Supportive care for vaginal cancer

Supportive care helps women meet the physical, practical, emotional and spiritual challenges of vaginal cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from vaginal cancer and adjusting to life after treatment is different for each woman, depending on the stage of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A woman who has been treated for vaginal cancer may have the following concerns.

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Vaginal cancer and its treatments can affect a woman’s self-esteem and body image. Often this is because cancer or cancer treatments may result in body changes, such as:

• scars
• hair loss
• skin changes
• changes in body weight
• an ostomy
• urinary or bowel problems
• sexual problems

Some of these changes can be temporary, others will last for a long time and some will be permanent.

For many women, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may feel angry or upset, afraid to go out or afraid others will reject them, even if the effects of treatment may not show on the outside of the body.

Find out more about self-esteem and body image.

Many women continue to have strong, supportive relationships and a satisfying sex life after vaginal cancer. If sexual problems occur because of vaginal cancer treatment, there are ways to manage them.

Some of the side effects of cancer treatment that can make sex painful or difficult include:

• Vaginal dryness caused by cancer treatments, such as radiation therapy or surgery.
• Vaginal narrowing caused by scarring after radiation therapy to the pelvic area or some vaginal cancer surgeries.
• Treatment-induced menopause caused by cancer treatments such as radiation therapy or surgery.

Some women may lose interest in having sex. It is common to have a decreased interest in sex around the time of diagnosis and treatment.

When the woman first starts having sex after treatment, she may be afraid that it will be painful or that she will not have an orgasm. The first attempts at being intimate with a partner may be disappointing. It may take time for the couple to feel comfortable with each other again. Some women and their partners may need counselling to help them cope with these feelings and the effects of cancer treatments on their ability to have sex.

Find out more about sexuality and cancer and sexual problems for women.

Lymphedema is a chronic form of swelling that occurs when lymph fluid builds up in tissues. It usually occurs in parts of the body where large numbers of lymph nodes have been removed.

You may have lymphedema in your legs if lymph nodes were removed from your pelvis or groin. Lymphedema is more likely to occur if you were also given radiation therapy to the pelvis.

If lymphedema develops, your healthcare team can suggest ways to reduce swelling as much as possible and help prevent further fluid buildup. This may include elevating the limb, exercise, physical therapy and pain management. You can also ask for a referral to a healthcare professional who specializes in managing lymphedema.

Find out more about lymphedema.

Many women who are treated for vaginal cancer worry that the cancer will come back. It is important to learn how to deal with these fears to maintain a good quality of life.

In addition to the support offered by the treatment team, a mental health professional, such as a social worker or counsellor, can help you learn how to cope and live with a diagnosis of vaginal cancer.

An ostomy connects an internal cavity on the abdomen to an opening that leads outside the body. Women who have a pelvic exenteration will have the bladder or rectum or both removed. If you have your bladder removed, a urostomy allows urine to pass out of the body. If you have your rectum removed, a colostomy allows stool to pass out of the body. Women who have the bladder and rectum removed will have 2 ostomies, a urostomy and a colostomy.

Many women can adapt to and live normally with an ostomy, although they have to learn new skills and how to care for it. Specially trained healthcare professionals (called enterostomal therapists) teach people how to care for their ostomies.

Find out more about living with an ostomy.

Women who have radiation therapy to the pelvis have a small risk of developing a second cancer in the area treated with radiation. This area can include the colon, rectum, anus or bladder. While the possibility of developing a second cancer is frightening, the benefit of treating vaginal cancer with radiation therapy usually far outweighs the risk of developing another cancer.

Living a healthy lifestyle and working with your healthcare professional to develop a wellness plan for staying healthy may help lower the risk of second cancers. Being aware of changes in your health and reporting problems to your doctor are also important parts of follow-up care after cancer treatment.