Vaginal cancer

Vaginal cancer is a rare type of cancer that starts growing in the vagina. It’s rarer than other cancers of the female reproductive system such as cervical cancer or uterine cancer, although the symptoms may be similar.

At our Advocate Cancer Institute locations, we have the expert teams and advanced equipment needed to confirm your diagnosis and provide treatment to support your physical and reproductive health.

What are the early signs of vaginal cancer?

Vaginal cancer often has no symptoms in its early stages and its symptoms are similar to symptoms of other conditions. Potential vaginal cancer symptoms you may notice include:

• Spotting not related to your menstrual cycle
• Pain during penetrative sex
• Blood in your urine or stool
• An unusual or foul-smelling vaginal discharge.

If vaginal cancer spreads outside your pelvic area, you may notice these potential vaginal cancer symptoms:

• Constipation
• Edema (swelling) in your legs
• Frequent urge to urinate
• Lower abdominal, back or pelvic pain
• Pain during urination

What does vaginal cancer look and feel like?

You can’t see vaginal cancer growths because your vagina is inside your body. You may see flat lumps, sores or wart-like growths around the opening of your vagina if cancer is also growing on your external genitals (vulva) or the area between your vagina and anus (perineum).

Types of vaginal cancer

The most common type of vaginal cancer forms in cells of the vaginal lining and is called squamous cell vaginal cancer. It usually grows slowly and stays around your vagina, but it may move and grow in other areas of your body.

Adenocarcinoma vaginal cancer is less common. It starts in the glandular cells of the vagina. Normal glandular cells release fluids to cleanse and lubricate your vagina.

Two other very rare cancers of the vagina are melanoma vaginal cancer, which grows in pigment-producing cells, and sarcoma vaginal cancer, which grows in muscles or connective tissue.

Vaginal cancer risk factors

Risk factors increase your chances of developing a disease or condition. Vaginal cancer has several risk factors, including:

• Age 60 or older
• Some types of HPV infection
• Previous hysterectomy for a tumor (benign or cancerous)
• Having cervical cancer
• Smoking
• Having HIV

Drinking alcohol may increase your risk of vaginal cancer, although there isn’t solid evidence about this yet.

Diagnosis of vaginal cancer

During your annual physical exam, your OB-GYN or primary care doctor may notice signs of vaginal cancer. They’ll ask you about any potential vaginal cancer symptoms you may have noticed and gather a family and personal medical history. In addition to a regular physical exam, they’ll perform a pelvic exam to judge the size, shape and position of your vagina, cervix and uterus.

You may need imaging tests to confirm your diagnosis. After you’re diagnosed, tests or biopsies will also help tell if vaginal cancer has spread to other parts of your body. Some of the tests you may undergo are:

• Chest X-ray: Shows whether cancer has spread to your lungs.
• CT (computed tomography scan): Confirms presence, location and size of a tumor, and whether cancer has spread to nearby tissues or organs.
• Cystoscopy: Looks inside your urethra and bladder to check for abnormal cells.
• MRI (magnetic resonance imaging): Helps doctors see whether a tumor is cancerous.
• PET scans: Combined with the injection of a specific dye into a vein, these scans identify cancer cells that have absorbed the dye.
• Proctoscopy: Looks inside your anus and rectum to check for abnormal cells.

Vaginal cancer treatment

If you’re diagnosed with vaginal cancer, your doctors will work with you to determine the best treatment for you. Cancer surgery may be recommended to remove any cancerous areas along with some of the healthy tissue surrounding them. During surgery, nearby lymph nodes are often removed to help determine if cancer has spread or is likely to spread.

When possible, you’ll receive minimally invasive robotic surgery.

Either radiation therapy or chemotherapy may be recommended to shrink or destroy the area of cancer. Radiation or chemo may be used alone or before or after surgery.

For vaginal cancer, topical chemotherapy is sometimes used to deliver the drug with a cream or lotion applied to the surface of the cancerous area.

Immunotherapy is a newer treatment that is being used for vaginal cancer. Immunotherapy uses various methods to help your immune system seek out and destroy cancer cells.

You may wish to talk to your doctor about the possibility of clinical trials that are testing aspects of cancer treatment. They’ll let you know about ongoing trials that may benefit your treatment.

Preserving fertility

Some treatments for vaginal cancer may affect your ability to conceive a child. If preserving your fertility is important to you, talk to your doctor about your options. We may be able to help you preserve fertility before treatment or start a family after treatment completion.