere along the tract; this is a phenomenon known as the „field effect.” […] HPV infection, which evidence indicates is associated with the pathogenesis of squamous cell vaginal carcinoma, could explain this phenomenon, because HPV is associated with cervical, vaginal, and vulvar disease.

• #9 Vaginal Cancer | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30938

  The pathways of carcinogenesis for vaginal cancer can be divided into human papillomavirus (HPV) induced and non-HPV induced. As with cervical cancer, the HPV 16 virus strain accounts for most HPV-positive patients. Within the HPV DNA, the activity of the viral reading frames E6 and E7 create proteins that interfere with critical cell cycle points. E6 interferes with suppressive tumor protein p53 and E7 with retinoblastoma protein. These are significant factors in HPV-related neoplasia, including primary vaginal cancer. The E5 protein may also play a role in immune evasion. […] Like the premalignant cervical lesions and carcinoma of the cervix, continual HPV infection, especially the HPV 16 subtype, is associated with the long-term development of high-grade squamous intraepithelial lesions (HSIL) and carcinoma of the vagina. The squamous cells of the vaginal mucosa are similar to the cells of the ectocervix. Recently, the terminology for precancerous lesions has changed from the vaginal intraepithelial lesion (VAIN) 1 to the low-grade squamous intraepithelial lesion and VAIN 2-3 to the high-grade squamous intraepithelial lesion. Because the vaginal epithelium does not transform via squamous metaplasia, vaginal tissue less commonly undergoes malignant transformation from HPV infection. […] Tumors that involve the vagina or cervix are strongly associated with high-risk clinicopathologic features, including increased tumor thickness, ulceration, positive surgical margins, lymph node metastasis, and poor long-term clinical outcomes, including death.

• #10 Vaginal cancer pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Vaginal_cancer_pathophysiology

  Vaginal intraepithelial neoplasia is defined by the presence of squamous cell atypia without invasion. […] Two etiologies have been proposed to explain the strong association between VaIN and neoplasia elsewhere in the lower genital tract. […] A second theory is that lower genital tract neoplasia share common etiologic factors, since approximately one-half of VaIN lesions are associated with concomitant cervical or vulvar neoplasia. […] Tissues of common embryological origin are susceptible to neoplasia from exposure to similar carcinogenic stimuli. In particular, exposure to human papillomavirus (HPV) appears to induce neoplasms in all three locations of the lower female genital tract (cervix, vagina, vulva). […] HPV infection HPV-associated lesions are often multifocal (originating within several discrete foci at one anatomic site) and multicentric (involving several distinct anatomic sites of the lower genital tract).

• #11 Vaginal Cancer – Introduction, Etiology and Pathology, Symptoms | health.am

  http://www.health.am/cr/vaginal-cancer/

  The etiology of vaginal cancer has not been identified. Note that vaginal cancer is not histologically homogeneous; several types of lesions exist, each with its own characteristics, age predilection, aggressiveness, and prognosis. This suggests that a single etiologic factor is unlikely. Although some histologic types of vaginal cancer have been associated with exposure to certain agents, so far no clear cause-and-effect relationship has been found between any of those agents and vaginal carcinoma. […] The identification of HPV deoxyribonucleic acid (DNA) in squamous cell cancer cells by in situ hybridization (21%) and southern blot hybridization (56%) strongly suggests a possible role for HPV in the pathogenesis of squamous cell vaginal carcinoma. […] HPV subtypes 16 and 18 have the highest oncogenic potential and are most commonly linked to dysplastic changes in the female genital tract. Because HPV is sexually transmitted, this association raises the question as to whether women who engage in high-risk sexual behaviors, such as sex with multiple partners, are at risk for developing vaginal cancer.

• #12 Vaginal Cancer | GLOWM

  https://www.glowm.com/section-view/heading/Vaginal%20Cancer/item/260

  Human papillomavirus (HPV) has been implicated in the pathogenesis of vaginal cancer, much like cervical carcinoma. Waggoner and colleagues found HPV 31 DNA exclusively in the clear-cell adenocarcinomas that contained HPV sequences. A larger, population-based study of patients with vaginal intraepithelial neoplasia (VAIN) III and invasive vaginal squamous cell cancers found similar risk factors to those related to cervical cancer. Compared with controls, these patients were more likely to have multiple sexual partners, early age at first intercourse, and to be current smokers. HPV DNA was detected in more than 80% of patients with VAIN III and 60% of patients with invasive cancers. Antibodies to HPV 16 were strongly related to the risk for cancer. […] In 1971, Herbst and associates first reported the correlation between clear-cell adenocarcinoma of the vagina and cervix and the use of DES. The incidence of clear-cell adenocarcinoma in women prenatally exposed to DES is estimated to be between 0.14 and 1.4 cases per 100,000. The median age of these DES-exposed patients at tumor diagnosis was 19 years. An association was found between the risk for vaginal cancer and the time of first exposure to DES. The greatest risk for vaginal cancer from exposure to DES was found to occur during the first 16 weeks of pregnancy. This risk decreased when exposure began at 17 weeks or later. A question that remains unanswered is whether DES exposure is related to vaginal and cervical squamous cell cancers, which typically present later in life. To address this issue, Hatch and colleagues performed a retrospective cohort study of 3899 DES-exposed women versus 1374 controls. They found a relative risk of 2.1 for high-grade dysplasia of the vagina or cervix with DES exposure. The low incidence of invasion precluded statistical analysis regarding cancer.

• #13 What Causes Vaginal Cancer? HPV, DES, and Other Risk Factors

  https://www.healthline.com/health/cancer/causes-of-vaginal-cancer

  Vaginal cancer is a very rare, slow-growing cancer found in the vagina. Its commonly caused by human papillomavirus (HPV). […] More than half of all cases of vaginal cancer are caused by HPV. […] When a person contracts HPV, their body may stop producing certain proteins. These proteins are important for fueling a gene that suppresses tumor growth and prevents cancer. […] Diethylstilbestrol (DES) is a synthetic form of estrogen that was often prescribed between 1940 and 1971 for miscarriages and preterm delivery. People who had exposure to DES in utero may have an increased risk of developing clear cell carcinoma and precancerous conditions, such as vaginal adenosis. […] Vaginal cancer may also result from other cancers spreading to your vagina. […] Vaginal cancer is most often caused by infection with HPV. It may be more common in women with fetal exposure to DES and other risk factors, like previous cancer or a compromised immune system.

• #14 Vaginal Cancer: Overview, Risk Factors, Pathogenesis

  https://emedicine.medscape.com/article/269188-overview

  Koyamatsu et al suggested that in cervical cancer, HPV 16 and 18 plays a common causal role, that in vulvar cancer, p53 gene mutations are the main carcinogenic cause, and that vaginal cancer has transitional characteristics between cervical and vulvar cancer. […] Another explanation for the association between vaginal cancer and cervical and vulvar carcinoma is that an occult residual disease such as VAIN is trapped within the vaginal cuff posthysterectomy and goes unnoticed until it develops into invasive carcinoma. […] A third possibility for the association between vaginal cancer and carcinoma of the cervix or vulva is radiation carcinogenesis. […] The pathogenesis by which DES may play a role in inducing clear cell adenocarcinoma is unclear. […] Most vaginal cancers occur in the upper third of the vagina. Reports are contradictory as to whether the anterolateral wall or the posterior wall is the more frequent site. Reports suggesting that the upper posterior wall is the most common site favor the hypothesis that irritating substances, such as vaginal secretions and semen, pool in the posterior fornix and cause chronic irritation, which could lead to induction of a carcinogenic process.

• #15 Vaginal Cancer – Introduction, Etiology and Pathology, Symptoms | health.am

  http://www.health.am/cr/vaginal-cancer/

  Long-term pessary use and chronic irritation of vaginal mucosa in women with procidentia have been associated with vaginal cancer. […] Secondary carcinoma of the vagina is seen more frequently than primary vaginal cancers. Secondary, or metastatic, tumors may arise from cervical, endometrial, or ovarian cancer, breast cancer, gestational trophoblastic disease, colorectal cancer, or urogenital or vulvar cancer. […] HPV, early hysterectomy, and prior radiation are possible risk factors for vaginal cancer, but no specific etiologic agent has been identified.

• #16 Vaginal cancer | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vaginal-cancer

  Vaginal cancer is one of the rarest gynaecological cancers. […] Generally, vaginal cancer tends to be a secondary cancer, which means cancer cells have migrated to the vagina from somewhere else in the body, such as the cervix or vulva. About 95 per cent of cancers that start in the vagina are squamous cell carcinomas, which means the cancer originated from skin cells. […] Another group of women prone to vaginal cancers are those who were exposed to the drug diethylstilbestrol (DES) while in utero (in their mothers womb). […] Some research suggests that using a pessary to treat a prolapsed uterus may, over time, irritate the vagina and potentially cause vaginal cell changes. […] A DES daughters reproductive system can change after her exposure to DES. This may include alteration of the shape of the uterus and cervix. Many DES daughters have vaginal adenosis, which is a risk factor for clear-cell cancer (adenocarcinoma), the rare vaginal cancer associated with DES daughters.

