Treatments

If you are diagnosed with vaginal cancer, you might have surgery, chemotherapy, radiation therapy, or a combination of these treatments.

Your personal care team will create a plan that is based on your overall health and the location, size, and stage of your cancer. Our goal is to treat the cancer while giving you the best possible quality of life. If you want to get pregnant in the future and haven’t gone through menopause, your doctor may suggest fertility-preserving treatment. Your gynecologic oncologist will develop a personalized treatment plan based on the extent of your cancer.

Surgery

Gynecologic oncologists are the best surgeons for vaginal cancer. Our surgeons at Columbia University are world-renowned specialists from several disciplines who undertake the most complex surgeries as a team.

Surgery for vaginal cancers may include:

  • Laser ablation, which uses a laser beam to burn away abnormal tissue. This minor procedure is done in an outpatient center under anesthesia. You’ll probably go home the same day. Laser ablation is typically used for women with precancerous vaginal abnormalities, called vaginal intraepithelial neoplasia. Laser ablation is typically not used for vaginal cancer.
  • Vaginectomy, which involves removing all or parts of your vagina.
  • Total hysterectomy, which removes your cervix, uterus, and surrounding parts of your vagina.
  • Inguinal or pelvic lymph node dissection, which removes these lymph nodes if cancer has spread.

Radiation Therapy

Radiation therapy uses high-energy X-rays to destroy cancer cells. Radiation therapy may be part of your treatment plan based on the tumor size, extent, and location. If your doctors determine you are not a candidate for surgery, radiation is usually delivered in combination with chemotherapy with the goal to destroy tumor cells while keeping urinary and bowel function. Your radiation oncologist, who is part of your personal care team, will design an optimal treatment plan for you for the best possible results.

Your radiation treatment plan may include one or a combination of the following types of radiation therapy, depending on your disease stage:

External Beam Radiation

External beam radiation is used to deliver radiation to the pelvis. We use conformal techniques to help minimize radiation dose to the bladder, bowel, and rectum while focusing the radiation on areas within the pelvis where tumor cells have or may have spread to. 

Treatments are delivered daily as an outpatient over a few weeks. Each treatment lasts only a few minutes.

Brachytherapy

Brachytherapy, or internal radiation, is a treatment where a radioactive source is placed directly inside or very close to the tumor. It is able to deliver very high doses of radiation while sparing surrounding normal tissues. There are many different types of applicators that may be used to deliver brachytherapy in the pelvis. Your radiation oncologist will meet with you to discuss whether brachytherapy should be part of your treatment plan and what type of brachytherapy would be most appropriate.

Chemotherapy

Vaginal cancer is rare, and there haven’t been many studies about what type of chemotherapy is best. Most doctors treat vaginal cancer with the same chemotherapy as cervical cancer. Women with vaginal cancer typically receive a low dose of chemotherapy in combination with radiation. The most commonly used chemotherapy drug for vaginal cancer is cisplatin.

Chemotherapy uses medications (chemicals) to stop cancer growth and spread and to prevent cancer from recurring by causing rapidly dividing cancer cells to become damaged and die.

Chemotherapy is “systemic” medicine—it interferes with all fast-dividing cells in your body. This is why it causes side effects like hair loss.

Chemotherapy is often given through an IV in our infusion center, but it can sometimes be given through a pill. It’s given in cycles across a few weeks, with each treatment followed by a rest period. We most commonly use the drugs carboplatin and paclitaxel for vaginal cancer. You will get an infusion weekly or every three weeks.

Clinical Trials

You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of cervical cancer patients. You can talk to your care team about whether a clinical trial is an option for you.

Learn More About Clinical Trials

Gynecologic Oncology Survivorship Program

Once you’re finished with treatment, you’ll enter a period of surveillance to make sure your cancer doesn’t return, and if it does, to catch it early.

Our experts in the Gynecologic Oncology Survivorship Program create an individualized Survivorship Plan for you. This plan is a comprehensive assessment that includes all the treatment you received, possible late side effects to watch for, a blueprint for future cancer screening, a surveillance plan, and a personalized plan for wellness activities to improve your lifestyle.