Vaginal Cancer

Columbia provides specialized care for people with vaginal cancer and other rare gynecologic cancers. Because vaginal cancer is uncommon, patients often benefit from care provided by gynecologic oncologists with experience diagnosing and treating these complex cancers.

Your treatment is personalized based on the type of cancer, its location, whether it has spread, your overall health, and your treatment goals. Our multidisciplinary team works together to provide comprehensive care while prioritizing your comfort, quality of life, and long-term health.

What Is Vaginal Cancer?

Vaginal cancer is a rare cancer that begins in the vagina, the muscular canal that connects the cervix to the outside of the body.

Most vaginal cancers develop in the thin, flat cells that line the inside of the vagina. This type is called squamous cell carcinoma. Less common types include adenocarcinoma, melanoma, and sarcoma.

Although vaginal cancer is uncommon, it can often be treated successfully, particularly when it is diagnosed at an early stage.

What Causes Vaginal Cancer?

Vaginal cancer develops when cells in the vagina change and grow out of control. The exact cause is not always known.

Many vaginal cancers are associated with persistent infection with certain high-risk types of human papillomavirus (HPV), a common virus that can spread through sexual contact. In most people, HPV goes away on its own. In some cases, however, the virus remains in the body and causes abnormal cell changes that may eventually develop into cancer.

What Are the Risk Factors for Vaginal Cancer?

Risk factors for vaginal cancer may include:

• Persistent HPV infection
• A history of cervical cancer or cervical precancer
• A history of vaginal or vulvar precancer
• Smoking
• A weakened immune system, including HIV infection
• Older age
• Exposure before birth to a medication called diethylstilbestrol (DES)

Having one or more risk factors does not mean you will develop vaginal cancer. Some people diagnosed with vaginal cancer have no known risk factors.

What Are the Symptoms of Vaginal Cancer?

Early vaginal cancer may not cause symptoms. As the disease progresses, symptoms may include:

• Bleeding after sex
• Bleeding after menopause
• Bleeding between periods
• Watery, bloody, or unusual vaginal discharge
• Pelvic pain
• Pain during sex
• A lump or mass in the vagina
• Pain or difficulty with urination
• Constipation or changes in bowel habits

Because these symptoms can also be caused by other gynecologic conditions, it is important to see a healthcare provider if they are new, persistent, or worsening.

When Should I See a Doctor?

You should see a healthcare provider if you have abnormal vaginal bleeding, unusual discharge, pelvic pain, pain during sex, or a lump in the vagina.

These symptoms do not necessarily mean you have cancer, but they should be evaluated to determine the cause and, if necessary, begin treatment as early as possible.

How Is Vaginal Cancer Diagnosed?

Vaginal cancer is diagnosed through a physical examination, biopsy, and imaging studies when appropriate.

Tests may include:

• Pelvic examination
• Pap test
• HPV test
• Colposcopy, which uses a special magnifying instrument to examine the vagina and cervix
• Vaginal biopsy
• CT scan, MRI, or PET scan

A biopsy is needed to determine whether cancer is present. Imaging studies help determine the extent of the cancer and guide treatment planning.

How Is Vaginal Cancer Treated?

Radiation therapy is one of the most common treatments for vaginal cancer and may be used alone or together with chemotherapy. Some patients receive brachytherapy, a form of internal radiation therapy that delivers radiation directly to the tumor while limiting exposure to nearby healthy tissues.

Surgery may be recommended for selected patients with early-stage disease or smaller tumors. For more advanced cancers, treatment often includes a combination of radiation therapy, chemotherapy, immunotherapy, targeted therapy, or participation in a clinical trial.

Your gynecologic oncologist will discuss the treatment options that are most appropriate for your diagnosis and goals.