• #17

  http://www.bccancer.bc.ca/health-info/types-of-cancer/pelvic-area/vagina

  Vaginal cancer is very rare. Vaginal cancer is also called vaginal carcinoma or carcinoma of the vagina. Vaginal cancer is very rare. These are some of the risk factors for this cancer. Not all of these risk factors may cause this cancer, but they may help the cancer start growing. […] Having a human papillomavirus (HPV) infection. […] Radiation therapy for cervical cancer. […] Having cervical, vulvar or anal cancer.

• #18 Vaginal cancer – UpToDate

  https://www.uptodate.com/contents/vaginal-cancer

  Vaginal cancer is more common than vulvar cancer. Most vaginal tumors are squamous cell carcinomas, but melanoma, sarcoma, adenocarcinoma, and other histologic types also occur. Most cases of vaginal cancer are likely mediated by human papillomavirus (HPV) infection, as with cervical cancer. In a case-control study of 156 women with in situ or invasive vaginal cancer, over 50 percent were positive for antibodies to HPV subtypes 16 or 18. Thus, vaginal cancer has the same risk factors as cervical neoplasia: multiple lifetime sexual partners, early age at first intercourse, and being a current smoker. There is evidence that some high-grade vulvar and vaginal intraepithelial neoplasia are monoclonal lesions derived from high-grade or malignant cervical disease. This was supported by a retrospective cohort study of over 130,000 women in which women with cervical intraepithelial neoplasia 3 (CIN 3) had a significantly increased rate of developing vaginal cancer compared with all women within the same population and time period. A fourfold or greater increased risk was found until 25 years following CIN 3 diagnosis. Similarly, in a case series, 30 percent of all women with in situ or invasive vaginal disease had been treated for a prior anogenital tumor (primarily cervical), and 17 of 25 (70 percent) of invasive cancer biopsy specimens contained HPV 16/18 DNA. Similarly, in a series of 153 women with vaginal cancer treated at the Princess Margaret Hospital, 51 patients had a prior gynecologic malignancy; of these, 34 had cervical cancer.

• #19 Vaginal cancer pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Vaginal_cancer_pathophysiology

  The disparity between the relatively high incidence of CIN and rarity of VaIN in women who test positive for HPV may be due to increased susceptibility of the metaplastic transformation zone of the cervix to oncogenic stimuli. […] Women who have been exposed to diethylstilbestrol (DES) in utero often have squamous metaplasia of the vagina instead of normal columnar epithelium; this observation may explain the increased incidence of VaIN noted in some studies of these women. […] Women who have the human papillomavirus (HPV) are more likely than other women to develop this rare cancer. […] Women who have been infected with herpes simplex virus are also at higher risk for vaginal cancer. […] Women whose mothers took DES known as DES daughters develop clear-cell adenocarcinoma of the vagina or cervix more often than women in the general population. […] Vaginal squamous cell carcinoma arises from the thin, flat squamous cells that line the vagina. […] Vaginal adenocarcinoma arises from the glandular (secretory) cells in the lining of the vagina that produce some vaginal fluids.

• #20 Therapeutic Mechanisms of Treatment in Cervical and Vaginal Cancer – touchONCOLOGY

  https://touchoncology.com/gynaecological-cancers/journal-articles/therapeutic-mechanisms-of-treatment-in-cervical-and-vaginal-cancer/

  Proton-coupled electron transfer from the M2 or M2b diferric tyrosyl radical (Y122) through a 35 amino acid electron and proton tunnel to the catalytic site on M1 (cysteine C439) forms the root mechanism by which RNR accomplishes its task of catalyzed ribonucleotide reduction. […] It is speculated that sources of dNDPs after DNA-damaging insults include ribonucleotide reduction first by a M1-M2b mediated process and subsequently by a M1-M2 mechanism. […] Nature balances such demandsupply economics by utilizing not only a de novo RNR enzyme reduction of ribonucleotides, but also a complementary deoxynucleoside salvage system. […] The ability to disrupt the natural demandsupply balance sheet through an increase in dNTP demand (i.e., radiation, cisplatin) while also restricting supply through pharmacologic inhibitors of de novo RNR activity (i.e., gemcitabine, hydroxyurea [HU], and triapine) has been tested in clinical trials.

