Vaginal cancer

Question 1

List the options for treatment of VAIN

Answer 1

• Medical:
  
  • Imiquimod
  • 5-fluorouracil
• Surgical:
  
  • CO2 laser vaporisation
  • Surgical excision

Question 2

Outline the work-up and investigations for suspected vaginal cancer

Answer 2

• Colposcopy of vagina, cervix and vulva, full-thickness biopsies
• +/- EUA if exam difficulties
• Imaging: MRI pelvis, PET-CT
• Bloods: FBC, U&Es, LFTs

Question 3

Outline the FIGO staging for vaginal cancer

Answer 3

Stage I: confined to vagina

Stage II: spread to paravaginal tissues but not pelvic sidewall or LNs.

Stage III: spread to pelvic sidewall, lower ⅓ vagina and renal tract, pelvic and groin nodes.

Stage IV: spread to bladder, bowel, outside pelvis

Question 4

Outline management options of vaginal cancer by stage:

Answer 4

Stage I upper vagina: radical hysterectomy, vaginectomy, pelvic lymphadenectomy.

Stage I lower vagina: radical wide local excision, bilateral groin node dissection.

Stage II-IV: chemoradiation