Vaginal Cancer: Overview

What is vaginal cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Vaginal cancer starts in the cells that form the vagina or birth canal. The vagina connects the uterus to the outside of the body. Most vaginal cancers start in the cells that line the inside of the vagina. They can start in other parts of the vagina, too.

Who is at risk for vaginal cancer? 

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change. 

The risk factors for vaginal cancer include:

• Older age

• HPV (human papillomavirus) infection

• Changed cervical cells or cervical cancer in the past

• Smoking tobacco

• Your birth parent took a medicine called DES while pregnant with you

• Changes in the cells lining the vagina (vaginal adenosis)

Talk with your healthcare provider about your risk factors for vaginal cancer and what you can do about them.

Can vaginal cancer be prevented?

There is no sure way to prevent vaginal cancer. Some risk factors can be controlled to help reduce risk.

Are there screening tests for vaginal cancer?

There are currently no regular screening tests for vaginal cancer. Screening tests are done to check for disease in people who don’t have symptoms. But sometimes a Pap test may find abnormal cells that started in the vagina. And regular pelvic exams may help find vaginal cancer early, when it’s small and before it has spread. 

What are the symptoms of vaginal cancer?

You can have vaginal cancer with no symptoms. Common signs of vaginal cancer include:

• Bleeding or discharge not related to your period

• A lump in your vagina

• Pelvic pain

• Pain during sex

• Bleeding from the vagina after sex

• Pain when you urinate

• Trouble having a bowel movement (constipation)

Many of these may be caused by other health problems. But it's important to see a healthcare provider if you have any of these symptoms. Only a healthcare provider can tell if you have cancer.

How is vaginal cancer diagnosed?

The most common way to find vaginal cancer is unusual bleeding that causes a person to see a healthcare provider. The healthcare provider will do a pelvic exam and a Pap test. A colposcopy may be done. To do this, the provider uses a lighted tool with a magnifying lens to get a close-up look at the inside of the vagina. The tool is not put into your vagina, but a speculum is put in to open the vaginal walls so they're easier to see. 

A biopsy is the only way to know if a lump or change is cancer. Small pieces of tissue (samples) are taken out and tested for cancer cells. A hollow needle may be used to take out the bits of tissue. The samples are sent to a lab. Your results will come back in about 1 week.

After a diagnosis of vaginal cancer, you may need other tests, like X-rays and imaging scans. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much cancer there is and if and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

How is vaginal cancer treated?

Your treatment choices depend on the type of vaginal cancer you have, test results, and the stage of the cancer. Other things to think about are if you want to be able to have kids and your overall health. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Cancer treatments are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have spread in your body. When taken by pill or injection, chemotherapy is a systemic treatment.

You may have just one treatment or a combination of treatments. Most people with vaginal cancer will be treated with radiation and chemotherapy. Sometimes you may have surgery.

Talk with your healthcare providers about your treatment choices. Make a list of questions. Think about the benefits and possible side effects of each choice. Talk with your healthcare provider about your concerns before making a decision.

What are treatment side effects?

Cancer treatment, such as chemotherapy and radiation, can damage normal cells. This can cause side effects, such as hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Vaginal cancer treatments can also affect your sex life. This may be hard to talk about, but sex is an important part of life. Ask what you can expect to happen and what you can do to help limit any changes.

Coping with vaginal cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about vaginal cancer

• Most vaginal cancers start in the cells that line the inside of the vagina. They can start in other parts of the vagina, too.

• Talk with your healthcare provider about your risk factors for vaginal cancer and what you can do about them.

• There are currently no regular screening tests for vaginal cancer. But sometimes a Pap test may find abnormal cells that started in the vagina. And regular pelvic exams may help find vaginal cancer early, when it’s small, before it has spread, and is more easily treated.

• A biopsy is the only way to know if a lump or change is cancer.

• Your treatment choices depend on the type of vaginal cancer you have, test results, and the stage of the cancer.

• Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.