The vagina (birth canal) leads from the cervix (the opening of the uterus) to the outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which begins in the thin, flaT-cells that line the vagina. Other types of vaginal cancer are adenocarcinoma (cancer that begins in cells that make mucus and other fluids), melanoma, and sarcoma. Infection with certain types of human papillomavirus (HPV) causes most vaginal cancer. Vaccines that protect against infection with these types of HPV may reduce the risk of vaginal cancer. Vaginal cancer is not common.

Signs & Symptoms

Vaginal cancer often does not cause early signs or symptoms. It may be found during a routine pelvic exam and Pap test. Signs and symptoms may be caused by vaginal cancer or by other conditions. Check with your doctor if you have any of the following:

  • Bleeding or discharge not related to menstrual periods
  • Pain during sexual intercourse
  • Pain in the pelvic area
  • A lump in the vagina
  • Pain when urinating
  • Constipation

Treatment

There are three types of standard treatment. One of our gynecologic cancer specialists, Marcia C. Bowling, MD, Ajit Gubbi, DO or Dené C. Wrenn, MD, MS, can help you determine the best care plan for you.

  • Surgery is the most common treatment of vaginal cancer. The following surgical procedures may be used:
    • Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor
    • Wide local excision: A surgical procedure that takes out the cancer and some of the healthy tissue around it
    • Vaginectomy: Surgery to remove all or part of the vagina
    • Total hysterectomy: Surgery to remove the uterus, including the cervix
    • Lymph node dissection: A surgical procedure in which lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy. If the cancer is in the upper vagina, the pelvic lymph nodes may be removed. If the cancer is in the lower vagina, lymph nodes in the groin may be removed.
    • Pelvic exenteration: Surgery to remove the lower colon, rectum, bladder, uterus, cervix, vagina, and ovaries. Nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.

Skin grafting may follow surgery, to repair or reconstruct the vagina. Skin grafting is a surgical procedure in which skin is moved from one part of the body to another. A piece of healthy skin is taken from a part of the body that is usually hidden, such as the buttock or thigh, and used to repair or rebuild the area treated with surgery.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

  • Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat vaginal cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life.
  • Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated. Topical chemotherapy for squamous cell vaginal cancer may be applied to the vagina in a cream or lotion.