Vaginal cancer usually begins with precancerous changes that may last for many years. Precancerous lesions in the vagina are often called vaginal intraepithelial neoplasia (VAIN). Intraepithelial means that the precancerous cells are only in the lining layer of the vagina. This is called the epithelium. But these changes may develop into invasive vaginal cancer in some women.
These are the 3 grades of VAIN.
- VAIN 1 (the thinnest)
- VAIN 2
- VAIN 3 (the thickest, also called carcinoma in situ or stage 0 vaginal cancer)
If your doctor makes a diagnosis of VAIN with colposcopy and biopsy, he or she may treat it right away. The type of treatment your doctor suggests depends, in part, on how far the lesion has progressed. Your doctor may suggest one of these types of treatment.
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LEEP (loop electrosurgical excision procedure). Your doctor may use LEEP to remove a very thin strip of tissue. This procedure uses an electrical current to cut lesions out. You may have this done in the doctor’s office after the doctor puts medicine into your vagina to numb it. You may have mild cramping during LEEP, which takes about 10 minutes. Also, expect to have mild to moderate cramping, and bleeding afterward.
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Topical chemotherapy. Your doctor applies a chemotherapy drug to the lining of the vagina. The drug kills cancer cells in the lining. The drug most often used is Efudex (fluorouracil, also called 5-FU). You usually receive treatments once a week for about 10 weeks or every night for 1 or 2 weeks. You may notice irritation to the vagina or vulva.
What to expect after your treatment depends on which treatments you receive. Your doctor will explain steps you can take to aid healing. Be sure to ask your doctor how often you’ll need follow-up exams or tests. For example, you may need more frequent Pap tests or colposcopy.
