Cancers that start in the vagina (primary vaginal cancer) are rare. Fewer than 300 women are diagnosed with this type of cancer in the UK each year.
The vagina is a muscular tube that extends from the opening of the womb (cervix) to the folds of skin (vulva) between a woman's 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).
There are different types of vaginal cancer. This information is only about squamous cell cancer and adenocarcinoma of the vagina. They are both 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 mainly affects women 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 usually affects women under 30. But it can affect older women too.
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 area
- 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.
There are certain things that can increase the chance of developing vaginal cancer. These are called risk factors.
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 causes and risk factors of vaginal cancer.
If you have symptoms, you usually begin by seeing your GP. They will then refer you to a specialist doctor (gynaecologist) at the hospital. They may arrange for you to have some of the following tests:
Taking a sample of cells from the cervix
Examination under anaesthetic (EUA)
This is an examination of the vagina and cervix under a general anaesthetic. It allows your doctor to examine you thoroughly without it being uncomfortable. They may remove small samples of tissue (biopsies). Your doctor may also look into your bladder and the lower end of your large bowel (the colon and rectum) to see if the cancer has spread.
You may have some slight bleeding for a couple of days after an EUA. Your doctor or nurse can tell you more about the examination and what to expect afterwards.
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 will help your doctors plan the most appropriate treatment for you. Your doctor or specialist nurse will explain more about the tests you need. They may include the following:
A PET-CT scan is a combination of a CT scan, which takes a series of x-rays to build up a three-dimensional 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.
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 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 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 for women.
Treatment for vaginal cancer may include:
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.
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. You usually have it once a week throughout your radiotherapy.
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 times.
Late effects of radiotherapy
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.
Everyone has their own way of dealing with illness and the emotions they have. You may find it helpful to talk to family and friends or to your doctor or nurse. You can also call our cancer support specialists free on 0808 808 0000.