Cancers that start in the vagina (primary vaginal cancer) are rare. Around 250 women are diagnosed with vaginal 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 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.
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 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.
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
- 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.
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.
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
Taking a sample of cells from the cervix
Examination under anaesthetic (EUA)
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:
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.
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.
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:
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 given as a drip (IV infusion). 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 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:
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.
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).
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.
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 firstname.lastname@example.org
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.
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.
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We want everyone affected by cancer to feel our information is written for them.
We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.
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. Our aims are for our information to be as clear and relevant as possible for everyone.
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