Vaginal Cancer

Vaginal cancer is a rare type of gynecologic cancer. It forms in the cells and tissues of the vagina, the muscular tube that connects the cervix to the outside of the body.

In its early stages, vaginal cancer may not cause any symptoms. That's why knowing the signs and understanding your risk can help you recognize changes and seek treatment sooner.

If you’re diagnosed with vaginal cancer, you don’t have to navigate it alone. The gynecologic oncology team at Atrium Health Levine Cancer is here to support you with expert, personalized care and guidance throughout your cancer journey.

What does vaginal cancer look and feel like?

Vaginal cancer may appear as a lump, growth or sore inside the vagina. It may also cause an area of the vaginal lining to look or feel different from the surrounding tissue.

You may not be able to see or feel vaginal cancer yourself. A provider can examine the vagina and look for abnormal areas. If they find an area that looks unusual, they may perform a biopsy to check for cancer cells.

Types of vaginal cancer

The vagina contains different types of cells and tissues. The type of vaginal cancer depends on where the cancer starts. The most common types include:

• Squamous cell carcinoma: Starts in the thin, flat cells lining the vagina. This is the leading type of vaginal cancer.
• Adenocarcinoma: Starts in gland cells in the vaginal lining.
• Melanoma: Starts in the pigment-producing cells of the vagina.
• Sarcoma: Starts in the muscle or connective tissue of the vagina.

What are the early signs of vaginal cancer?

Abnormal vaginal bleeding is one of the most common signs of vaginal cancer. This may include bleeding after sex, between menstrual periods or after menopause. Watery or bloody discharge, sometimes with an unusual odor, can also be a sign.

Some people have no symptoms, especially when vaginal cancer is found at an early stage. Regular gynecologic care, including pelvic exams and Pap smears, can help identify unusual changes.

How does cancer on the vagina spread?

Vaginal cancer can spread to nearby tissues or organs if it grows beyond the vagina. It may spread to the cervix, uterus, vulva, bladder or rectum. Cancer cells can also travel through the lymphatic system to nearby lymph nodes.

In some cases, cancer that starts in another part of the body can spread to the vagina. This is called metastatic cancer and is different from vaginal cancer that starts in the vagina. Cancer that starts in the bladder, colon, rectum or uterus can sometimes spread to the vagina.

Vaginal cancer tests and diagnosis

Diagnosing vaginal cancer starts with a review of your symptoms and health history with your provider, followed by a pelvic exam. During the exam, your provider looks for abnormal areas in the vagina, cervix and nearby tissues.

Other tests may include:

• Colposcopy: If an area looks unusual, your provider may recommend a colposcopy. This procedure uses a lighted, magnifying device to examine the vagina more closely.
• Biopsy: A biopsy is needed to confirm a vaginal cancer diagnosis. During a biopsy, your provider removes a small sample of tissue for testing.
• Imaging tests: You may also need imaging tests, such as magnetic resonance imaging (MRI), computed tomography (CT) or positron emission tomography (PET), to determine the size and location of the cancer and whether it's spread.

Vaginal cancer treatments

Your treatment depends on the type and stage of vaginal cancer, where the cancer is located and your overall health. Your care team will work with you to develop a treatment plan based on your specific needs.

Treatment options may include:

• Surgery: Surgery may remove the cancer and some surrounding healthy tissue.
• Radiation therapy: Radiation uses high-energy beams to destroy cancer cells. It may be used alone or with other treatments.
• Chemotherapy: Chemotherapy uses medicines to destroy cancer cells or slow their growth. It may be used with radiation therapy for some vaginal cancers.
• Targeted therapy or immunotherapy: For some advanced or recurrent vaginal cancers, medicines that target specific cancer cells or help your immune system recognize and attack cancer cells may be an option.

Your care team will explain the benefits, risks and expected side effects of your treatment options and help you decide what approach is right for you.