15579 Vaginal Cancer

Overview

Vaginal cancer is a disease in which abnormal cells grow in the vagina, the muscular tube that connects the outside of the body to the uterus (womb). It is a rare type of cancer. When it is found early, treatment is often successful.

No, vaginal cancer is not common. It accounts for only about 1 to 2 percent of all cancers of the female reproductive system. Most women who are diagnosed are over age 60.

Vaginal cancer can affect women of any age, but it is most often found in women after menopause. Women who have had HPV infections, who smoke, or who had cervical or vulvar cancer may have a higher risk.

Symptoms

Common symptoms

• Abnormal vaginal bleeding (for example, bleeding after sex, between periods, or after menopause)
• Watery, bloody, or foul-smelling vaginal discharge
• A lump or mass that you can feel in the vagina
• Pain during sex
• Pelvic pain or pain in the lower belly
• Needing to urinate often or pain when urinating
• Constipation or pain when passing stool (less common)

Causes

Main causes

• Infection with certain types of HPV (human papillomavirus) — a very common virus spread through skin-to-skin contact during sex
• Long-term irritation of the vagina, although this is less common
• Changes (mutations) in the DNA of vaginal cells, which may happen over time without a clear reason

Risk factors

• Being older (most cases are diagnosed in women over 60)
• Being infected with HPV, especially high-risk types
• Smoking tobacco
• Having had cervical cancer or cervical pre-cancer
• Having used a diethylstilbestrol (DES) medicine during pregnancy — this is a condition affecting daughters of women who took DES in the past (DES is no longer in use)
• Weakened immune system, such as from HIV or certain medicines

When to see a doctor

See a doctor urgently if:

• If you have sudden heavy vaginal bleeding, call for emergency help right away.
• If you have a fever along with pelvic pain, or if you feel very unwell, seek medical care the same day.

Book a routine appointment if:

• If you notice any new bleeding, discharge, or discomfort in the vaginal area, make an appointment with your doctor or gynecologist.
• If you have symptoms that do not go away after a week, such as pain or unusual discharge, get them checked.
• If you have had HPV or cervical dysplasia in the past, keep all recommended follow-up visits.

Diagnosis

To diagnose vaginal cancer, a doctor will ask about your symptoms and medical history, do a physical exam, and examine the outside and inside of your vagina and pelvic area. They may take a small sample of tissue (a biopsy) to look at under a microscope. Imaging tests like MRI or CT scans may also be used to see if the cancer has spread.

Tests that may be done

• Pelvic examination — the doctor feels the vagina, uterus, and ovaries for any lumps or changes
• Speculum examination — a special tool is used to gently open the vaginal walls so the doctor can see the inside of the vagina and cervix
• Pap test (smear test) — a swab of cells is taken from the cervix and vagina to look for abnormal cells
• Biopsy — a tiny piece of suspicious tissue is removed to be checked in a laboratory
• Colposcopy — a special magnifying device is used to look at the vagina and cervix more closely
• Imaging scans (MRI, CT, or PET) — these take detailed pictures to check whether cancer has grown into nearby tissue or spread elsewhere

What to expect at your appointment

A pelvic exam can feel a little uncomfortable, but it usually only takes a few minutes. If a biopsy is needed, you may feel a pinching or cramping sensation. After the biopsy, you might have light spotting or discharge for a few days. Your doctor will explain the results and what they mean, and if cancer is found, they will talk about next steps in a calm, supportive way.

Treatment

Treatment for vaginal cancer depends on the type, size, and stage (how far it has grown or spread), as well as your overall health and personal preferences. Your medical team — which may include a gynecologic oncologist, radiation oncologist, and other specialists — will work with you to create a plan. In many cases, early-stage vaginal cancer can be cured.

