A rare cancer in the vagina, or canal connecting the uterus to the outside vulva. Early detection and treatment are key.
What is vaginal cancer?
Primary vaginal cancer is a rare type of cancer that arises from malignant cells in the vaginal lining, or occasionally the deeper tissues in the tissues. The vagina is a muscular canal that extends from the cervix (the lower part of the uterus) to the vulva outside of the body. Primary vaginal cancer is very rare. It is more likely that cancer found in the vagina has spread from another location.
The American Cancer Society estimates that vaginal cancer diagnoses account for only 1 to 2% of all cancers in the female genital tract, making it very rare. It often occurs later in life, with the average age at diagnosis around 60 years old. Our AHN Gynecological Oncology team has experience in treating this rare cancer and understands the complexities of treatment.
We also cater to your emotional needs after diagnosis. We know the logistics of cancer treatment can be daunting, and we are here to support you:
- Navigation Team: The Navigation Team coordinates appointments, answers questions, and provides guidance. Learn more about the Navigation Team.
- Social workers: An oncology social worker helps patients and families cope with the emotional aspects of living with cancer.
- Support services: We provide a range of support services to treat the whole person, such as support groups and palliative care. Find out more about support services.
AHN Gynecologic Oncology Center of Excellence
The AHN Gynecologic Oncology Center of Excellence is a specialized center dedicated to the comprehensive care of women with gynecologic cancers and complex gynecologic conditions. We focus on cancer care from diagnosis to treatment to ringing the bell. We collaborate with specialists throughout the cancer center and hopsital system to develop customized treatment plans and to provide exceptional care.
Why choose AHN for vaginal cancer treatment?
At the Cancer Institute, we take a collaborative approach to your care. You meet with a devoted team of cancer specialists, typically within three days of diagnosis. Your team quickly works to design an effective treatment plan tailored to the stage of the cancer. We routinely discuss your progress and determine if we should change the treatment to better meet your needs. At the Cancer Institute, you can expect:
- Patient-centered care: We meet with you and your family to discuss the details of your treatment plan so you feel confident and informed. You’ll see the same team of physicians throughout your care. Your doctors get to know you, your family, and your personal preferences. We also offer robust support services to keep you living the best quality of life during treatment.
- Sophisticated treatment: Your specific treatment will largely depend on how far the cancer has spread. We offer an array of options to stop the cancer in its tracks. Treatments may include chemotherapy, raditation therapy, or surgery.
- Access to clinical trials: We participate in many clinical trials, keeping you at the forefront of the latest treatment options.
- A convenient, after-hours cancer clinic: AHN opened the first After Hours Oncology Clinic in western Pennsylvania for patients with cancer. If you are experiencing side effects from treatment, call your physician’s office, then visit our clinic, conveniently located at West Penn Hospital. We treat you quickly without exposing your compromised immune system to the germs you may encounter in a traditional emergency room. Plus, our clinic is more affordable than a visit to the ER. And since our oncology specialists have access to your records, they may even be able to advise you over the phone and save you from making a trip.
Vaginal cancer symptoms and signs
Being aware of any changes in your body and seeking medical care early is helpful in detecting vaginal cancer. The symptoms can overlap with other health issues, so it’s important to talk to your doctor about any new or worsening health conditions or changes you’ve noticed.
Symptoms and signs of vaginal cancer can include:
- Unusual vaginal bleeding, such as bleeding after intercourse, bleeding between periods, or after menopause
- Watery vaginal discharge
- A lump or mass in the vagina
- Pain in the pelvic area
- Pain during intercourse
- Frequent or urgent urination
- Constipation or blood in the stool.
Causes and risk factors
While the exact causes of vaginal cancer aren't fully understood, certain factors can increase your risk of developing the disease.
- Age: The risk of vaginal cancer increases with age.
- Exposure to diethylstilbestrol (DES): Women whose mothers took DES during pregnancy have an increased risk.
- Human papillomavirus (HPV) infection: HPV is a common sexually transmitted virus that can cause gynecologic cancers, such as vaginal, cervical, and vulvar cancer.
- Smoking: Smoking increases the risk of many cancers, including vaginal cancer.
- Previous history of cervical cancer or cervical intraepithelial neoplasia (CIN): These conditions can increase the risk of vaginal cancer.
Vaginal cancer screening and diagnosis
One of the best ways to support your overall reproductive and vaginal health is by having regular pelvic exams. These exams are essential, playing a crucial role in the prevention and early detection of cervical and vaginal cancers. These exams, along with screenings like Pap tests, can identify precancerous changes, allowing for timely intervention and treatment. Early detection significantly improves treatment outcomes and overall survival rates.
The screening and diagnosis options for vaginal cancer often include:
- Pelvic exam: A routine physical examination of the vagina, cervix, uterus, bladder, and rectum.
- Pap test: While primarily a cervical cancer screening tool, a Pap test can sometimes detect abnormal cells in the vagina.
- Colposcopy: If abnormal cells are found during a Pap test or pelvic exam, a colposcopy uses a lighted, magnifying instrument to examine the vagina and cervix more closely.
- Biopsy: A tissue sample is taken from any suspicious areas during a colposcopy for further examination by a pathologist to render a diagnosis.
- Imaging tests: May include MRI, CT scans, and PET scans, to determine the extent of the cancer.
Types and stages of vaginal cancer
There are several types of vaginal cancer. The most common are:
- Squamous cell carcinoma: This is the most common type, accounting for the majority of vaginal cancers. It develops from the squamous cells that line the surface of the vagina. It's often associated with HPV infection.
- Adenocarcinoma: This type develops from glandular cells in the vagina. A subtype called clear cell adenocarcinoma is linked to DES exposure in women whose mothers took the drug during pregnancy.
- Melanoma: This type develops from melanocytes, the pigment-producing cells in the skin. Vaginal melanoma is rare.
- Sarcoma: This is a rare type of cancer that develops from connective tissues in the vagina, such as muscle or blood vessels.
The staging of vaginal cancer is based on the TNM system, which considers the extent of the primary tumor (T), if the nearby lymph nodes are affected (N), and if tumors have spread, also called metastasis (M). The stages range from one to four, with higher numbers indicating more advanced cancer. Your AHN care team will talk with you about the staging of your specific cancer, but overall, the staging of vaginal cancer generally means:
- Stage 0 (VAIN3/Carcinoma in situ): Abnormal cells are found only in the surface layer of cells lining the vagina. This is considered a precancer.
- Stage 1: The cancer is confined to the vaginal wall.
- Stage 2: The cancer has spread to the paravaginal tissues (the tissues next to the vagina) but has not reached the pelvic wall.
- Stage 3: The cancer has spread to the pelvic wall and/or may have spread to the regional lymph nodes.
- Stage 4A: The cancer has spread to nearby organs, such as the bladder or rectum.
- Stage 4B: The cancer has spread to distant sites, such as the lungs, liver, or bone.
Vaginal cancer treatment
Vaginal cancer treatments can have significant effects on fertility and sexual health. It's essential for patients to discuss these potential impacts with their health care team before starting treatment to understand their options and make informed decisions.
Surgery
Surgery may be recommended to remove the cancerous tissue. The type of surgery depends on the size and location of the tumor. Your surgeon will discuss in detail if surgery is recommended to treat your cancer. Surgical options could include:
- Local excision: Removal of the tumor and a small amount of surrounding tissue. This may be an option for vaginal precancer or very early-stage cancer.
- Vaginectomy: A partial vaginectomy removes only a portion of the vagina. This can shorten or narrow the vagina, leading to pain or discomfort during intercourse (dyspareunia). A total vaginectomy will eliminate the possibility of vaginal intercourse.
- Radical vaginectomy: Removes the entire vagina, along with surrounding tissues and lymph nodes. This may be performed in conjunction with a hysterectomy.
- Hysterectomy: Removal of the uterus and cervix. This may be performed if the cancer is in close proximity to or has spread to these organs. This will eliminate the possibility of carrying a pregnancy in the future.
- Pelvic exenteration: An extensive surgery that involves removing the vagina, cervix, uterus, ovaries, fallopian tubes, bladder, and rectum/colon. This is typically reserved for very specific scenarios, when cancer has recurred locally in the pelvis after prior radiation treatment. This ultraradical surgery is a life-altering procedure that can impact body image and sexual function.
- Lymph node removal: Lymph nodes in the pelvis and/or groin may be removed to check for cancer spread.
Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells. Radiation is generally preferred as treatment of vaginal cancer confined to the pelvis. It can be used as primary treatment, alone or in combination with surgery or chemotherapy, or after surgery. Types of radiation therapy used to treat vaginal cancer include:
- External beam radiation therapy (EBRT): Radiation is delivered from a machine outside the body.
- Brachytherapy (internal radiation): Radioactive material is placed directly into or near the tumor using applicators.
Chemotherapy
These medicines directly kill cancer cells, much like antibiotics kill bacteria. Because the medicines also damage normal cells, side effects can occur, such as hair loss, nausea, or lowered blood counts. Fortunately, the body’s normal cells are more resilient and recover much better than cancer cells, so the side effects are usually temporary. We monitor you carefully and calculate your dose of chemotherapy to maximize effectiveness and minimize side effects. Our oncology social workers and a Navigation Team are available to answer questions and provide support.
Some chemotherapy drugs can damage the ovaries, leading to temporary or permanent infertility. The risk depends on the specific drugs used, the dose, and the patient's age. Chemotherapy can also cause menopausal symptoms like vaginal dryness, hot flashes, and decreased libido, which can impact sexual function.
Targeted therapy
Targeted therapy drugs target specific molecules involved in cancer growth and spread. These drugs may be used to treat certain types of vaginal cancer.
Immunotherapy
Immunotherapy helps the body's immune system fight cancer. We use the latest immunotherapy drugs available. It may be an option for advanced vaginal cancer.
Clinical trials
Our oncology team meets monthly to discuss new clinical trials, ensuring you have access to the latest treatment options. Ask your primary care doctor or oncologist for more information about active or upcoming clinical trials.
Fertility preservation for women
Certain cancer treatments can make it difficult or impossible to conceive a child later. At AHN, you may choose to freeze (cryopreserve) and store unfertilized eggs or fertilized embryos for later use. We’ll connect you with AHN’s fertility treatment specialists and high-risk pregnancy doctors at our Center for Reproductive Medicine.
Vaginal cancer FAQs
Given the rarity of vaginal cancer, questions are completely normal and expected. Your AHN care team is your best resource to get answers to your specific case; but to help get you started in gathering trusted information, we’ve compiled frequently asked questions that our patients often have. Use these when meeting with your care team to help guide your conversations.
Can you die from vaginal cancer?
Yes, if not diagnosed and treated early, vaginal cancer can be fatal. However, with early detection and appropriate treatment, the prognosis can be favorable.
What causes vaginal cancer?
The exact cause isn't always clear, but most vaginal cancers are linked to the human papillomavirus (HPV). Other risk factors that can cause vaginal cancer include:
- Older age
- History of cervical cancer or abnormal cervical cells
- Smoking
- Diethylstilbestrol (DES) exposure in utero
- HIV infection
Is vaginal cancer curable?
Yes, vaginal cancer is often curable, especially when detected and treated in its early stages. Treatment options include surgery, radiation therapy, and chemotherapy. The specific approach depends on the stage and type of cancer, as well as the patient's overall health.
What does vaginal cancer feel like?
In its early stages, vaginal cancer may not cause any noticeable symptoms. But, as it progresses, symptoms can include:
- Unusual vaginal bleeding or discharge
- Pain in the pelvis
- Pain during intercourse
- A lump or mass in the vagina
- Frequent or painful urination
- Constipation or blood in the stool
What is the first stage of vaginal cancer?
The first stage of vaginal cancer is Stage I, where the cancer is confined to the vaginal wall.
Contact us
Call 412-578-HOPE 412-578-4673 to speak with an AHN Cancer Institute scheduling coordinator, schedule your appointment online, or connect with a nurse navigator.
Cancer screening
We hold weekly and monthly cancer screening clinics throughout western Pennsylvania to make it easy to screen for seven different types of cancer, including cervical cancer. Pap tests primarily screen for cervical cancer, but they can sometimes detect abnormal cells in the vagina as well. Schedule a screening to help detect cancer early, before symptoms begin.
Second opinions
If you want a second opinion regarding a cancer diagnosis, treatment options, or prognosis, our team of oncology specialists can review your medical records at AHN. To get started, fill out our Second Opinion Request form. Our Navigation Team will contact you within the next 24 – 48 hours to discuss next steps and schedule.
Our locations
Visit our locations page to find a Cancer Institute location near you.