Vaginal Cancer

This section will take you through the basics of what you need to know about vaginal cancer. It will introduce you to the people who may be part of your treatment team and identify the different types of treatments for vaginal cancer. Hopefully, this information will help prepare you to talk with your treatment team and to feel more confident about your treatment plan.

View the information in this section in our brochure, Vulvar and Vaginal Cancers: Your Guide available at the links below.

Vaginal Cancer Overview

Vaginal cancer begins in the vagina, the muscular tube, also called the birth canal, that connects the outer genitalia to the uterus. Most of these cancers are in the lining (squamous epthelilum) of the vagina and usually affect people between 50-70 years old. Primary vaginal cancer is one of the rarest gynecologic cancers as oftentimes cancer cells found in the vagina originate from the uterus, vulva, or other organs.

Because many vaginal cancers are associated with the Human Papillomavirus (HPV) types 16 and 18, vaginal cancer can be prevented by the vaccinations advocated for the prevention of cervical cancer.

Types of Vaginal Cancers

There are four types of vaginal cancer, depending on where the cancer began.

Vaginal squamous cell carcinoma is the most common type and refers to the thin, flat cells that line the surface of the vagina.

Vaginal adenocarcinoma begins in the glandular cells on the surface of the vagina.

Vaginal melanoma develops on the pigment-producing cells of the vagina.

Vaginal sarcoma develops in the connective tissue cells or smooth muscle cells in the vagina walls.

Vaginal Cancer Symptoms

Vaginal cancer, especially at the precancerous and early stages, may not cause any symptoms.

Common signs for more advanced vaginal cancer include:

  • Unusual vaginal bleeding (i.e., between menses, after intercourse, new postmenopausal
  • Pain (vaginal, vulvar, lower abdominal/pelvic, back or flank)
  • Problems with urination or bowel movements
  • Watery vaginal discharge
  • Lump or mass in the vagina

Medical Evaluation and Diagnosis

Vaginal cancer can be found during a routine pelvic examination. To detect this cancer, people sometimes are given a Pap test to look for abnormal cells, an inspection of the vagina with a special lighted microscope and/or sample (biopsy) of the vaginal tissue for testing.

If vaginal cancer is suspected or diagnosed, it is important to seek care first from a gynecologic oncologist—medical doctors with specialized training in treating gynecologic cancers who can manage your care from diagnosis to completion of treatment. Use our Seek a Specialist tool to find a gynecologic oncologist in your area.

During your treatment, you will come in contact with many health care professionals—these people make up your treatment team. They will work with each other and you to provide the special care you need. Learn more about your treatment team.

Surgical Staging

In general, cancers are divided into categories or stages, with the assignment with a stage based on the risk for recurrence.

Vaginal Cancer Stages

Stage 1:

The cancer is found only in the vaginal wall.

Stage 2:

The tumor has spread to the tissue next to the vagina.

Stage 3:

The cancer has spread to the lymph nodes or the pelvis.

Stage IVA:

In addition to spreading to nearby lymph nodes, the cancer also has spread to the bladder, rectum or pelvis

Stage IVB:

The cancer has spread beyond the vagina to areas like the lungs.

Vaginal cancer treatment and side effects

Most patients with vaginal cancer are treated with surgery or radiation therapy.

Vaginal Cancer Treatment Options

Like radiation therapy, surgery is used primarily for early-stage vaginal cancer that is limited to the vagina or, in selected cases, nearby tissue. Large tumors present a challenge since so many important organs are located in the pelvis.

There are several operations to treat vaginal cancer:

● Removal of small tumors or lesions: Cancer only on the surface of the vagina
is removed along with a small part of surrounding healthy tissue to ensure that all
of the cancer cells have been removed.
● Removal of the vagina (vaginectomy): Removing part of your vagina (partial
vaginectomy) or your entire vagina (radical vaginectomy) may be necessary to
remove all of the cancer. Depending on the extent of the cancer (see section
above on staging), it may be necessary to perform a hysterectomy (removal of
the uterus and ovaries) and nearby lymph nodes at the same time.
● Removal of the majority of the pelvic organs (pelvic exenteration): this may involve removal of the
urethra/ bladder/distal ureters and/or anus/rectum. Exenteration is used if the cancer has spread
locally or if vaginal cancer recurs after radiation

Side effects of surgery

Some discomfort is common after surgery. It often can be controlled with medicine. Tell your treatment team if you are experiencing pain. Other possible side effects are:

● Nausea and vomiting
● Infection or fever
● Wound problem
● Fullness due to fluid in the abdomen
● Shortness of breath due to fluid around the lungs
● Anemia
● Swelling caused by lymphedema, usually in the legs
● Blood clots
● Difficulty urinating or constipation

Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects you experience. They can help you find ways to manage them.

Chemotherapy are drugs used to kill cancer cells. Chemotherapy usually injected into a vein, but sometimes can be given as a pill. At the present time, it is not known if chemotherapy is effective for people with vaginal cancer. Chemotherapy can be used as a radiation sensitizer to make the radiation therapy more effective.

Side effects of chemotherapy

Each person responds to chemotherapy differently. Some people may have very few side effects while others experience several. Most side effects are temporary. They include:
• Nausea
• Loss of appetite
• Mouth sores
• Increased chance of infection
• Bleeding or bruising easily
• Vomiting
• Hair loss
• Fatigue

Be sure to talk with your treatment team members about any side effects that you experience. They can help you find ways to manage them.

Radiation therapy (also called radiotherapy) use high-energy x-rays, or other types of radiation, to kill cancer cells or stop them from growing. Radiation is frequently used for more advanced stages of the disease (Stage II-IVA).

For people being treated for vaginal cancer, the radiation can be delivered in two ways.

● External radiation: uses a machine that directs the radiation toward the entire abdomen or just the pelvis, depending on the location of the cancer.
● Internal radiation (also called brachytherapy): involves placing radioactive devices in the vagina or surrounding tissue for a specified period of time.
● Proton beam: Proton therapy, also called proton beam therapy, uses protons rather than x-rays to treat cancer.

The extent of the cancer dictates which or both of these delivery systems are used and in what order.

Side effects of radiation

The side effects of radiation therapy depend on the dose used and the part of the body being treated. Common side effects include:

● Anemia
● Blood in urine or stool
● Diarrhea
● Dry, reddened skin in the treated area
● Discomfort when urinating
● Fatigue
● Narrowing of the vagina
● Pain with intercourse

Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects you experience. They can help you find ways to manage them.

Importance of Participation in Clinical Trials

There are many ongoing clinical trials studying new and better ways to treat gynecologic cancers. Many treatment options are available today because people diagnosed with gynecologic cancers were willing to participate in prior clinical trials.

Clinical trials are designed to test some of the newest and most promising treatments for gynecologic cancers. The Foundation for Women’s Cancer partners with NRG Oncology (formerly Gynecologic Oncology Group), part of the National Cancer Institute cooperative group working only on gynecologic cancer clinical trials, and others to make information about current clinical trials available. For more information about clinical trials available for enrollment, visit