• #21 Vaginal cancer – Wikipedia

  https://en.wikipedia.org/wiki/Vaginal_cancer

  Vaginal cancer is an extraordinarily rare form of cancer that develops in the tissue of the vagina. Primary vaginal cancer originates from the vaginal tissue most frequently squamous cell carcinoma, but primary vaginal adenocarcinoma, sarcoma, and melanoma have also been reported while secondary vaginal cancer involves the metastasis of a cancer that originated in a different part of the body. […] The human papilloma virus (HPV) is strongly associated with vaginal cancer. […] There are two primary types of vaginal cancer: squamous-cell carcinoma and adenocarcinoma. Squamous-cell carcinoma of the vagina arises from the squamous cells (epithelium) that line the vagina. This is the most common type of vaginal cancer. […] Vaginal adenocarcinoma arises from the glandular (secretory) cells in the lining of the vagina. Adenocarcinoma is more likely to spread to the lungs and lymph nodes.

• #22 Vaginal Cancer | Doctor

  https://patient.info/doctor/vaginal-cancer

  Vaginal cancer is usually a squamous cell carcinoma involving the posterior wall of the upper third of the vagina. It may directly invade the bladder or rectum. Lesions may be ulcerative or exophytic. […] The distinction between squamous cell carcinoma and adenocarcinoma is important because the two types represent distinct diseases, each with a different pathogenesis and natural history: […] Approximately 80% of cases of primary vaginal cancer are squamous cell vaginal cancer. This initially spreads superficially within the vaginal wall and later invades the paravaginal tissues and the parametria. Distant metastases occur most commonly in the lungs and liver. […] Approximately 15% of cases of primary vaginal cancer are adenocarcinoma. This has a peak incidence between 17 and 21 years of age and differs from squamous cell carcinoma by an increase in pulmonary metastases and supraclavicular and pelvic node involvement.

• #23 What is vaginal cancer? | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/vaginal/what-is-vaginal-cancer

  Vaginal cancer starts in the cells of the vagina. A cancerous (malignant) tumour is a group of cells that can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body. […] Changes to cells of the vagina can cause precancerous conditions. This means that the abnormal cells are not yet cancer, but there is a chance that they may become cancer if they aren’t treated. […] But in some cases, changes to vaginal cells can cause vaginal cancer. Most often, vaginal cancer starts in flat, thin cells called squamous cells. The squamous cells make up the lining of the vagina. This type of cancer is called squamous cell carcinoma (SCC) of the vagina. Cancer can also start in the glandular cells, which make mucus. This type of cancer is called adenocarcinoma of the vagina.

• #24 What is vaginal cancer? | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/vaginal/what-is-vaginal-cancer

  Other types of vaginal cancer can also develop, but they are less common. Melanoma of the vagina starts in melanocytes, which are cells that make pigments. […] Another type of cancer can start in the muscle or connective tissue cells in the vagina. This type of cancer is called sarcoma. […] Precancerous conditions of the vagina can develop into vaginal cancer. They are abnormal changes (called dysplasia) in the cells of the vagina.

• #25 Vaginal Cancer | GLOWM

  https://www.glowm.com/section-view/heading/Vaginal%20Cancer/item/260

  Vaginal carcinoma spreads primarily by local tissue invasion and lymphatic permeation with embolization, similar to cervical and vulvar malignancies, although hematogenous spread can occur. The vagina has a fine network of capillaries throughout the mucosa and the muscularis that anastomose freely and join laterally into major drainage channels. The lymphatic system of the vagina has many variations, which may account for some treatment failures. Once the preferred routes of drainage are obstructed by tumor, the very extensive anastomotic connections may account for the often bizarre and widespread nature of metastases. The tumor may locally infiltrate the paracolpium, parametrium, bladder, and rectovaginal septum. The proximity of the cervix and vulva make it inevitable that a significant number of vaginal cancers become classified as cervical or vulvar primaries.

• #26 Vaginal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/vaginal

  Vaginal cancer starts in the cells of the vagina. The most common type of vaginal cancer is squamous cell carcinoma. […] Risks for vaginal cancer include human papillomavirus (HPV) infection, exposure to diethystilbestrol (DES) and a history of squamous intraepithelial lesion (SIL). […] Cancer cells have the potential to spread from the vagina to other parts of the body where they can grow into new tumours. This process is called metastasis. […] Vaginal cancer can be treated with surgery, radiation therapy and chemotherapy.

