Vaginal Cancer

What Is Vaginal Cancer?

Vaginal cancer is a rare cancer that begins in the vagina, the muscular canal that connects the uterus to the outside of the body. Because it is uncommon, many people have never heard much about it until they or someone they know needs evaluation for symptoms.

This cancer can develop in different parts of the vaginal lining and may grow slowly or behave more aggressively depending on the type. In some women, vaginal cancer may arise after years of abnormal cell changes. In others, it may be linked to previous cervical cancer or ongoing HPV infection.

Even though vaginal cancer is uncommon, early symptoms can often be overlooked or dismissed. Persistent symptoms should never be brushed aside just because the cancer is rare. Early diagnosis can make treatment much more effective.

Signs and Symptoms of Vaginal Cancer

Symptoms can be subtle at first, which is one reason the disease may not be diagnosed immediately.

Watch for:

• Vaginal bleeding not related to menstruation

• Bleeding after intercourse

• Bleeding after menopause

• Unusual vaginal discharge

• A lump or mass in the vagina

• Vaginal itching

• Pain during sex

• Pelvic pain

• Pain with urination

• Constipation or trouble passing stool in some cases

These symptoms may be caused by other conditions, but they should still be evaluated promptly.

Why Does Vaginal Cancer Happen?

Vaginal cancer usually develops because cells in the vaginal lining undergo changes over time and begin growing in an uncontrolled way. A long-term infection with high-risk HPV is one of the major risk factors.

Other risk factors may include:

• Previous cervical cancer or precancerous cervical changes

• HPV infection

• Smoking

• Older age

• Weakened immune system

• History of pelvic radiation

• Exposure to diethylstilbestrol (DES) before birth in some cases

• Chronic irritation or abnormal cell changes in the vagina

Diagnosis of Vaginal Cancer

Diagnosis may begin when a patient reports bleeding, discharge, or pain. Since vaginal cancer is rare, careful evaluation is important.

• Pelvic examination: The doctor examines the vagina and surrounding areas for visible or palpable changes.

• Pap test or HPV-related testing: May detect abnormal cells, especially if the cancer started from nearby cervical changes.

• Colposcopy: A magnified inspection of the vagina and cervix.

• Biopsy: Tissue is removed from the suspicious area to confirm cancer.

• Imaging tests: MRI, CT scan, or PET scan may help determine the extent of the disease.

• Cystoscopy or proctoscopy: May be done if the cancer is suspected to involve the bladder or rectum.

A biopsy is the key step. Without tissue confirmation, the diagnosis cannot be made with confidence.

Treatment Options for Vaginal Cancer

Treatment depends on the size of the tumour, where it is located, and whether it has spread.

• Surgery: In some early-stage cases, surgery may involve wide local excision (removal of the cancer with surrounding healthy tissue) or vaginectomy (removal of part or all of the vagina), depending on the size and location of the tumour.

• Radiation therapy: Commonly used and sometimes the main treatment.

• Chemotherapy: May be combined with radiation in certain cases.

• Topical or local treatments: Sometimes used for very early abnormal cell changes.

• Reconstructive surgery: Reconstructive surgery may be needed in selected cases, especially after vaginectomy, where part or all of the vagina is removed.

In many cases, treatment is planned by a team that may include a gynecologic oncologist, radiation specialist, and supportive care experts.

Recovery and Follow-Up

Recovery can vary widely. Some people recover well after small procedures, while others may need a longer period of healing after radiation or surgery.

Follow-up may involve:

• Regular pelvic exams

• Repeat imaging when needed

• Managing vaginal dryness or scarring after treatment

• Emotional support

• Monitoring for recurrence

• Sexual health counseling if needed

• Multidisciplinary Care

In many cases, treatment is planned by a team that may include:

• Gynecologic oncologist 

• Radiation specialist 

• Plastic surgeon

• Supportive care experts 

This all women team approach helps ensure both cancer treatment and recovery needs are addressed properly.

When to Seek Medical Help

Seek medical attention if you have:

• Bleeding after sex

• Bleeding after menopause

• Persistent vaginal discharge

• Persistent vaginal itching

• Pelvic pain that continues

• A noticeable lump or growth

• Pain when urinating or having bowel movements