Staging and grading of vaginal cancer

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

Staging of vaginal cancer

The stage of vaginal cancer describes:

  • where it is
  • how far it has grown from where it started
  • if it has spread.

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 most appropriate treatment.

Number staging system

Vaginal cancers are usually staged using a number system. A number between 1 and 4 is given to the tumour, depending on:

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

Lymph nodes are part of the lymphatic system, which helps protect the body against infection and disease. There are groups of lymph nodes throughout the body. They are linked by fine tubes containing lymph fluid.

Female pelvic lymph nodes

Stage 1

The cancer is only in the vagina.

Stage 2

The cancer has grown through the wall of the vagina.

Stage 3

The cancer has spread to the wall of the pelvis and/or has spread to nearby lymph nodes.

Stage 4

The cancer has spread to other organs. This can be divided into:

  • Stage 4A - The cancer has grown into organs nearby, such as the bladder or the back passage (rectum).
  • Stage 4B - The cancer has spread to organs further away in the body, such as the lungs. This is called secondary or metastatic cancer.

Grading of vaginal cancer

Grading refers to the appearance of the cancer cells under the microscope. It gives an idea of how quickly the cancer may develop:

  • Low-grade (grade 1) means the cancer cells look very similar to normal cells. They are usually slow-growing and less likely to spread.
  • Moderate-grade (grade 2) means the cancer cells look more abnormal. They may grow more quickly.
  • High-grade (grade 3) means the cancer cells look very abnormal. They are more likely to grow quickly or spread to other parts of the body.

We understand that waiting to know the stage and grade of your cancer can be a worrying time. We're here if you need someone to talk to. You can:

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.

Content under review

Due to the pandemic, there have been delays in us updating this information as quickly as we would have wanted. Our team is working hard to put this right.

The language we use

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.

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