• #27 What Is Vaginal Cancer? | Types of Vaginal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/vaginal-cancer/about/what-is-vaginal-cancer.html

  Vaginal cancer starts in the vagina. There are many different types of vaginal cancer, but the most common is called squamous cell carcinoma. It starts in the lining of the vagina. […] Most cases of vaginal cancer are squamous cell carcinomas. These cancers start in the squamous cells that make up the epithelial lining of the vagina. They’re most common in the upper part of the vagina near the cervix. If not treated, over time, they can grow deeper into and through the vaginal wall and spread to nearby tissues. They can also spread to other parts of the body, most often the lungs, but also the liver and bones. […] Squamous cell cancers of the vagina often develop slowly. First, some of the normal cells of the vagina get pre-cancerous changes (VAIN). Then some of the pre-cancer cells turn into cancer cells. This process can take many years.

• #28 Risks and causes of vaginal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/vaginal-cancer/risk-causes

  Age increases the risk of developing vaginal cancer. As vaginal cancer is rare, the increased risk is still very small. […] Cervical cancer is the main type of cancer linked to HPV. Other types of cancer, including vaginal cancer are also caused by HPV. […] HPV is present in: more than 9 out of 10 (more than 90%) vaginal cancers […] A condition called VAIN can mean you are more at risk of getting vaginal cancer. VAIN stands for vaginal intraepithelial neoplasia. It means there are changes to the cells in the inner lining of the vagina. Some of these changes could become cancerous if not treated. […] Cervical cancer or pre cancerous changes in your cervical cells may also increase the risk of developing vaginal cancer. […] HIV or AIDS may increase the risk of vaginal cancer as well as other cancers in the genital or anal area. This may be because HIV and AIDS lower immunity so the body is less able to overcome HPV infection.

• #29 Vaginal Cancer – Missouri Cancer Associates

  https://missouricancer.com/cancer_type/vaginal-cancer/

  Risk factors for vaginal cancer include the following: Being aged 60 or older, being exposed to DES while in the mother’s womb, having human papilloma virus (HPV) infection, having a history of abnormal cells in the cervix or cervical cancer, having a history of abnormal cells in the uterus or cancer of the uterus, having had a hysterectomy for health problems that affect the uterus. […] Tests that examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal cancer. […] Signs and symptoms of vaginal cancer include pain or abnormal vaginal bleeding. […] There are different types of treatment for patients with vaginal cancer. […] Different types of treatments are available for patients with vaginal cancer. […] Surgery is the most common treatment of vaginal cancer.

• #30 Vaginal Cancer > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/vaginal-cancer

  Vaginal cancer is very rare, even among cancers of the female genital tract, which are themselves uncommon. About 1,200 cases are diagnosed each year. Vaginal cancer most commonly affects postmenopausal women aged 50 and older. Its more common among Black and Latinx women than white women. […] The majority of cases of cancer of the vagina are metastic disease, meaning that the cancer started elsewhere in the body and spread to the vagina. Most metastatic vaginal cancers have spread from either the cervix or vulva because they are all HPV-related. […] Doctors arent sure what causes all types of vaginal cancer, but human papillomavirus (HPV) has been linked to the most prevalent type, vaginal squamous cell carcinoma. […] The presence of a harmful HPV subtype in the body may lead to inflammation, which may encourage the growth of abnormal cells. Cells may develop into vaginal intraepithelial neoplasia, which sometimes precedes vaginal canceror cells may become cancerous.

• #31 Vaginal Cancer | Mays Cancer Center

  https://cancer.uthscsa.edu/cancer-care/types-and-treatments/vaginal-cancer

  Vaginal cancer cells can come from many different types of cells that make up the vagina (muscular channel in the female genital tract). […] Vaginal cancer is one of the rarest types of cancers to affect the female reproductive system. This cancer commonly affects older women in later life (after age 60). […] Human papillomavirus (HPV) is a common virus that spreads through sexual contact. Many HPV infections cause no obvious symptoms or health problems. Certain strains can turn healthy cells into cervical, vaginal or vulvar cancer sometimes years after being infected. […] Having HPV or the herpes simplex virus increases your chances of developing vaginal cancer. […] Many of these vaginal cancers are associated with a human papillomavirus (HPV) infection. […] A team of cancer doctors with different areas of expertise reviews your case and develops a personalized treatment plan.

• #32 Vaginal Cancer – Introduction, Etiology and Pathology, Symptoms | health.am

  http://www.health.am/cr/vaginal-cancer/

  Another association that strengthens the link between HPV infection and vaginal cancer is the presence of a premalignant lesion in the vagina, known as vaginal intraepithelial neoplasia (VAIN). […] Other infectious agents that appear to be associated with vaginal cancer are herpes simplex virus (HSV) and Trichomonas vaginalis. […] A history of cervical intraepithelial neoplasia (CIN), invasive cervical carcinoma, or invasive vulvar carcinoma has also been associated with vaginal carcinoma. […] Diethylstilbestrol (DES), a drug previously used in the first trimester to prevent pregnancy loss, has a strong association with clear cell adenocarcinoma of the vagina. […] In a 2004 publication, Hellman et al reviewed 341 cases of primary carcinoma of the vagina from 1956-1996 and suggested that the etiology of vaginal cancer may be age related.

