Make a Gift
Vaginal cancer is a cancer that starts in the vagina. There are several types of vaginal cancer, but the most common is squamous cell carcinoma, a cancer that starts in a layer of cells in the lining of the vagina.
Vaginal cancer prognosis depends on the type of cancer and the stage at which it is diagnosed.
Vaginal cancer is a rare cancer, accounting for 1% to 2% of cancers in the female genital tract. It occurs primarily in older women; 67 is the average age of those diagnosed.
According to the Centers for Disease Control, in the U.S. in 2020 (the latest year for which data is available), 1,272 women were diagnosed with vaginal cancer and 423 women died from the disease.
The five-year survival rate for vaginal cancer is 51%.
With a 12-doctor team, the gynecologic oncologists at the CU Cancer Center are one of the largest groups of physicians dedicated to women’s cancer care in the United States.
As the only National Cancer Institute-designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region, the University of Colorado Cancer Center has doctors who provide cutting-edge, patient-centered vaginal cancer care and researchers focused on diagnostic and treatment innovations.
There are numerous vaginal cancer clinical trials being conducted by CU Cancer Center members at any time. These trials offer patients options to traditional vaginal cancer treatment and can result in remission or increased life spans.
There are a few main types of vaginal cancer, each named for the type of cell in which it forms.
Vaginal pre-cancer, or VAIN, is a condition where some of the cells in the vagina look abnormal and may become cancerous over time. Women who have had a hysterectomy (a surgery to remove the uterus) or were previously treated for cervical cancer are more likely to have VAIN.
Vaginal cancer has multiple risk factors: behaviors or conditions that increase a person’s chances of getting a disease such as cancer. Risk factors for vaginal cancer include:
Vaginal cancer can usually be treated successfully if it is diagnosed before the cancer has spread to distant parts of the body. Patients with early-stage vaginal cancer may not experience symptoms, but those with later stages of the disease may.
Symptoms of vaginal cancer include:
Screening is used to look for cancer before a person shows any symptoms of the disease. Regular HPV and Pap tests can help to detect vaginal cancer.
Based on a patient’s symptoms and after an initial physical examination, a doctor may order certain tests to determine whether the patient has vaginal cancer. Though testing procedures can vary based on the type of vaginal cancer the doctor is looking
for, common screenings for vaginal cancer include:
After diagnosing the presence of vaginal cancer, the doctor will identify the stage of the disease. The stage is determined by several factors, including where exactly the disease formed, how extensive it is, and whether and how much it has spread.
Doctors typically use the TNM system to determine the stage of vaginal cancer. The TNM system assesses the size and extent of the tumor (T) and whether it has ulcerated; whether the cancer has spread to nearby lymph nodes (N); and the presence and extent of metastasis (M) to distant lymph nodes, bones, and organs.
After the TNM assessment, the doctor will assign an overall stage number from I to IV, which can be further broken down based on the size of the original tumor and the extent to which the cancer has spread. In general, the lower the stage the better the prognosis and treatment options.
Stage IA: Cancer is in the vagina only and is not larger than 2 centimeters. The cancer has not spread to nearby lymph nodes or distant sites in the body.
Stage IB: Cancer is in the vagina only and is larger than 2 centimeters. The cancer has not spread to nearby lymph nodes or distant sites in the body.
Stage IIA: Cancer has grown through the wall of the vagina but has not reached the pelvic wall. The cancer is not larger than 2 centimeters, and it has not spread to nearby lymph nodes or distant sites in the body.
Stage IIB: Cancer has grown through the wall of the vagina but has not reached the pelvic wall. The cancer is larger than 2 centimeters, and it has not spread to nearby lymph nodes or distant sites in the body.
Stage III: Cancer can be any size and may be growing into the pelvic wall. It may also be blocking the flow of urine, causing the kidneys not to work. The cancer may have spread to nearby lymph nodes in the pelvis or groin, but it has not spread to other lymph nodes or distant sites.
Stage IVA: The cancer is growing into the bladder or rectum, or it is growing out of the pelvis. It may have spread to nearby lymph nodes in the pelvis or groin, but it has not spread to other lymph nodes or distant sites.
Stage IVB: The cancer has spread to distant organs such as the liver or lungs. It may also have spread to the bones. It can be any size.
The treatment for vaginal cancer is customized to each patient and depends on the stage at which the patient is diagnosed, and the patient’s general health.
Vaginal cancer care teams may include multiple health care specialists, including primary care providers, gynecologists, gynecologic oncologists, medical oncologists, hematologists, and radiation oncologists, as well as nurse practitioners, physician assistants, nurses, psychologists, social workers, and rehabilitation specialists. CU Cancer Center doctors offer specialized care for patients with vaginal cancer.
Treatments for vaginal cancer include radiation therapy, surgery, and chemotherapy. Patients may receive one or more of these treatments in combination. Some patients may also be eligible to participate in clinical trials — doctor-led research studies of new or experimental procedures or treatments.
Radiation therapy is the most common treatment for vaginal cancer. It uses high-powered energy to kill cancer cells. A doctor who specializes in radiation therapy to treat cancer is a radiation oncologist. The two main types of radiation therapy used to treat vaginal cancer are external beam radiation and intracavitary brachytherapy. Vaginal cancer is most commonly treated with a combination of both types of radiation therapy.
External-beam radiation therapy (EBRT) is the most common radiation treatment and uses a machine located outside the body to focus a beam of X-rays on the area with the cancer.
Intracavitary brachytherapy, or internal radiation therapy, places radioactive materials inside the body to provide a localized treatment. In the case of vaginal cancer, radioactive materials are placed into a cylinder that is inserted into the vagina. In LDR brachytherapy, the cylinder stays in place for 1–2 days, and the patient must remain in a hospital bed throughout the treatment. In HDR brachytherapy, the cylinder stays in place for a shorter period in an outpatient procedure. Treatments are given 1¬–2 weeks apart.
Surgeries for vaginal cancer include local — or wide — excision, vaginectomy, trachelectomy, and hysterectomy.
Local excision: A local — or wide — excision is a surgery to remove the cancer, along with a nearby rim of normal tissue. This procedure is often used as a treatment for VAIN. For some cancers, surgeons also remove a small number of lymph nodes to check for cancer spread.
Vaginectomy: Vaginectomy is surgery to remove the vagina. In a partial vaginectomy, only part of the vagina is removed, and in a radical vaginectomy, the entire vagina is removed along with the tissue around it.
Trachelectomy: A trachelectomy is surgery to remove the cervix, which is near the upper part of the vagina in which cancer most often starts.
Hysterectomy: In some cases of vaginal cancer, the uterus and cervix must be removed to get rid of all the cancer cells. This surgery is called a hysterectomy.
Chemotherapy uses drugs to kill rapidly growing cancer cells. Drugs are either injected into a vein or taken orally. Chemotherapy may be given along with radiation therapy prior to surgery.
Chemotherapy drugs for vaginal cancer include cisplatin, carboplatin, fluorouracil (5-FU), paclitaxel (Taxol), docetaxel (Taxotere), and irinotecan.
The University of Colorado (CU) Cancer Center partners with UCHealth, Children’s Hospital Colorado, and Rocky Mountain Regional VA to provide clinical care. Please make an appointment with one of our clinical partners to be seen by a CU Cancer Center doctor.
Information reviewed by Saketh Guntupalli, MD in January 2024.