Vaginal cancer

What is vaginal cancer?

Cancers that start in the vagina (primary vaginal cancer) are rare. Around 250 women are diagnosed with vaginal cancer in the UK each year.

It is more common for cancer to start in an area close by, such as cervix or womb, and grow into the vagina. This information is only about cancers that start in the vagina.

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What is cancer?

The vagina

The vagina is a muscular tube that extends from the opening of the womb (cervix) to the folds of skin (vulva) between your legs. It allows blood from your periods (menstruation) to drain out of the body. It is also the passageway through which babies are born (the birth canal).

People who have a vagina include women, trans (transgender) men and people assigned female at birth.

Types of vaginal cancer

There are different types of vaginal cancer. This information is only about squamous cell cancer and adenocarcinoma of the vagina. They are treated in a similar way.

Squamous cell cancer (SCC)

The most common type of vaginal cancer is squamous cell cancer (SCC). This starts in squamous cells that line the vagina. It usually starts in the upper part of the vagina and is more common over the age of 60.

Adenocarcinoma

Adenocarcinoma is rare. It starts in the glandular cells in the vagina. These normally make liquid to lubricate the vagina. It is most common under the age of 30.

Rare types

Some other less common types of vaginal cancer include:

melanoma
small cell carcinoma
sarcoma
lymphoma
clear cell cancers.

For more information about these you can call our cancer information specialists.

Symptoms of vaginal cancer

The most common symptoms of vaginal cancer are:

bleeding after the menopause, between periods or after sex
blood-stained vaginal discharge
pain when peeing (passing urine), needing to pee often, or blood in your pee
pain in the pelvic (lower tummy) area
constipation
feeling you need to poo, even though you have just been (tenesmus)
swelling in your legs.

These symptoms can be caused by many other conditions. But if you notice any of them, it is important to see your doctor.

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Do I have cancer?

Causes of vaginal cancer

There are certain things that can increase the chance of developing vaginal cancer. These are called risk factors.

The main risk factor for vaginal cancer is HPV (human papilloma virus).

Having one or more risk factors does not mean you will get vaginal cancer. Also, having no risk factors does not mean you will not develop vaginal cancer.

We have more information about the possible causes of vaginal cancer.

Diagnosis of vaginal cancer

If you have symptoms, you usually start by seeing your GP. They will then refer you to a specialist doctor (gynaecologist) at the hospital. They may arrange some of the following tests:

Internal (vaginal) exam

An internal (vaginal) examination is when the doctor gently checks the inside of the vagina for any lumps or swellings.
Taking a sample of cells from the cervix

This is the same test that is used for cervical screening. It checks for any abnormal cells in the cervix.
Colposcopy

A colposcopy uses a microscope called a colposcope to look closely at your vagina. They will take a sample of tissue (biopsy) from any areas that look abnormal.
Examination under anaesthetic (EUA)

An EUA is an examination of the vagina and cervix under a general anaesthetic. It allows your doctor to examine you thoroughly without it being uncomfortable.

Further tests for vaginal cancer

If the tests show you have vaginal cancer, you will have further tests. Most of these are done to find out whether the cancer has spread to the pelvis or to other parts of the body. This helps your doctors plan the best treatment for you. They will explain more about the tests you need. These may include:

Blood tests

You have blood tests to check your general health.
Chest x-ray

You may have a chest x-ray to check your lungs are healthy.
CT scan

A CT scan takes a series of x-rays which builds up a detailed picture of the inside of the body.
MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body.
PET-CT scan

A PET-CT scan is a combination of a CT scan, which takes a series of x-rays to build up a detailed picture, and a positron emission tomography (PET) scan. A PET scan uses low-dose radiation to measure the activity of cells in different parts of the body.

Waiting for test results can be a difficult time, we have more information that can help.

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Staging and grading of vaginal cancer

The stage of the vaginal cancer describes its size and whether it has spread. The grade describes how quickly it may develop.

A number between 1 and 4 is given to the cancer, depending on:

its growth in the vagina and surrounding tissues
whether it has spread to lymph nodes or other organs.

Your cancer doctor will tell you the stage of the cancer when they have all your test results. Knowing the stage of the cancer helps your doctors advise you on the best treatment.

We have more information about staging and grading of vaginal cancer.

Treatment for vaginal cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making making treatment decisions. You may be offered some treatments as part of a clinical trial.

The treatment you have will depend on different factors. These include:

the stage of the cancer
where it is in the vagina
your general health.

Some cancer treatments can affect whether you can get pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment. We have more information about fertility.

Treatment for vaginal cancer may include the following:

Radiotherapy

Radiotherapy treats cancer using high-energy rays. This is the most common treatment for vaginal cancer.
Chemotherapy

Chemotherapy uses anti-cancer drugs to destroy cancer cells. Chemotherapy is often given with radiotherapy. It may also be given to treat vaginal cancer that has spread to other parts of the body. Sometimes it is given before surgery, but this is not common.
Chemoradiation

Radiotherapy is often given with chemotherapy to treat vaginal cancer. This is called chemoradiation. The combination of treatments can be more effective than radiotherapy on its own. The chemotherapy drug most commonly used is cisplatin given as a drip (IV infusion). You usually have it once a week throughout your radiotherapy.
Surgery

Surgery is usually only used for small stage 1 cancers and for cancers that were not cured by radiotherapy.

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After vaginal cancer treatment

After your treatment, you will have regular follow-up appointments with your cancer doctor or specialist nurse.

Let them know as soon as possible if you have any problems or notice new symptoms between these appointments.

You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.

Macmillan is also here to support you. If you would like to talk, you can:

call the Macmillan Support Line on 0808 808 00 00.
chat to our specialists online.
visit our vaginal cancer forum to talk with people who have been affected by vaginal cancer, share your experience, and ask an expert your questions.

Late effects of radiotherapy

Radiotherapy for vaginal cancer can sometimes cause side effects that do not go away, or that develop months or years later. If these happen, there are lots of ways they can be managed or treated. We have more about this in our information about late effects of pelvic radiotherapy.

Sex life

You may not feel like having sex for a while after treatment. If you have a partner, you may both need time to get used to any changes. You can still share your feelings for each other through cuddling, massage, kissing and stroking.

After treatment, you may find that your sex life slowly improves. Changes may get better over time, but sometimes they are permanent. If you have any problems or are worried about this talk to your doctor or nurse. They can explain what to expect and there are often things that can help.

We have more about cancer and sex that includes information about coping with changes during and after treatment. We also have information about how cancer can affect how you feel about your yourself (body image).

Your feelings

It is common to have many different emotions when you are told you have cancer. These include anger, shock, guilt, anxiety and fear. These are all normal feelings. There are lots of different reactions to cancer. There is no right or wrong way to feel. You will cope with things in your own way.

Talking to family, friends or other people affected by cancer, may help. Or you may prefer to get help from people who do not know you well. Or you may not want to talk about how you are feeling.

There is no right or wrong way to cope, but help is available if you need it. Our cancer support specialists can give you information about counselling in your area. Call 0808 808 0000. Our Online Community is also a good place to meet people who may be in a similar situation.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

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Finishing cancer treatment

About our information

References

Below is a sample of the sources used in our vaginal cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Adams T, Cuello M. Cancer of the Vagina: FIGO cancer report 2018. International journal of gynaecology and obstetrics. p14-21.

Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019.

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.