• #33 Vaginal Cancer: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/cancer/gynecologic-cancer/vaginal-cancer

  Vaginal cancer occurs when cancer cells grow out of control in the vagina, which connects the uterus with the outer genitals (vulva). Vaginal cancer is rare cancers that begin in other parts of the body (uterus, bladder, rectum) and spread to the vagina are more common. Most cases of vaginal cancer start in the lining of the vagina. […] Many cases of vaginal cancer have no clear cause, but some cases of vaginal cancer have been linked to an infection of human papillomavirus (HPV). The most common sexually transmitted infection, HPV can go away on its own but if it lingers, can lead to vaginal or cervical cancer. […] Several risk factors can increase your likelihood of developing a vaginal cancer, including: […] Vaginal intraepithelial neoplasia (VAIN). These abnormal, but not cancerous, cells found in the vagina are associated with an increased risk of developing vaginal cancer. VAIN is often caused by HPV.

• #34

  https://www.gleneagles.com.sg/conditions-diseases/vaginal-cancer/symptoms-causes

  Some cases of vaginal cancer do not have a clear cause. Others may be due to: […] Most cases of vaginal cancer are associated with HPV infection, a common sexually transmitted disease. If an HPV infection persists for a long period of time, it may lead to vaginal and cervical cancer. […] It is also associated with a higher risk of vaginal cancer. […] Women whose mothers had this synthetic estrogen during pregnancy are at a greater risk of developing clear-cell adenocarcinoma of the vagina than other women. […] The risk of vaginal cancer increases with age. Most people diagnosed with vaginal cancer are older than 60 years. […] Conditions like the human immunodeficiency virus (HIV) or lupus are associated with greater risk of vaginal cancer. […] VAIN is mostly caused by HPV infection. A woman diagnosed with this has vaginal cells that do not appear normal, and some women may eventually develop vaginal cancer.

• #35 Risks and causes of vaginal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/vaginal-cancer/risk-causes

  Lupus increases the risk of vaginal cancer. This may be because people with lupus are more at risk of HPV as their immune systems arent functioning well. […] Daughters of women who took DES during their pregnancy, particularly during the first 12 weeks of pregnancy are more at risk of getting a type of vaginal cancer called clear cell adenocarcinoma. […] Smoking tobacco might increase your risk of getting vaginal cancer.

• #36 Vaginal cancer

  https://www.cancervic.org.au/cancer-information/types-of-cancer/vaginal-cancer/vaginal-cancer-overview.html

  Cancer in the vagina can be either a primary or secondary cancer. The two types of cancer are different and are often treated differently. […] Many cases of vaginal cancer are caused by infection with HPV, which is a very common virus in people who are sexually active. […] Although HPV infection and vaginal HSIL are the main risk factors, other things that increase the risk include: previously having HSIL of the cervix or cervical cancer, smoking tobacco (which can make cancer more likely to develop in people with HPV), being aged over 70 (almost half of all vaginal cancers are in women over 70), having a weakened immune system, exposure to a drug called diethylstilbestrol (DES), which was prescribed to pregnant women from the 1940s to the early 1970s to prevent miscarriage. The female children of women who took DES have a small but increased risk of developing clear cell carcinoma of the vagina.

• #37 About Vaginal Cancer | Cancer Council NSW

  https://www.cancercouncil.com.au/vaginal-cancer/about-vaginal-cancer/

  These changes may be precancerous. This means there is an area of abnormal tissue (a lesion) in the vagina that is not cancer, but may develop into cancer over time if left untreated. […] SIL usually has no symptoms and is often caused by human papillomavirus (HPV). Most cases of SIL don’t develop into vaginal cancer.

• #38 Vaginal cancer

  https://www.cancervic.org.au/cancer-information/types-of-cancer/vaginal-cancer/vaginal-cancer-overview.html

  Sometimes the squamous cells in the lining of the vagina start to change. These changes may be precancerous. This means there is an area of abnormal tissue (a lesion) in the vagina that is not cancer, but may develop into cancer over time if left untreated. […] SIL usually has no symptoms and is often caused by human papillomavirus (HPV). Most cases of SIL don’t develop into vaginal cancer.