Self-care at home

• Ask your doctor about how to manage pain or discomfort at home, and always follow their advice on wound care after a biopsy or surgery.
• Wear loose, comfortable clothing and cotton underwear to reduce irritation.
• Keep your follow-up appointments so your recovery is monitored closely.
• If you have side effects, such as fatigue or soreness, let your care team know. They can suggest ways to ease them.

Medical treatments

Medical treatments generally include surgery to remove the cancer, radiation therapy (using high-energy rays to destroy cancer cells), and chemotherapy or targeted therapy (medicines that kill or stop cancer cells). The exact approach depends on your situation. For some early cancers, laser surgery or local excision (removing just the cancer) may be enough. For larger cancers, a combination of radiation and chemotherapy is often used. Your doctor will explain the options in detail and help you choose the best plan for you.

When is surgery considered?

Surgery may be recommended for early-stage vaginal cancer, especially when the cancer is small and has not spread. In these cases, a surgeon may remove just the tumor, part of the vagina, or sometimes the whole vagina, cervix, or uterus, depending on what is needed to remove the cancer completely.

Living with this condition

Living with vaginal cancer can bring physical and emotional challenges. You may need to take time to rest after treatment, and you might have side effects like fatigue, vaginal dryness, or changes in how you feel during sexual activity. Talking openly with your care team and a counselor or support group can help you adjust. Many women find that gentle exercise, relaxation techniques, and a daily routine help them feel more in control.

Lifestyle tips

• Quit smoking — this can improve your body's ability to heal and reduce the risk of the cancer coming back.
• Limit alcohol if you are receiving treatment, as alcohol can interfere with some treatments and worsen fatigue.
• Stay as active as you can, but listen to your body and rest when you need to.
• Practice good hygiene, especially after treatment, to prevent infections.
• Communicate with your partner about intimacy, and ask your doctor about lubricants or other help if sex is painful.

Diet and exercise

Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help keep your strength up during recovery. Some people find it easier to eat small meals throughout the day. Gentle activities like walking, stretching, or light yoga can boost energy and improve mood. Always check with your doctor before starting any new exercise, especially after surgery.

Mental health and emotional wellbeing

Being diagnosed with cancer is a shock, and it is normal to feel anxious, sad, or overwhelmed. You may worry about your health, body image, or relationships. These feelings are valid. It can help to talk to a psychologist or counselor who specialises in cancer care, or to join a support group where you can share experiences with others who understand.

Prevention

There is no guaranteed way to prevent vaginal cancer, but you can lower your risk. Avoiding HPV infection (through vaccination and safer sex) and not smoking are the two most important steps. Regular pelvic exams and Pap tests can also detect pre-cancerous changes, which can be treated before they turn into cancer.

Vaccines

The HPV vaccine helps protect against the types of HPV that cause most vaginal cancers as well as cervical and other cancers. It is recommended for both girls and boys, ideally before they become sexually active. Even if you are older, ask your doctor or local health service whether the HPV vaccine could be beneficial for you.

Screening programmes

There is no routine screening test specifically for vaginal cancer for women at average risk. However, regular Pap tests and pelvic exams can help find abnormal cells in the vagina or cervix that might become cancer. Women who have had treated cervical pre-cancer or cervical cancer may need more frequent check-ups, as their risk of vaginal cancer is slightly higher.

Complications

If left untreated

• Cancer can spread from the vagina to nearby tissues such as the cervix, uterus, bladder, or rectum
• Cancer can travel through lymph nodes to other parts of the body, like the lungs or liver
• Heavy or persistent bleeding may lead to anemia (low blood count), causing fatigue and weakness
• Untreated cancer can cause urinary or bowel blockages, leading to severe pain or other serious problems

Long-term outlook

The outlook for vaginal cancer depends very much on the stage at diagnosis. When vaginal cancer is found early, the chance of successful treatment is high, and many women are completely cured. Even when the cancer is more advanced, treatments have improved greatly and can slow the disease, control symptoms, and help you live well. Your doctor will talk honestly with you about your specific situation and what you can expect.

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