Vaginal Cancer

Is vaginal cancer preventable?

Many women with this cancer have no known risk factors, so it's not always possible to prevent vaginal cancer. However, you may lower your risk of this disease by avoiding HPV infection and smoking, which are both linked to vaginal cancer and others.

Can screening detect vaginal cancer early?

There are no formal vaginal cancer screening guidelines. While regular HPV and Pap smear tests that screen for cervical cancer can detect abnormalities in the cervix, the goal of those tests is not to detect vaginal cancer or precancer (vaginal intraepithelial neoplasia, or VAIN). Still, it's important to stay on top of routine gynecologic care and to discuss any concerns or changes to your body with your doctor.

What tests diagnose vaginal cancer?

If you experience vaginal cancer signs, your doctor will perform a physical exam and ask questions about your health, lifestyle, and personal and family medical history. One or more tests or procedures may be used to confirm a vaginal cancer diagnosis, including:

• Colposcopy: Similar to a pelvic exam, your doctor may examine the vagina in the office. During this test, they'll use a colposcope, which has magnifying lenses, to closely view the vaginal walls and cervix.
• Biopsy: This procedure involves removing a small tissue sample for evaluation by a pathologist under a microscope.
• Imaging tests: Imaging, such as CT, MRI, or PET scans, can show how far the cancer has spread.
• Endoscopic tests: Although uncommon for diagnosing vaginal cancer, endoscopy procedures may be used to check for cancer spread to certain organs. For example, a proctosigmoidoscopy allows your doctor to use a thin, lighted tube to evaluate any potential spread to the rectum and colon, while a cystoscopy may be used to check for spread to the bladder.

What is the most common type of vaginal cancer?

Overall, these cancers are extremely rare. However, most cases of vaginal cancer begin in the squamous cells of the vagina and are called squamous cell carcinoma.

Other, even rarer subtypes of this cancer may include:

• Adenocarcinomas
• Melanomas
• Sarcomas

It's more common for women to develop a gynecologic cancer that begins in another organ in the female reproductive system and spreads to the vagina. These cancers are named based on the organ where they start.

What are the stages of vaginal cancer?

Staging describes the extent of disease, or how far cancer has spread. Vaginal cancer stages include:

• Stage O (carcinoma in situ or CIS): This precancerous stage develops when abnormal cells develop on the surface of the vaginal skin. Vaginal precancer is often called vaginal intraepithelial neoplasia or VAIN.
• Stage I: Cancer is contained to the vaginal walls
• Stage II: Cancer may have spread outside of the vaginal walls but not to the walls of the pelvis
• Stage III: Cancer has spread beyond the vagina to the walls of the pelvis and possibly nearby lymph nodes
• Stage IV (metastatic vaginal cancer): Cancer has spread outside of the vagina to other organs

What does vaginal cancer treatment involve?

After a vaginal cancer diagnosis, a multidisciplinary team of doctors will meet to review the treatment options best suited for you. Treatment varies based on different factors, including:

• The type and stage of your cancer
• Your overall health
• Your goals and preferences

Treatment is personalized to you and may involve one or more of the following approaches.

Surgery

If you have early-stage vaginal cancer, your doctors may recommend surgery. The type of surgery that will be appropriate for you will depend on the location, size, and stage of your cancer. Our gynecologic oncologists are experts in all types of surgery for vaginal cancers, including:

• Laser surgery: Destroys precancerous cells (VAIN) only, using a thin laser beam
• Local or wide excision: Removal of the cancer and a portion of healthy tissue that surrounds it
• Vaginectomy: Removal of all or part of the vagina
• Trachelectomy: Removal of the cervix that preserves the vagina for women who wish to keep their ability to have children
• Hysterectomy: Removal of the uterus and cervix and some or none of the vagina
• Lymph node dissection: Examination and removal of affected lymph nodes
• Vaginal reconstruction: Sophisticated procedures that use skin or tissue grafts to rebuild the appearance and function of the vagina and surrounding areas

If you are a candidate for surgery, your doctor will thoroughly explain the pros and cons of your options and help you feel confident in knowing what to expect during and after treatment.

Chemotherapy

Chemotherapy is a cancer treatment that affects the whole body. This approach involves different medications and drug combinations to destroy cancer cells. Some may be given orally via a pill while others may be used topically as a lotion or ointment, or intravenously infused into the bloodstream. Our medical oncologists are experts in the latest chemotherapy options for treating vaginal cancer. If this treatment is appropriate for you, you can expect individualized recommendations on the timing, dosage, and type of chemotherapy that will be most effective for you.

Learn More About Chemotherapy

Immunotherapy

Immunotherapy stimulates the body's immune response to cancerous cells. There are several different types of this therapy available for treating other, more common cancers. We continue investigating its role in treating gynecologic cancers, such as vaginal cancer.

Learn More About Immunotherapy

Radiation therapy

Radiation is a common vaginal cancer treatment. It involves using high-energy rays or particles to kill cancer cells. Radiation therapy may be delivered from outside of the body using external beam radiation therapy or internally to the vagina using brachytherapy. Your care team will include radiation oncologists who use the most advanced radiation technologies available today to more precisely pinpoint radiation while limiting exposure to healthy tissue. They'll also closely monitor your body's response and help you manage any uncomfortable symptoms throughout treatment, making adjustments as necessary.

Learn More About Radiation Therapy