Vaginal Cancer
A rare cancer that starts in the vagina
Quick Facts
- Type: Gynecologic cancer
- Most common type: Squamous cell carcinoma
- Main link: Human papillomavirus (HPV)
- Common in: Women over 60
Overview
Vaginal cancer is an uncommon cancer that starts in the vagina, the muscular canal leading from the cervix to the outside of the body. Most vaginal cancers begin in the thin, flat cells that line the vagina and are called squamous cell carcinomas. Less often, cancer arises from glandular cells (adenocarcinoma) or other cell types.
It is important to know that cancer found in the vagina is more often the result of cancer spreading from another organ, such as the cervix or uterus, than cancer that starts in the vagina itself. True (primary) vaginal cancer is rare. When found early, it is often very treatable, which is why recognizing symptoms and keeping up with routine pelvic exams and screening matters.
Symptoms
Early vaginal cancer may cause no symptoms and is sometimes found during a routine exam. When symptoms appear, they may include:
- Unusual vaginal bleeding, such as after intercourse or after menopause
- Watery vaginal discharge
- A lump or mass in the vagina
- Pain during intercourse
- Pelvic pain
- Painful or frequent urination, or constipation, if the cancer presses on nearby organs
These symptoms can be caused by many non-cancerous conditions, but any unusual or post-menopausal vaginal bleeding should always be evaluated by a doctor.
Causes
Most vaginal cancers are linked to long-term infection with certain high-risk types of human papillomavirus (HPV), a common sexually transmitted virus. In most people the immune system clears HPV, but a persistent infection can cause cell changes that may eventually become cancer.
A less common form, a type of adenocarcinoma, has been linked to exposure before birth to a medication called DES (diethylstilbestrol) that was given to some pregnant women decades ago. In many cases, however, the exact cause cannot be identified.
Risk Factors
- Older age, with most cases occurring after age 60
- Infection with high-risk HPV
- A history of cervical pre-cancer or cervical cancer
- Smoking
- Exposure to DES before birth
- A weakened immune system
- Multiple sexual partners or early age at first intercourse, which raise HPV exposure
Diagnosis
Vaginal cancer is diagnosed through examination and tissue testing:
- Pelvic exam and Pap test: A routine exam and cervical screening can sometimes detect abnormal cells in the vagina.
- Colposcopy: A lighted magnifying instrument is used to look closely at the vaginal walls.
- Biopsy: A small tissue sample is removed and examined under a microscope to confirm cancer.
- Imaging: If cancer is confirmed, scans such as MRI, CT, or PET help determine whether and how far it has spread (staging).
Treatment
Treatment depends on the type of cancer, its size, its location in the vagina, and whether it has spread. A team of gynecologic cancer specialists usually plans care.
- Radiation therapy: A common treatment, sometimes given externally and sometimes placed inside the vagina (brachytherapy).
- Chemotherapy: Often combined with radiation to make it more effective, or used when cancer has spread.
- Surgery: Removal of the tumor or, in some cases, part or all of the vagina and nearby tissue, depending on the stage.
The best results come from early diagnosis. Follow-up care after treatment monitors for any return of the cancer and helps manage side effects.
Prevention
Because most vaginal cancers are linked to HPV, many of the same steps that prevent cervical cancer can lower the risk:
- Get the HPV vaccine, which protects against the high-risk types most likely to cause cancer
- Attend regular pelvic exams and cervical screening
- Do not smoke
- Use condoms, which lower but do not eliminate the risk of HPV
- Report any unusual bleeding or discharge to your doctor promptly
When to See a Doctor
See a doctor if you notice:
- Any vaginal bleeding after menopause
- Unusual bleeding, such as after intercourse or between periods
- A lump, watery discharge, or persistent pelvic pain
While these symptoms are often caused by harmless conditions, they should always be checked. Keeping up with routine pelvic exams and cervical screening also helps catch problems early, when they are most treatable.
Frequently Asked Questions
What are the early signs of vaginal cancer?
Early vaginal cancer often causes no symptoms. When signs appear, they may include unusual vaginal bleeding (such as after intercourse or after menopause), watery discharge, a vaginal lump, or pelvic pain. Any post-menopausal bleeding should always be checked by a doctor.
Is vaginal cancer caused by HPV?
Most vaginal cancers are linked to long-term infection with high-risk types of human papillomavirus (HPV). HPV is common and usually clears on its own, but a lasting infection can cause cell changes that may become cancer over time.
Can vaginal cancer be prevented?
The risk can be lowered. The HPV vaccine protects against the virus types most likely to cause vaginal and cervical cancer, and regular pelvic exams and cervical screening can catch changes early. Not smoking also reduces risk.
How is vaginal cancer treated?
Treatment depends on the stage and type but commonly includes radiation therapy, often combined with chemotherapy, and sometimes surgery. A team of gynecologic cancer specialists tailors the plan to each person, and early-stage cancer is often very treatable.
Is most cancer found in the vagina actually vaginal cancer?
Often not. Cancer in the vagina is more frequently the spread of cancer from another organ, such as the cervix or uterus, than a cancer that begins in the vagina itself. True primary vaginal cancer is rare.
References
- National Cancer Institute (NCI). Vaginal Cancer Treatment.
- American Cancer Society. Vaginal Cancer.
- Mayo Clinic. Vaginal cancer — Symptoms and causes.
- Centers for Disease Control and Prevention (CDC). HPV and Cancer.