Vagina Flashcards
What is the starting point of the vagina?
The vagina starts at the cervix and opens at the vulva.
What type of organ is the vagina?
The vagina is a hollow organ with a muscular wall and a lumen lined mostly with squamous cell epithelium.
What is the vaginal fornix?
The vaginal fornix is a circular fold formed where the vagina cups around the exocervix, connecting to the uterus.
Where is the vagina located?
The vagina is located in the true pelvis.
What is the position of the vagina relative to the bladder?
The vagina is posterior to the bladder.
What is the position of the vagina relative to the rectum?
The vagina is anterior to the rectum.
What is the etiology and epidemiology of vaginal cancer?
Vaginal cancer is extremely rare malignancies.
What age group is most affected by vaginal cancer?
Individuals aged 70 and older are most affected.
Which demographic has the highest risk for vaginal cancer?
Hispanic women are at the most risk, followed by African American women.
What virus is strongly correlated with vaginal cancer?
There is a strong correlation between HPV (Human Papillomavirus) and vaginal cancer.
What are some other risk factors for vaginal cancer?
Other risk factors include smoking, multiple sexual partners, sexual intercourse at an early age, STDs, diethylstilbestrol exposure, previous history of carcinoma in-situ of the cervix, immunosuppression, and history of vaginal irritation.
What is the typical presentation of patients with vaginal intraepithelial neoplasms?
Most patients are asymptomatic at the time of diagnosis.
What typically prompts a diagnosis of vaginal cancer?
Abnormal Pap smear results.
What are typical symptoms of vaginal cancer?
Visible lesion, unusual vaginal bleeding, watery vaginal discharge, a lump or painless mass, painful urination, frequent urination, constipation.
What is an example of unusual vaginal bleeding?
Bleeding after intercourse or after menopause.
What screening methods are available for vaginal cancer?
PAP, colposcopy, biopsy.
What is the most common type of vaginal cancer?
Squamous cell carcinoma (90%)
What type of vaginal cancer is associated with DES exposure?
Clear cell adenocarcinoma
What are other types of vaginal cancer?
Malignant melanomas and sarcomas
Where is the most common site for sarcomas in vaginal cancer?
Upper third of posterior wall
What are the two staging systems for the vagina?
FIGO and TNM
What is Stage O in vagina staging?
Stage O indicates no evidence of disease.
What does Stage I represent in vagina staging?
Stage I indicates invasive cancer confined to the vagina.
What does Stage II signify in vagina staging?
Stage II indicates cancer that has spread beyond the vagina but not to the pelvic wall.
What is Stage III in vagina staging?
Stage III indicates cancer that has spread to the pelvic sidewall or involves lower third of the vagina.
What are the primary treatments for vaginal cancer?
Surgery and Radiation Therapy
What types of radiation therapy are used for vaginal cancer?
EBRT and Brachytherapy
What does EBRT stand for?
External Beam Radiation Therapy
How can early-stage vaginal cancers be treated?
They can be effectively treated with radiation alone or with surgery.
What are the types of Brachytherapy used for vaginal cancer?
Single-channel vaginal cylinder (SCVCB) and multi-channel vaginal cylinder (MCVCB) interstitial BT.
Is chemotherapy used in the treatment of vaginal cancer?
Yes, chemotherapy is also a treatment option.
What are the two effective types of radiation therapy for vaginal cancer?
External Beam Radiation Therapy and Brachytherapy are very effective!
How can early stage tumors be treated?
Patients with early stage tumors can be effectively treated with brachytherapy alone.
What is the total dose of radiation typically administered?
Total dose of 60-70 Gy
45 Gy in 25 fractions of EBRT followed by 5 Gy x 5 fractions HDR brachytherapy.
How are larger tumors treated?
Larger tumors are treated with a combination of EBRT and brachytherapy.
What is the dose tolerance of the vagina?
The dose tolerance of the vagina is high, reaching doses of 100Gy before extensive fibrosis is caused.
What is the dose tolerance of the uterus and cervix?
The uterus and cervix can also tolerate high doses of radiation, which facilitates the effective delivery of brachytherapy to these organs.
Which structures are the most radiosensitive?
The ovaries are the most radiosensitive structures.
What are the acute side effects of radiation treatment for vaginal cancer?
Fatigue, Diarrhea, Cystitis, Nausea, Anorexia
What are the chronic side effects of radiation treatment for vaginal cancer?
Chronic cystitis, Protosiamoiditis, Small bowel enteritis, Obstruction
Which areas usually show the most acute side effects from radiation treatment?
The vulva and perineum
Why do the vulva and perineum show the most acute side effects?
Due to the radiosensitivity of these structures and the quality of the treatment beams used for treatment