• #39 Preventing Vaginal Cancer | NYU Langone Health

  https://nyulangone.org/conditions/vaginal-cancer/prevention

  Vaginal cancer develops in the vagina, the muscular, tube-like structure that extends from the cervix, at the bottom of the uterus, to the vulva, which is the outer part of a womans genitals. It is an extremely rare type of cancer. […] NYU Langone doctors recommend several measures to help prevent vaginal cancer, including vaccination against human papillomavirus (HPV), practicing safer sex, smoking cessation, and the management of precancerous lesions. […] Over time, HPV infection may cause abnormal changes in the squamous cells that line the vagina. These may be precancerous, increasing a womans risk of developing a form of vaginal cancer called squamous cell carcinoma. […] These precancerous changes are called vaginal intraepithelial neoplasia, or dysplasia. […] Cells infected with HPV can take years, even decades, to develop into cancer. […] Smoking cigarettes increases the risk of developing vaginal cancer, as well as many other types of cancer. […] If your doctor finds precancerous changes in cells of the vagina, he or she can recommend effective treatment options that help reduce the chance of cancer developing.

• #40 Vaginal Cancer – Uterine, Cervical & Vaginal Disorders – Pathology – Picmonic for Medicine

  https://www.picmonic.com/pathways/medicine/courses/standard/pathology-196/uterine-cervical-vaginal-disorders-39464/vaginal-cancer_50406

  Vaginal cancer often occurs within the upper third of the posterior wall of the vagina. It is associated with HPV subtypes 16 and 18, and squamous cell carcinoma is the most common type. […] The high grade strains, HPV-16 and HPV-18, are associated with the pathogenesis of vaginal cancer. […] The most common subtype of vaginal cancer is squamous cell carcinoma. Primary SCC is rare, thus it often occurs secondary to cervical SCC. Other types include clear cell adenocarcinoma and sarcoma botryoides. […] Vaginal bleeding can occur in vaginal cancer. It typically presents as vaginal ulcerations with contact bleeding. Other symptoms include urinary frequency and malodorous discharge. […] Leukoplakia can be seen in vaginal cancer. It presents as a firmly adhered, well demarcated white plaque on the vaginal mucosa.

• #41 Vaginal cancer | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vaginal-cancer

  Vaginal cancer, as it grows, usually spreads locally first into nearby body parts such as the bladder and bowel. In advanced cases it spreads via the lymphatic or blood system to other organs such as the lungs and liver. […] Treatment options can include surgery, if the cancer is small, and radiation therapy or extensive surgery after radiation therapy when the cancer is very large or has recurred. […] If vaginal cancer has been diagnosed in its later stages, the cancer may have spread to the point where a cure is no longer possible. Treatment then focuses on improving quality of life by relieving the symptoms. This is called palliative treatment.

• #42 Vaginal cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/vaginal-cancer

  The main risk factor for vaginal cancer is HPV (human papilloma virus). […] Having one or more risk factors does not mean you will get vaginal cancer. Also, having no risk factors does not mean you will not develop vaginal cancer. […] The stage of the vaginal cancer describes its size and whether it has spread. The grade describes how quickly it may develop. […] Knowing the stage of the cancer helps your doctors advise you on the best treatment. […] Treatment for vaginal cancer may include the following: Radiotherapy treats cancer using high-energy rays. This is the most common treatment for vaginal cancer. […] Chemotherapy uses anti-cancer drugs to destroy cancer cells. Chemotherapy is often given with radiotherapy. […] Chemoradiation is often given with chemotherapy to treat vaginal cancer. […] Surgery is usually only used for small stage 1 cancers and for cancers that were not cured by radiotherapy.

• #43

  https://www.nhs.uk/conditions/vaginal-cancer/causes/

  More than half of all vaginal cancers are caused by an infection with certain types of human papillomavirus (HPV). […] You’re more likely to get vaginal cancer if you have had an HPV infection. […] But as there’s a link between vaginal cancer and HPV, cervical screening and HPV vaccination are the best ways to protect yourself.

• #44

  https://bpac.org.nz/2023/vaginal-cancer.aspx

  HPV infection is the main cause of vaginal cancer. […] Vaginal cancers typically arise from pre-cancerous vaginal lesions which occur from infection with HPV. […] Squamous cell carcinomas of the vagina typically arise from pre-cancerous lesions vaginal intraepithelial neoplasia that occur from infection with HPV. […] As the majority of primary vaginal cancers are squamous cell in origin, they share common risk factors with cervical cancer, the most significant being HPV infection (particularly with high-risk HPV type 16 and to a lesser extent, type 18). […] Persistent infection with high-risk HPV types (i.e. 16/18) is associated with the development of high-grade squamous intraepithelial lesions (HSIL) and vaginal cancer. […] Therefore, prophylactic HPV vaccination can be a prevention strategy against the development of pre-cancerous vaginal lesions and invasive vaginal cancer.

