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Topical Therapy for Vaginal Pre-Cancer
Topical therapy puts the drug right onto the affected area. This may be done to treat vaginal pre-cancer (vaginal intraepithelial neoplasia or VAIN), but it's not used to treat invasive vaginal cancer.
Two drugs are used most often for topical therapy:
- Fluorouracil (5-FU) is a chemotherapy drug that can be put directly on the lining of the vagina. This is repeated weekly for about 10 weeks or given nightly for 1 to 2 weeks. However, this treatment can cause severe vaginal and vulvar irritation. Also, it may not work as well as using a laser or simply removing the area of abnormal cells with surgery.
- Imiquimod (Aldara) is a cream that can be applied to the area of VAIN. Imiquimod is not a chemotherapy drug. Instead, it acts by boosting the body’s immune response to the area of abnormal tissue. This treatment has led to improvement of VAIN (the lesions changed from VAIN 2 or 3 to VAIN 1). In about half of women with VAIN 1 or 2, it has caused VAIN to go away.
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Fiascone S, Vitonis AF, Feldman S. Topical 5-Fluorouracil for Women With High-Grade Vaginal Intraepithelial Neoplasia. Obstet Gynecol. 2017 Dec;130(6):1237-1243. doi: 10.1097/AOG.0000000000002311. PMID: 29112645.
Gurumurthy M, Cruickshank ME. Management of vaginal intraepithelial neoplasia. J Low Genit Tract Dis. 2012;16(3):306-312.
Rahangdale L, Lippmann QK, Garcia K, Budwit D, Smith JS, van Le L. Topical 5-fluorouracil for treatment of cervical intraepithelial neoplasia 2: a randomized controlled trial. Am J Obstet Gynecol. 2014 Apr;210(4):314.e1-314.e8. doi: 10.1016/j.ajog.2013.12.042. Epub 2013 Dec 31. PMID: 24384495.
Sasagasako N, Kosaka K, Sagae Y, Itoh K, Aratake J, Yamada K, et al. Recurrent vaginal intraepithelial neoplasia successfully treated with topical imiquimod: A case report. Mol Clin Oncol. 2020 Sep;13(3):19. doi: 10.3892/mco.2020.2089. Epub 2020 Jul 13. PMID: 32754333; PMCID: PMC7391826.
Last Revised: September 23, 2024
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