Vaginal cancer

Cancers that start in the vagina are rare. In the UK, about 250 people are diagnosed with vaginal cancer each year. 

It is more common for cancer to start in an area close by, such as the cervix or womb, and grow into the vagina. This information is not about cancer that has spread to the vagina from other areas. This information is about cancers that start in the vagina. These are called primary vaginal cancers.

There are different types of vaginal cancer. This information is only about:

• squamous cell cancer (SCC)
• adenocarcinoma of the vagina.

These vaginal cancers are treated in a similar way.

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 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.

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 or chat online with our cancer information specialists.

Doctors do not know the exact causes of vaginal cancer. But there are risk factors that can increase your chance of developing it.

The main risk factor for vaginal cancer is HPV (human papilloma virus). This means that younger people can be affected.

Having a risk factor does not mean you will get vaginal cancer. And not having a risk factor does not mean you will not develop it.

Like other cancers, vaginal cancer is not infectious. You cannot catch it or pass it on to other people.

Age

Vaginal cancer is rare, but more likely:

• as you get older
• after the menopause.

It is uncommon, but younger people can also be affected.

HPV (human papilloma virus)

The main risk factor for vaginal cancer is infection with the human papilloma virus (HPV). People with HPV who smoke may have a higher risk. But most people who get HPV will not get vaginal cancer.

Vaginal intra-epithelial neoplasia (VaIN)

VaIN is the name for pre-cancerous changes in cells lining the vagina. It can develop if HPV remains in the vagina for a long time.

If VaIN is not treated, there is a chance it may eventually develop into vaginal cancer in some people.

Cancer or pre-cancerous changes in the cervix

People who have had cervical cancer or pre-cancerous changes in the cervix (CIN) have an increased risk of developing vaginal cancer. This is likely to be linked to HPV, which is the main cause of cervical cancer and CIN. This risk may be higher in people who smoke. But most people who have had cervical cancer or CIN will never develop vaginal cancer.

A weakened immune system

Your immune system helps protect your body from infection and illness. Other medical conditions such as HIV can affect the immune system. Some people need to take medicines to suppress the immune system.

If the immune system is not working well, it is less likely to get rid of infections like HPV.

Radiotherapy to the pelvis

People who have had radiotherapy to the pelvis may have a very slightly increased risk of vaginal cancer.

Diethylstilbestrol (DES)

Diethylstilbestrol (DES) can increase the risk of a very rare type of vaginal cancer called clear cell adenocarcinoma (CCA). Your risk is increased if your mother was prescribed the drug DES when she was pregnant with you.

DES has not been used for a long time. Doctors prescribed it to some pregnant women between 1940 and 1970. The risk is not very high, but you should have yearly check-ups to check for early signs of CCA.

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

Knowing the stage and grade helps your doctors plan the best treatment for you.

A number between 1 and 4 is given to describe the stage of 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.

You will have regular check-ups during and after your treatment. Follow-up appointments are a good time to talk to your cancer doctor or specialist nurse about any concerns you have. Between your follow-up appointments, it is important to let them know as soon as possible if you have any problems or notice new symptoms. You can also call your specialist nurse if you have questions or need advice.

For some people, follow-up appointments will be every few months for the first couple of years. But they will be once or twice a year after that. If the cancer is advanced, your doctor or specialist nurse can tell you how often you will have follow-up appointments and what these might involve.

At these appointments they will ask questions about how you are and how you are recovering from any treatment. You may have an internal examination.

They will also ask if you have any symptoms. They can talk to you about symptoms to be aware of such as vaginal bleeding or discharge.

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

Some people will have a different kind of follow-up where you are asked to contact your cancer team if you have any concerns. This may be called Patient Initiated Follow up or PIFU. If you are having this type of follow up, your doctor or specialist nurse will explain what to be aware of.

We have more information about follow-up care after treatment.

Radiotherapy for vaginal cancer can sometimes cause side effects that do not go away. Or they may develop months or years after treatment. If this happens, there are lots of ways they can be managed or treated.

Vaginal cancer and its treatments can affect your sexual wellbeing. They can cause changes that are physical, emotional and practical. How you feel about your body (body image) may change. You may have changes to your usual roles or routines. These areas are often linked. If there is a change to one area, it can affect another.

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. Some of the changes caused by treatments get better but some may be permanent. You may need time to adjust. Talk to your doctor or CNS if you have any problems or are worried about this. They can explain what to expect. 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).

Taking good care of yourself can help speed up your recovery after vaginal cancer treatment. Even small lifestyle changes may improve your wellbeing and long term health.

Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment. We have more information on leading a healthy lifestyle after treatment.