Vaginal Cancer: A Comprehensive Guide to Detection, Treatment and Prevention
Learn about vaginal cancer treatment options and life after diagnosis. Get insights on recovery from cancer, getting support and preventing the disease for a healthier future.
Written by Dr Sonia Bhatt
Last updated on 3rd Jul, 2025
Vaginal cancer is a rare gynaecological cancer that develops in the vaginal tissue. It develops when normal cells in the vaginal tissues alter their DNA. These changes cause cells to grow uncontrollably.
When vaginal cancer is detected in the early stages, the 5-year survival rate increases significantly for patients. This rate drops considerably in later stages. Keep reading to get a detailed insight into vaginal cancer care.
Types of Vaginal Cancer
Although vaginal cancer is relatively rare, it has many types. These types are classified based on the various types of cells attacked :
1. Squamous Cell Carcinoma
It is the most common type, accounting for most vaginal cancer cases. It develops in the thin, flat cells lining the vagina and generally progresses slowly. When detected early, it responds very well to treatment.
2. Adenocarcinoma
A significant contributor to vaginal cancer cases, this type starts in the glandular cells that produce vaginal fluid. Clear cell adenocarcinoma, a specific subtype, has been linked to DES (diethylstilbestrol) exposure before birth. Vaginal melanoma is a less common sub-type originating from pigment-forming cells.
3. Sarcomas
Extremely rare, these cancers arise from muscle or connective tissue cells. Due to their rarity, these types often require specialised treatment approaches.
Causes and Risk Factors of Vaginal Cancer
Human Papillomavirus (HPV) infection is the primary cause of vaginal cancer. HPV 16 and HPV 18 are the main cause behind 75% of the cases. It can be latent for years before it leads to cellular changes.
Age significantly impacts risk, with most diagnoses occurring after the age of 60. While genetic predisposition isn't a major factor, women with certain inherited conditions face higher risks.
Several other factors increase vaginal cancer risk, including:
Smoking doubles the risk through DNA damage
Previous cervical cancer or precancer indicates higher vulnerability
HIV infection weakens the immune system's ability to fight HPV
Multiple sexual partners increase HPV exposure risk
Early sexual activity (before age 17) raises long-term risk
Vaginal irritation from long-term pessary use
History of abnormal Pap (Papanicolaou) tests requires closer monitoring
Understanding these risk factors helps healthcare providers determine appropriate screening intervals. It also guides prevention strategies for high-risk individuals.
Recognising the Symptoms of Vaginal Cancer
Early-stage vaginal cancer often shows no symptoms. However, as the disease progresses, several signs may appear. The common symptoms are:
Vaginal bleeding between periods
Bleeding after sexual intercourse
Unusual watery or bloody discharge
Pain during urination
Discomfort during intercourse
Persistent vaginal itching or burning sensations
The rare symptoms are :
Unexplained weight loss
Chronic pelvic pain that radiates to the legs
Some patients report lower back pain without injury
Changes in bowel habits sometimes develop
Swelling in the legs can occur due to lymph node involvement
Frequent urinary tract infections
Diagnosis Process of Vaginal Cancer
Healthcare providers mostly use full physical examination and a review of medical history to diagnose vaginal cancer. Diagnostic tests include:
Pap (Papanicolaou) smear tests
Colposcopy examination
Biopsy of suspicious tissue
Imaging tests (Computed Tomography scan, Magnetic Resonance Imaging, Positron Emission Tomography)
Complete blood count
Chest X-ray
Pap smears can detect abnormal cell changes. Colposcopy provides a detailed vaginal wall examination. Doctors perform biopsies of suspicious areas. CT scans show if cancer has spread beyond the vagina.
MRI scans help determine tumour size and location. PET scans can identify distant cancer spread. Blood tests check overall health status.
Understanding Vaginal Cancer Stages
Vaginal cancer stages help determine the extent of the disease and guide treatment decisions:
Stage I indicates the cancer remains in the vaginal wall. The tumor size determines substages IA and IB.
Stage II shows spread to tissues near the vagina. Stage IIA affects the upper two-thirds of the vagina. Stage IIB involves nearby tissue but not the pelvic wall.
Stage III indicates spread to the pelvic wall. Cancer may reach nearby lymph nodes at this stage.
Stage IVA shows spread to the bladder or rectum. Stage IVB means cancer has reached distant organs. This stage mostly affects the lungs, liver and bones.
Treatments for Vaginal Cancer
The treatment considers a variety of factors, including cancer stage and type, along with the patient's general health condition. The common treatments for the disease are surgery, radiation, and chemotherapy.
Surgeries vary based on cancer stage and location. The procedures involve:
Laser surgery removes small surface tumours.
Local excision removes the tumour along with the tissue attached to it.
Vaginectomy removes a portion of all vagina.
In advanced cases, a radical hysterectomy is usually performed. In this procedure, the vagina, uterus, and the surrounding tissues are all removed.
External beam radiation therapy uses high-energy beams to destroy cancer cells. Here are common radiation therapies:
In external beam radiation therapy, radiation is directed from a machine outside the body to the area affected by cancer.
Brachytherapy involves placing radioactive material directly into the vagina using a small tube or plastic container known as a delivery system.
Most patients receive both types for better results.
Chemotherapy uses drugs that kill rapidly dividing cancer cells. Doctors may combine it with radiation for better effectiveness. Common drugs are cisplatin and fluorouracil. Treatment cycles go for mostly 3-4 weeks, with rest periods for the patient between cycles.
Living with Vaginal Cance
Managing the disease involves more than just medical treatment. Patients often face physical and emotional challenges. Common surgery side effects include :
Pain, bleeding, and infection risks are common.
Radiation is associated with conditions like skin irritation, blisters or ulcers, fatigue, and bladder problems.
Chemotherapy usually causes nausea, hair loss, and blood cell counts.
Medication and physical therapy are used to manage pain. Diet changes help with nausea. Regular rest periods reduce fatigue.
Skincare routines protect radiation-treated areas.
Support systems are crucial for mental health, including:
Regular follow-up care
Pain management strategies
Emotional support groups
Professional counseling
Family and friend networks
Prevention and Risk Reduction
Several measures can be followed to prevent the risk of vaginal cancer. These include:
HPV Vaccination: It avoids the causative infection caused by high-risk HPV. This vaccination should be dministered both to boys as well as to girls at a young age.
Regular Screening: Regular gynaecological examination, along with Pap tests, can help with the early identification of precancerous changes.
Lifestyle changes that can help avoid this type of cancer are:
Quitting smoking
Practising safe sexual intercourse
Following a nutritious diet
Regular exercising
Limiting alcohol consumption
Conclusion
A vaginal cancer diagnosis can be challenging, but knowledge about the disease and its treatments helps in making informed decisions. Early detection through screening is crucial for effective management. Continuous communication with healthcare providers is important to stay updated on treatments and manage side effects.
