Vaginal Cancer

Overview

Vaginal cancer is a rare type of cancer that begins in the vagina, the tube in females that connects the uterus (womb) to the outer genitals. Vaginal cancer most commonly develops in the cells that line the surface of the vagina, which is known as the birth canal.

Four of the main types of vaginal cancer are:

• Vaginal adenocarcinoma – this type begins in the glandular cells on the surface of the vagina.
• Vaginal melanoma – this type begins in the pigment-producing cells – known as melanocytes – of the vagina.
• Vaginal sarcoma – this type develops in the connective tissue or muscle cells of the walls of the vagina.
• Vaginal squamous cell carcinoma – this type begins in the thin, flat cells – known as squamous cells – that line the surface of the vagina. This is the most common type of vaginal cancer.

Vaginal cancer causes

Vaginal cancer occurs when the cells of the vagina develop mutations (changes) to their DNA, and then the abnormal cells multiply out of control.

Vaginal cancer risk factors

Factors that may increase your risk for developing vaginal cancer are:

• Becoming sexually active at a young age
• Being a smoker
• Being exposed to a miscarriage prevention drug known as diethylstilbestrol – or DES – during the 1950s
• Being older than age 60
• Having human immune insufficiency virus (HIV)
• Having multiple sexual partners
• Having vaginal intraepithelial neoplasia, or VAIN

Vaginal cancer symptoms

Signs and symptoms of vaginal cancer can include:

• Constipation
• Lump or mass in the vagina that can be felt
• Needing to urinate often (urgency)
• Pain while urinating
• Pelvic pain
• Unusual vaginal bleeding, such as after sexual intercourse or after menopause
• Watery discharge from the vagina

Vaginal cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam, including asking questions about your health history, your symptoms and related risk factors. During this time, your doctor will also perform a pelvic exam to check for irregularities.
• Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer.
• Colposcopy – during this exam, your doctor uses a lighted magnifying instrument (colposcope) to closely examine the surface of your vagina for any irregularities.
• Imaging tests – your doctor may use imaging tests – such as X-ray, computerized tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) scan – to look closely at the inside of your vagina and check for signs of vaginal cancer.

Vaginal cancer treatments

Depending on your personal health history, the extent of the cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible. Depending on the extent of your vaginal cancer, your doctor may recommend a partial or radical (complete) vaginectomy or removal of the vagina.
• Chemotherapy – you may need to also undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Radiation therapy – during this treatment, powerful energy beams – such as X-ray or protons – destroy cancer cells. Depending on what your doctor determines is best for you and your situation, the radiation therapy may be delivered outside or inside the body.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. Your doctor may suggest seeing an oncologist for more specialized treatment.