How Does My Doctor Know I Have Vaginal Cancer?
Even if you don’t have symptoms, your doctor or gynecologist may find vaginal cancer during a routine visit to have a pelvic exam and Pap test. If you’re having symptoms of vaginal cancer, your doctor will ask you about these things.
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Your other risk factors, such as a history of human papillomavirus (HPV) infection, vaginal adenosis, history of DES exposure, or previous cancer of the cervix or vulva
The doctor may also perform certain tests to check if you have vaginal cancer. You may need more than one. Here are some of the tests doctors use to diagnose or rule out vaginal cancer.
Pelvic Exam
This exam is recommended as a regular screening for cervical cancer in women. During this exam, your doctor may notice suspicious areas in the vagina or feel thickening or growths in the walls of the vagina. Your doctor does a pelvic exam in the office. You remove your clothes from the waist down and put on a hospital gown. You lie on your back on an exam table and bend your knees. You place your feet in supports called stirrups at the end of the table. This position allows the doctor to look at or feel your uterus, vagina, ovaries, fallopian tubes, bladder, and rectum. The doctor places a tool called a speculum inside your vagina to hold it open and widen it. This lets the doctor see the upper portion of your vagina and your cervix.
If the doctor or nurse notices something suspicious during the pelvic exam, additional tests can help the doctor determine whether you have vaginal cancer.
You may also have a Pap test and human papillomavirus (HPV) test during a pelvic exam.
Pap Test
The Pap test is a way to check for cancer in the cervix. The cervix is the lower part of the uterus that connects to the vagina. Your doctor uses a speculum to widen the vagina during the test. Then he or she gently scrapes a few cells from the wall of your cervix. A special doctor called a pathologist examines these cells under a microscope. This test can’t confirm a diagnosis of vaginal cancer. But it can rule out other gynecologic problems, such as certain infections or cervical cancer. If the doctor notes something unusual in the vagina, he or she may also remove cells from the vagina.
HPV Test
HPV is short for human papillomavirus. This virus usually goes away on its own. In rare cases, HPV can cause vaginal cells to change and become precancerous. Your doctor can do this test at the same time as a Pap test. The doctor uses a second swab to collect cells from your cervix and vagina. Your doctor may even be able to use the same sample for both tests.
Vaginal Colposcopy
For this outpatient procedure, your doctor uses a tool called a colposcope. This is an instrument similar to a microscope. It has binocular lenses that magnify cells of the vagina or cervix.
If your vagina has thinned due to lack of estrogen, the doctor may prescribe topical estrogen for a few weeks before the test. This helps thicken the tissue, which makes you more comfortable and helps make the test more accurate.
You are usually awake for this procedure. During colposcopy, the doctor uses a speculum to widen your vagina. The doctor may “paint” the walls of your cervix and vagina with a mild acetic acid solution. This vinegar-like solution causes any suspicious areas to turn white. Your doctor views your cervix, and then views the walls of your vagina while removing the speculum. If your doctor notices any suspicious-looking spots, he or she can remove them for further study. This is called a biopsy. The doctor may inject local anesthetic in these areas to make them numb before removing the tissue. If the abnormal area is small, your doctor may completely remove it with the biopsy.
The doctor sends any tissue samples to a lab. There, a pathologist checks the samples for cancer.
Biopsy
If the doctor finds something suspicious during your physical exam or tests, he or she will perform a biopsy. The doctor removes a small piece of tissue and sends the sample to a lab. Then a pathologist examines it under a microscope.