VAGINAL CARCINOMA

♦ Primary

♦ Secondary

Primary Incidence: The incidence of primary vaginal carcinoma is very rare (about 0.6 per 100,000 women). It constitutes about 1 percent of genital malignancies.

The primary vaginal carcinoma should fulfil the following criteria.

• The primary site of growth is in the vagina.
• The cervix and the vulva must not be involved.
• There must not be clinical evidence of metastatic disease.

Etiology: Exact etiology is unknown. Following

factors are often related:

• HPV may have a causal relationship.
• Progression from vaginal intraepithelial neoplasia (VAIN).
• Women with history of cervical cancer (multicentric neoplasia).
• Diethyl stilboesterol (DES) is related with clear cell adenocarcinoma of the vagina. This is found in those who had history of intrauterine exposure to diethyl stilboesterol.
• Previous irradiation therapy to the vagina or immunosuppression.
• Prolonged use of pessary.
• More common amongst whites than blacks.

PATHOLOGY: -

Site: The commonest site is in the upper-third of the posterior wall.

Naked eye: The growth may be ulcerative or fungative.

Histopathology: Squamous cell carcinoma accounts for more than 90 percent of the cases. The rest are adenocarcinoma, melanoma, fibrosarcoma, sarcoma botryoides and malignant mixed mullerian tumors.

Spread is by direct continuity, by lymphatics  and rarely, blood borne. Inguinofemoral lymph nodes and pelvic lymph nodes are commonly involved. Hematogenous spread involves the lungs, Liver or the bones.

Clinical features: The mean age of the patient is about 55 years.

SYMPTOMS

- May be asymptomatic, being accidentally discovered during routine screening procedures.

- Abnormal vaginal bleeding including postcoital bleeding is conspicuously present as an early symptom.

- Foul smelling discharge per vaginum.

SIGNS: -

- Speculum examination reveals an ulcerative, nodular or exophytic growth.

- The cervix looks apparently normal.

 DIAGNOSIS

• During cytology, screening procedure to detect abnormal cells.
• Colposcopic examination and targeted biopsy are helpful for patients with abnormal cytology or unexplained vaginal bleeding.
• Cystourethroscopy, proctosigmoidoscopy, CT/MRI (for nodes), are done.
• Biopsy from clinically suspected lesion.

HOMOEOPATHIC MANAGEMENT OF VAGINAL CARCINOMA: -

Here are some medicines that prove effective in managing cancer in women.

Baryta iodide :- This medicine provides instant relief and is highly efficient in the cases of cancerous cells.

Calcarea Flour :- Helpful in curing hardness and abnormal growth of the cells. It also prevents the growth of cancerous cells.

Silicea :- An effective painkiller, this medicine provides relief in pain caused by all types of cancers in women.

Conium:- Helpful in providing relief from pain as well as scarred tissues.

Phytolacca :- It works by managing painful cancerous cells.

Iodum :- Helpful for cases where hemorrhage has caused much destruction. It also gives relief in symptoms such as Excessive hunger and aggravation induced warmth.

Carbo animalis :- The patient gets relief in symptoms such as vaginal discharge, burning in the vulva, bluish skin, and swollen glands