Squamous cell carcinoma of the vagina

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Squamous cell carcinoma of the vagina (SCCV)

What it is
- SCCV is a cancer that starts in the flat, lining cells of the vagina. It usually grows slowly and may not cause symptoms early on.

How common it is
- It is the most common type of vaginal cancer, but vaginal cancers are rare overall. SCCV accounts for about 80–90% of vaginal cancers and about 2% of all gynecologic cancers.
- In the United States, about 3,000 new cases are diagnosed each year. The average age at diagnosis is about 60 years old, but it can occur in younger people too.

Symptoms
- Abnormal vaginal bleeding, especially after menopause
- A lump or mass in the vagina
- Pain during sex
- Pelvic pain, pain with urination, or constipation
- Some people have no symptoms early on

Risk factors
- HPV infection (especially high-risk HPV)
- Smoking
- Early age at first sexual intercourse and/or having many sexual partners
- Age over 60
- History of cervical cancer, alcohol use, and lower socioeconomic status
- Having had a hysterectomy or pelvic organ prolapse may also be linked

Diagnosis
- Pelvic exam and biopsy of vaginal tissue
- Additional tests can include Pap smear, colposcopy, and imaging studies (CT, MRI, PET) to see if the cancer has spread
- Chest X-ray and bone scans may be used to check for spread

Treatment
- The main treatments are tailored to the cancer’s stage and location, and whether the uterus or prior treatments affect plans
- Radiation therapy is common, either from outside the body or placed directly near the tumor
- Chemotherapy may be used, especially in later stages
- Surgery is uncommon but can be considered for very early, fully removable cancers
- After treatment, regular follow-up is needed to watch for recurrence. If the cancer comes back, treatment may be more limited, and palliative care may be used

Prognosis
- Outcome depends on how advanced the cancer is at diagnosis and the size of the tumor. Earlier, smaller tumors have a better prognosis.
- Factors like tumor location, previous hysterectomy, and age can influence outlook, but stage is the most important factor.

Key takeaways
- SCCV is the most common vaginal cancer but remains rare.
- HPV infection, smoking, and age are important risk factors.
- Early detection through exam and biopsy improves chances for successful treatment.