Your vagina is the muscular tube that connects your uterus, the pear-shaped organ that holds a developing fetus, to the outside of your body. When abnormal cells grow in the vagina, it’s called vaginal cancer.
Vaginal cancer is a rare disease. The American Cancer Society estimates that only 6,300 people in the US are diagnosed with it each year.
Types of Vaginal Cancer
Squamous cell carcinoma is the most common type of vaginal cancer, comprising 9 out of 10 cases of vaginal cancer. It starts in the cells that line your vagina and spreads slowly.
Adenocarcinoma is a rarer type of vaginal cancer. It starts in the glandular cells that make vaginal mucus. A rare form of adenocarcinoma is linked to women being exposed to the drug DES before birth.
Other rare types of vaginal cancer include melanoma and sarcomas. Sarcomas most commonly occur in children.
Risk factors for vaginal cancer are similar to those linked to cervical cancer and vulvar cancer. They include:
- History of abnormal, precancerous cells lining the inside of vagina (vaginal intraepithelial neoplasia, or VAIN)
- Exposure to the drug DES while in the mother’s womb in the 1950s
- Human papillomavirus (HPV) infection
- History of abnormal PAP smears
- Smoking and tobacco use
- History of cervical cancer
- History of HIV (human immunodeficiency virus)
Signs and symptoms of vaginal cancer are nonspecific and could be mistaken for other gynecologic conditions. It’s important to discuss any unusual symptoms with your doctor, such as:
- Bleeding not related to your menstrual period
- Bleeding after sex
- Pelvic pain
- Pain or bleeding when urinating or having bowel movements
- Lump in your vagina
- Watery or bad smelling discharge
Your doctor diagnoses vaginal cancer with a complete physical exam, including examining the inside of your vagina using a speculum and doing a pelvic exam. They might also do the following tests:
This detailed exam of your cervix and vagina uses a magnifying lens called a colposcope. Your doctor may take tissue samples (biopsies) from your cervix and vagina during the test. This procedure can cause more discomfort than a Pap, but most women tolerate it without anesthesia or pain medication.
Your doctor will take samples of abnormal-looking tissue inside your vagina. The tissue samples then go to a pathologist, who looks for abnormalities in the cells under a microscope.
If your doctor suspects vaginal cancer, it’s important that you get further testing and treatment from a gynecologic oncologist. This doctor is a specialist in cancer of the gynecologic system, and they see more cases of rare cancers like vaginal cancer than other doctors.
Your gynecologic oncologist will order other tests to see if cancer has spread beyond the original tumor site. This is called staging. They may include:
- Cystoscopy. Uses a small instrument with a video camera inside your bladder to check for signs of cancer.
- Proctoscopy. Uses a small instrument with a video camera inside your rectum to check for signs of cancer.
- A CT (computed tomography) scan. Converts data from different angles of X-ray images of your body into pictures on a monitor.
- An MRI (magnetic resonance imaging) test. Uses powerful magnetic fields to create a 3D picture of your lower abdomen and pelvis to detect tumors.
- A PET (positron emission tomography) scan. Uses a small amount of radionuclide glucose (sugar) injected into a vein. The PET scanner rotates around your body and makes a picture of where glucose is being used in your body. Malignant tumor cells show up brighter than normal cells.
The stages are determined based on how advanced the cancer is and helps your physician decide on a treatment plan. There are four different stages of vaginal cancer.
Stage I. Cancer is found only in your vaginal wall.
Stage II. Cancer has spread through your vaginal wall into the tissue around your vagina but not to the pelvic walls or lymph nodes.
Stage III. Cancer has spread to your pelvic side walls and/or your inguinal lymph nodes.
Stage IV. Cancer has spread to areas beyond your vagina. Stage IVa involves organs near your vagina, such as your bladder or rectum. Stage IVb involves organs distant to your vagina, such as your lungs or bone.