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Definition

Vaginal cancer is cancer of the vagina, a female reproductive organ.

Causes

Most vaginal cancers occur when another cancer, such as cervical, vulvar, or endometrial cancer, spreads. This is called secondary vaginal cancer.

Cancer that starts in the vagina is called primary vaginal cancer. This type of cancer is rare. Most primary vaginal cancers start in skin-like cells called squamous cells. This cancer is known as squamous cell carcinoma. The other types include:

• Adenocarcinoma
• Melanoma
• Sarcoma

The cause of squamous cell carcinoma of the vagina is unknown. But a history of cervical cancer is common in women with squamous cell carcinoma of the vagina. So it may be associated with human papilloma virus (HPV) infection.

Most women with squamous cell cancer of the vagina are over 50.

Adenocarcinoma of the vagina tends to affect younger women. The average age at which this cancer is diagnosed is 19. Women whose mothers took the medicine diethylstilbestrol (DES) to prevent miscarriages during the first 3 months of pregnancy are more likely to develop vaginal adenocarcinoma.

Sarcoma of the vagina is a rare cancer that mainly occurs in infancy and early childhood.

Symptoms

Symptoms of vaginal cancer can include any of the following:

• Bleeding after having sex
• Painless vaginal bleeding and discharge not due to a normal period
• Pain in the pelvis or vagina

Some women have no symptoms.

Exams and Tests

In women with no symptoms, the cancer may be found during a routine pelvic exam and Pap test.

Other tests to diagnose vaginal cancer include:

• Biopsy
• Colposcopy

Other tests that may be done to check if the cancer has spread include:

• Chest x-ray
• CT scan and MRI of the abdomen and pelvis
• PET scan

Other tests that may be done to know the stage of the vaginal cancer include:

• Cystoscopy
• Barium enema
• Intravenous urography (x-ray of kidney, ureters and bladder using contrast material)

Treatment

Treatment of vaginal cancer depends on:

• The type of cancer
• How far the disease has spread

Surgery is sometimes used if the cancer is small and located at the upper part of the vagina. Most women are treated with radiation. If the tumor is cervical cancer that has spread to the vagina, radiation and chemotherapy are both given.

Sarcoma may be treated with a combination of chemotherapy, surgery, and radiation.

Support Groups

You can ease the stress of illness by joining a support group whose members share common experiences and problems.

Outlook (Prognosis)

The outlook for women with vaginal cancer depends on the size and the stage of disease and the specific type of tumor.

Possible Complications

Vaginal cancer may spread to other areas of the body. Complications can occur from radiation, surgery, and chemotherapy.

When to Contact a Medical Professional

Contact your health care provider for an appointment if:

• You notice bleeding after sex
• You have persistent vaginal bleeding or discharge

Prevention

There are no definite ways to prevent this cancer.

The HPV vaccine is approved to help prevent cervical cancer. This vaccine may also decrease the risk of getting some other HPV-associated cancers, such as vaginal cancer. You can increase your chance of early detection by getting regular pelvic examinations and Pap smears.

References

Frumovitz M. Neoplastic diseases of the vulva and vagina. . In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 30.

Jhingran A, Russell AH, Seiden MV, et al. Cancers of the cervix, vulva, and vagina. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 84.

PDQ Adult Treatment Editorial Board. Vaginal Cancer Treatment (PDQ): Health Professional Version. 2024 Feb 16. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002. PMID: 26389242 pubmed.ncbi.nlm.nih.gov/26389242/.

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