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What is vaginal cancer?

Cancer can start any place in the body. Vaginal cancer starts in the vagina. It starts when cells in the vagina grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Cancer cells can spread to other parts of the body. Cancer cells in the vagina can sometimes travel to the lungs and grow there. When cancer cells do this, it’s called metastasis. To doctors, the cancer cells in the new place look just like the ones from the vagina.

Cancer is always named for the place where it starts. So if vaginal cancer spreads to the lungs (or any other place), it’s still called vaginal cancer. It’s not called lung cancer unless it starts from cells in the lung.

The vagina

The vagina starts at the cervix (the lower part of the uterus) and opens at the vulva (the outer female genitals). The vagina is usually collapsed with its walls touching each other. The vaginal walls have many folds that help the vagina open and expand during sex or the birth of a baby.

Different kinds of vaginal cancer

There are a few kinds of vaginal cancer. Your doctor can tell you more about the kind you have.

The most common kind is called squamous cell carcinoma. This kind starts in the cells that line the inside of the vagina.

Questions to ask the doctor

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of cancer you think I might have?
• What will happen next?

How does the doctor know I have vaginal cancer?

Some signs of vaginal cancer are bleeding (often after sex), spotting, or discharge from the vagina. Sometimes vaginal cancer causes pain during sex. The doctor will ask you questions about your health and do a physical and pelvic exam.

Tests that may be done

If signs point to vaginal cancer, more tests will be done. Here are some of the tests you may need:

Colposcopy : The doctor takes a close look at the inside of the vagina (and the cervix) using a lighted magnifying device or scope. The scope stays outside the body.

Biopsy: In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have cancer.

CT scan: This is also called a “CAT scan.” It’s a special kind of x-ray that takes detailed pictures to look for the cancer in the body.

MRI scan: This test uses radio waves and strong magnets instead of x-rays to make detailed pictures. MRI may be used to see if the cancer has spread.

Chest x-rays: X-rays may be done to see if the cancer has spread to your lungs.

PET scan: This test uses a kind of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. A PET scan can help show if the cancer has spread.

Questions to ask the doctor

• What tests will I need?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have vaginal cancer, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage is based on how much the cancer has grown or spread through the vagina. It also tells if the cancer has spread to lymph nodes or to other organs that are close by or far away.

Your cancer can be stage 0, 1, 2, 3, or 4. Stage 0 is also called carcinoma in situ. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has grown or spread outside the vagina. Ask the doctor about the cancer stage and what it means for you.

Questions to ask the doctor

• Do you know the stage of the cancer?
• If not, how and when will you find out the stage of the cancer?
• Would you explain to me what the stage means in my case?
• Based on the stage of the cancer, how long do you think I’ll live?
• What will happen next?

What kind of treatment will I need?

The treatment plan that’s best for you will depend on:

• The type and stage of the cancer
• Where the cancer is in the vagina
• The chance that a type of treatment will cure the cancer or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

Radiation treatments

Radiation is the main treatment for most women. It uses high-energy rays (like x-rays) to kill cancer cells.

Radiation can be aimed at the vagina and/or lymph nodes from a machine outside the body. This is called external beam radiation.

Radiation can also be given by putting a tube of radiation in the vagina. This is called internal radiation or brachytherapy.

Many times, both types of radiation are used.

Sometimes this treatment is given along with chemo to help shrink a tumor so it’s easier to take it out with surgery. This is called chemoradiation.

Side effects of radiation treatments

If your doctor suggests radiation treatment, talk about what side effects might happen. The most common side effects of radiation are:

• Skin changes where the radiation is given
• Feeling very tired
• Loose stools
• Vaginal scarring, pain, and dryness

Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect during and after treatment.

Surgery

Surgery can be used to treat vaginal cancer. If you need it, ask your doctor what type you'll need. There are many kinds of surgery. The type used depends on where the cancer is and how big it is. Some types of surgery can change the way your body works.

Each type has pros and cons. Find out if there will be changes in how you get rid of body waste (pee or poop) or changes in your sex life.

Side effects of surgery

Any type of surgery can have risks and side effects. Ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat women with vaginal cancer should be able to help you with any problems that come up.

Chemo

Chemo is the short word for chemotherapy, the use of drugs to fight cancer. The drugs are often given through a needle into a vein. These drugs go into the blood and spread through the body.

Chemo is not a common treatment for vaginal cancer. But it may be used if the cancer has spread. It can also be used to help shrink tumors before surgery. In most cases, it's given along with radiation.

Side effects of chemo

Chemo can make you feel very tired, sick to your stomach, and cause your hair to fall out. But these problems go away after treatment ends.

There are ways to treat most chemo side effects. If you have side effects, talk to your cancer care team so they can help.

Clinical trials

Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better.

If you'd like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials. See Clinical Trials to learn more.

Clinical trials are one way to get the newest cancer treatment. They are the best way for doctors to find better ways to treat cancer. If your doctor can find one that’s studying the kind of cancer you have, it’s up to you whether to take part. And if you do sign up for a clinical trial, you can always stop at any time.

What about other treatments that I hear about?

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment, too?
• What will these treatments be like?
• What’s the goal of these treatments?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Will I be able to have children after treatment?
• Will I be able to enjoy sex after treatment?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• How soon do I need to start treatment?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What’s the next step?

What will happen after treatment?

You’ll be glad when treatment is over. But it’s hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer you’re cancer-free, the less often the visits are needed.

Be sure to go to all of these follow-up visits. Your doctors will ask about symptoms, do physical exams, and may do blood tests or other tests to see if the cancer has come back. You will also need to keep getting screening tests.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.