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Vaginal Cancer


Pedro T. Ramirez

, MD, The University of Texas MD Anderson Cancer Center;

Gloria Salvo

, MD, MD Anderson Cancer Center

Last full review/revision Sep 2020
Topic Resources

Cancer of the vagina, an uncommon cancer, usually develops in the cells lining the vagina, typically in women over 60.

  • Vaginal cancer may cause abnormal vaginal bleeding, particularly after sexual intercourse.

  • If doctors suspect cancer, they remove and examine samples of tissue from the vagina (biopsy).

  • The cancer is surgically removed, or radiation therapy is used.

In the United States, vaginal cancer accounts for only about 1% of gynecologic cancers. The average age at diagnosis is 60 to 65.

Locating the Internal Female Reproductive Organs

Internal Female Genital Organs

More than 95% of vaginal cancers are squamous cell carcinomas Squamous Cell Carcinoma Squamous cell carcinoma is cancer that begins in the squamous cells of the skin. Thick, scaly growths appear on the skin and do not heal. To diagnose the cancer, doctors do a biopsy. Treatment... read more Squamous Cell Carcinoma (carcinomas), which develop in the flat, skinlike cells that form the surface of vaginal lining. Most other vaginal cancers are adenocarcinomas, which develop from gland cells. One rare type, clear cell adenocarcinoma, occurs almost exclusively in women whose mothers took the drug diethylstilbestrol (DES), prescribed to prevent miscarriage during pregnancy. (In 1971, the drug was banned in the United States.)

If untreated, vaginal cancer continues to grow and invades surrounding tissue. Eventually, it may enter blood and lymphatic vessels, then spread to the bladder, rectum, nearby lymph nodes, and other parts of the body.

Symptoms of Vaginal Cancer

The most common symptom of vaginal cancer is abnormal bleeding from the vagina, which may occur during or after sexual intercourse, between menstrual periods, or after menopause. Sores may form on the lining of the vagina. They may bleed and become infected. Some women also have a watery discharge. A few women have no symptoms.

Large cancers can also affect the bladder, causing a frequent urge to urinate and pain during urination. In advanced cancer, abnormal connections (fistulas) may form between the vagina and the bladder or rectum.

Diagnosis of Vaginal Cancer

  • Biopsy

Doctors may suspect vaginal cancer based on symptoms, abnormal areas seen during a routine pelvic examination, or an abnormal Papanicolaou (Pap) test result. Doctors may use an instrument with a binocular magnifying lens (colposcope Colposcopy Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more Colposcopy ) to examine the vagina.

To confirm the diagnosis, doctors remove tissues from the vaginal wall to examine under a microscope (biopsy). They make sure to get tissue samples from any growth, sore, or other abnormal area seen during the examination.

Other tests, such as use of a viewing tube (endoscopy) to examine the bladder or rectum, a chest x-ray, and computed tomography (CT), may be done to determine whether the cancer has spread.

Staging of vaginal cancer

Doctors stage the cancer based on how far it has spread. Stages range from I (the earliest) to IV (advanced):

  • Stage I: The cancer is confined to the wall of the vagina.

  • Stage II: The cancer has spread through the wall of the vagina to nearby tissues but is still within the pelvis (which contains the internal reproductive organs, bladder, and rectum).

  • Stage III: The cancer has spread throughout the pelvis (but not to the bladder or rectum).

  • Stage IV: The cancer has spread to the bladder or rectum or outside the pelvis (for example, to the lungs or bone).

Prognosis of Vaginal Cancer

The prognosis for women with vaginal cancer depends on the stage of the cancer.

The percentages of women who are alive 5 years after diagnosis and treatment (5-year survival rate) are

  • Stage 1: About 75 to 95%

  • Stage 2: 50 to 80%

  • Stage 3: 30 to 60%

  • Stage 4: 15 to 50%

Treatment of Vaginal Cancer

  • For early-stage vaginal cancers, surgery to remove the vagina, uterus, and nearby lymph nodes and sometimes radiation therapy

  • For most other vaginal cancers, radiation therapy

Treatment of vaginal cancer also depends on the stage.

For early-stage vaginal cancers, surgery to remove the vagina, uterus, and lymph nodes in the pelvis and the upper part of the vagina is the treatment of choice. Sometimes radiation therapy is used after the surgery.

Radiation therapy is used for most other vaginal cancers. It is usually a combination of internal radiation therapy (using radioactive implants placed inside the vagina, called brachytherapy) and external radiation therapy (directed at the pelvis from outside the body).

Radiation therapy cannot be used if fistulas have developed. In such cases, some or all of the organs in the pelvis are removed (called pelvic exenteration). These organs include the reproductive organs (vagina, uterus, fallopian tubes, and ovaries), bladder, urethra, rectum, and anus. Which organs are removed and whether all are removed depends on many factors, such as the cancer's location, the woman's anatomy, and her goals after surgery. Permanent openings—for urine (urostomy) and for stool (colostomy Understanding Colostomy An obstruction of the intestine is a blockage that completely stops or seriously impairs the passage of food, fluid, digestive secretions, and gas through the intestines. The most common causes... read more )—are made in the abdomen so that these waste products can leave the body and be collected in bags. After the procedure, women usually have some bleeding, a discharge, and considerable tenderness and pain for a few days. Typically, the hospital stay is 3 to 5 days. Complications, such as infection or opening of the surgical incision, blockages in the intestine, and fistulas, can occur.

Sexual intercourse may be difficult or impossible after treatment for vaginal cancer.

More Information

The following is an English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • National Cancer Institute: Vaginal Cancer: This web site provides links to general information about vaginal cancer, as well as links to information about causes, prevention, screening, treatment, and research and about coping with cancer.

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