• #45 Vaginal Cancer | Foundation For Women’s Cancer

  https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/vaginal-cancer/

  Vaginal cancer begins in the vagina, the muscular tube, also called the birth canal, that connects the outer genitalia to the uterus. Most of these cancers are in the lining (squamous epithelium) of the vagina and usually affect people between 50-70 years old. Primary vaginal cancer is one of the rarest gynecologic cancers as oftentimes cancer cells found in the vagina originate from the uterus, vulva, or other organs. […] Because many vaginal cancers are associated with the Human Papillomavirus (HPV) types 16 and 18, vaginal cancer can be prevented by the vaccinations advocated for the prevention of cervical cancer. […] Vaginal cancer can be found during a routine pelvic examination. To detect this cancer, people sometimes are given a Pap test to look for abnormal cells, an inspection of the vagina with a special lighted microscope and/or sample (biopsy) of the vaginal tissue for testing.

• #46 Vaginal and Vulvar Cancer – Gynecologic Cancer Initiative

  https://gynecancerinitiative.ca/vaginal-and-vulvar-cancer/

  In addition, this team has demonstrated that HPV-independent lesions are less sensitive to radiation therapy. […] This research provides one step in improving outcomes for women faced with a diagnosis of vulvar cancer. […] Based on our previous work on the molecular stratification of ovarian and endometrial cancer, we propose to use a similar approach to better understand the etiology and pathogenesis of vulvar cancer with the goal of developing management strategies that are biologically-informed. […] To tackle this problem, we propose to catalogue the molecular features of both HPV-dependent and HPV-independent precancerous vulvar lesions using next generation sequencing technologies, with the hopes of finding a biomarker that could be used to accurately identify the premalignant growths. […] All these factors combined, there is a clear need to develop better ancillary tests for early detection and diagnosis and more personalized treatment approaches for specific vulvar cancer types based on their unique molecular alterations.

• #47 Vaginal and Vulvar Cancer – Gynecologic Cancer Initiative

  https://gynecancerinitiative.ca/vaginal-and-vulvar-cancer/

  Vaginal cancer originates in the vagina, which is also known as the birth canal, and is approximately four times rarer than vulvar cancer. […] At both these sites, changes to cells of the vulva or vagina can lead to precancerous conditions. This means that the abnormal cells are not yet cancer, but there is a chance that they may become cancer if they arent treated. A cancerous (malignant) tumour is a group of cells that can grow into and destroy nearby tissue. […] New research, done in BC, definitively shows that HPV and non-HPV diseases are distinct conditions as they behave differently and have different treatment needs. Non-HPV lesions are associated with more frequent recurrence and a higher risk of death. […] The data in BC suggests that aggressive surgery may be more important in HPV-independent lesions; the higher recurrence rate seen in recent years may be secondary to a change in surgical practice where less morbid surgical interventions had been favoured.

• #48 Vaginal Cancer > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/vaginal-cancer

  When vaginal cancer is caught and treated before it spreads beyond the vagina, 75% of people survive for 5 years or longer. When the cancer spreads to the lymph nodes, the 5-year survival rate is 40%. And when the cancer spreads to distant body parts, only 21% of people live 5 years or longer. […] Researchers at Yale are actively investigating the role of HPV in cancers of the lower genital tract with the goal of early detection and prevention before a cancer even develops.

• #49 Vaginal cancer – The Eve Appeal

  https://eveappeal.org.uk/information-and-advice/gynaecological-cancers/vaginal-cancer/

  Whilst there have been advances in radiation therapy, more research is needed to improve the treatments for vaginal cancer. This may include immunotherapy, which uses the immune system to kill the cancer cells, or other targeted treatments (drugs which target specific proteins and genes which help cancer cells survive and grow).

• #50 Vaginal Cancer | Mays Cancer Center

  https://cancer.uthscsa.edu/cancer-care/types-and-treatments/vaginal-cancer

  We treat rare vaginal cancers using a combination of advanced radiation therapies and chemotherapy not available at other centers in San Antonio. […] Your treatment plan may include external radiation therapy or brachytherapy (radiation delivered inside the body). We use highly specialized techniques, including interstitial and intracavitary brachytherapy, to precisely place radiation compartments next to or inside a gynecological tumor. […] Advanced imaging and computer software enable us to treat tumors with powerful, precise doses. At the same time, we protect healthy tissues that surround a tumor, which helps us minimize treatment side effects.

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