About Vaginal Cancer

Vaginal cancer is a rare type of cancer that forms in the vagina, the small canal that runs from the uterus to outside the body (also known as the birth canal).

There are two main types of vaginal cancer:

Squamous cell carcinoma, the most common type, forms in the cells lining the vagina. It is found most often in women age 60 or older.

Adenocarcinoma is cancer that begins in the glandular (secretory) cells in the lining of the vagina. It is found most often in women age 30 or younger.

Vaginal cancer can often be cured in its early stages. A Pap test can find abnormal cells that may be cancer.

Factors that may increase a woman's risk include:

• Human papillomavirus (HPV) infection. The majority of vaginal cancers are thought to be caused by HPV. 
• A history of abnormal cells in the vagina, a precancerous condition called vaginal intraepithelial neoplasia (VAIN)
• Age 50 or older
• Multiple sexual partners
• HIV Infection
• Early age at first intercourse
• Smoking
• Exposure to diethylstilbestrol (DES) while in the mother's womb (taken off market in 1971). The risk was seen in younger women and it is not clear whether the risk persists as women age. 

Often there are no symptoms in the early stages of the disease. If symptoms do occur, they may include:

• Unusual vaginal bleeding
• Watery vaginal discharge
• A vaginal lump
• Pelvic pain
• Pain during intercourse
• Painful urination

Diagnosis may include:

• A thorough medical history and physical exam
• Pelvic exam - to check for lumps or anything else unusual
• HPV test - to collect a specimen from the surface of the cervix and/or vagina to look for genetic material from the HPV virus (DNA or RNA) 
• Pap test - to collect cells from the surface of the cervix and/or vagina for examination under a microscope, to look for cell changes
• Biopsy - removal of a small piece of vaginal tissue for examination under a microscope, to look for cancerous or precancerous cells
• Colposcopy - uses a special magnification instrument known as a colposcope to view the vagina and/or cervix and check for abnormal areas

If the diagnosis is vaginal cancer, more tests may be run to determine the extent or "stage" of the disease - how far the cancer cells have spread and the best treatment strategy.

These tests may include:

• Biopsies - to test tissue samples from other areas
• Imaging tests - such as x-rays, computed tomography (CT) scans, MRIs (magnetic resonance imaging), and PET scans (positron emission tomography)
• Additional tests that are occasionally performed are: 
  • Cystoscopy - to determine if the cancer has spread to the bladder
  • Proctoscopy - to determine if the cancer has spread to the rectum

Treatment depends on the individual patient and their cancer, but may include one or more of the following:

• Surgery - to remove or destroy the cancerous tissue
• Radiation - Radiation treatments use high-energy x-rays to kill cancer cells
• Chemotherapy - the use of medications typically given intravenously (through a vein), to make the radiation more effective and to stop the growth/spread of cancer cells

While there is no proven way to prevent vaginal cancer, it may be possible to reduce your risk through:

• HPV vaccination
• Routine pelvic exams and Pap tests
• Smoking cessation