Vaginal cancer is a rare cancer that occurs in your vagina — the muscular tube that connects your uterus with your outer genitals. Vaginal cancer most commonly occurs in the cells that line the surface of your vagina, which is sometimes called the birth canal.
While several types of cancer can spread to your vagina from other places in your body, cancer that begins in your vagina (primary vaginal cancer) is rare.
A diagnosis of early-stage vaginal cancer has the best chance for a cure. Vaginal cancer that spreads beyond the vagina is much more difficult to treat.
Vaginal cancer is cancer that occurs in the vagina — the muscular tube that connects the uterus with the outer genitals.
Early vaginal cancer may not cause any signs and symptoms. As it progresses, vaginal cancer may cause signs and symptoms such as:
See your doctor if you have any signs and symptoms related to vaginal cancer, such as abnormal vaginal bleeding. Since vaginal cancer doesn't always cause signs and symptoms, follow your doctor's recommendations about when you should have routine pelvic exams.
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
It's not clear what causes vaginal cancer. In general, cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal cells.
Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor).
Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).
Vaginal cancer is divided into different types based on the type of cell where the cancer began. Vaginal cancer types include:
Vaginal cancer most commonly begins in the thin, flat squamous cells that line the surface of the vagina. Other types of vaginal cancer may occur in other cells on the surface of the vagina or in the deeper layers of tissue.
Factors that may increase your risk of vaginal cancer include:
Atypical cells in the vagina called vaginal intraepithelial neoplasia. Being diagnosed with vaginal intraepithelial neoplasia (VAIN) increases your risk of vaginal cancer.
With VAIN, cells in the vagina appear different from normal cells, but not different enough to be considered cancer. A small number of those with VAIN will eventually develop vaginal cancer, though doctors aren't sure what causes some cases to develop into cancer and others to remain benign.
VAIN is frequently caused by the sexually transmitted human papillomavirus (HPV), which can cause cervical, vaginal and vulvar cancers, among others. Vaccines that prevent some types of HPV infection are available.
Other risk factors that have been linked to an increased risk of vaginal cancer include:
Vaginal cancer may spread (metastasize) to distant areas of your body, such as your lungs, liver and bones.
There is no sure way to prevent vaginal cancer. However, you may reduce your risk if you:
Vaginal cancer is sometimes found during a routine pelvic exam before signs and symptoms become evident.
During a pelvic exam, your doctor carefully inspects the outer genitals, and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries. He or she also inserts a device called a speculum into your vagina. The speculum opens your vaginal canal so that your doctor can check your vagina and cervix for abnormalities.
Your doctor may also do a Pap test. Pap tests are usually used to screen for cervical cancer, but sometimes vaginal cancer cells can be detected on a Pap test.
How often you undergo these screenings depends on your risk factors for cancer and whether you've had abnormal Pap tests in the past. Talk to your doctor about how often you should have these health screenings.
Your doctor may conduct a pelvic exam and Pap test to check for abnormalities that may indicate vaginal cancer. Based on those findings, your doctor may conduct other procedures to determine whether you have vaginal cancer, such as:
Once your doctor diagnoses vaginal cancer, steps will be taken to determine the extent of the cancer — a process called staging. The stage of your cancer helps your doctor decide what treatments are appropriate for you. In order to determine the stage of your cancer, your doctor may use:
During a pelvic exam, your doctor inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she can evaluate your uterus, ovaries and other pelvic organs.
Your treatment options for vaginal cancer depend on several factors, including the type of vaginal cancer you have and its stage. You and your doctor work together to determine what treatments are best for you based on your goals of treatment and the side effects you're willing to endure. Treatment for vaginal cancer typically includes surgery and radiation.
Types of surgery that may be used to treat vaginal cancer include:
Removal of the majority of the pelvic organs (pelvic exenteration). This extensive surgery may be an option if cancer has spread throughout your pelvic area or if your vaginal cancer has recurred.
During pelvic exenteration, the surgeon may remove many of the organs in your pelvic area, including your bladder, ovaries, uterus, vagina, rectum and the lower portion of your colon. Openings are created in your abdomen to allow urine (urostomy) and waste (colostomy) to exit your body and collect in ostomy bags.
If your vagina is completely removed, you may choose to undergo surgery to construct a new vagina. Surgeons use pieces of skin, sections of intestine or flaps of muscle from other areas of your body to form a new vagina.
With some adjustments, a reconstructed vagina allows you to have vaginal intercourse. However, a reconstructed vagina isn't the same as your own vagina. For instance, a reconstructed vagina lacks natural lubrication and creates a different sensation when touched due to changes in surrounding nerves.
Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation can be delivered two ways:
Radiation therapy kills quickly growing cancer cells, but it may also damage nearby healthy cells, causing side effects. Side effects of radiation depend on the radiation's intensity and where it's aimed.
If surgery and radiation can't control your cancer, you may be offered other treatments, including:
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
How you respond to your cancer diagnosis is unique. You might want to surround yourself with friends and family, or you may ask for time alone to sort through your feelings. The shock and confusion of your diagnosis may leave you feeling lost and unsure of yourself. To help you cope, try to:
Maintain intimacy with your partner. Vaginal cancer treatments are likely to cause side effects that make sexual intimacy more difficult for you and your partner. If treatment makes sex painful or temporarily impossible, try to find new ways of maintaining intimacy.
Spending quality time together and having meaningful conversations are ways to build your emotional intimacy. When you're ready for physical intimacy, take it slowly.
If sexual side effects of your cancer treatment are hurting your relationship with your partner, talk to your doctor. He or she may offer ways to cope with sexual side effects and may refer you to a specialist.
Create a support network. Having friends and family supporting you can be valuable. You may find it helps to talk with someone about your emotions. Other sources of support include social workers and psychologists — ask your doctor for a referral if you feel like you need someone to talk to.
Talk with your pastor, rabbi or other spiritual leader. Other people with cancer can offer a unique perspective and may better understand what you're going through, so consider joining a support group — whether it's in your community or online. Contact the American Cancer Society for more information on support groups.
Start by making an appointment with your family doctor or a gynecologist if you have any signs or symptoms that worry you. If it's determined that you have vaginal cancer, you'll likely be referred to a doctor who specializes in cancers of the female reproductive system (gynecologic oncologist).
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready, and what you can expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions ahead of time can help you make the most of your time together. List your questions from most important to least important in case time runs out. For vaginal cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared in advance, don't hesitate to ask questions as they occur to you during your appointment.
Your doctor will likely have a number of questions for you. If you're ready to answer them, it may help make time for additional questions you may have. Your doctor may ask: