Vaginal Cancer Facts

Vaginal cancer is a rare type of cancer that begins in the cells of the vagina. The vagina is a muscular canal that connects the cervix, the lower part of the uterus, to the vulva on the outside of the body.

Primary vaginal cancer begins in the vagina. Cancer that starts in another organ, such as cervical cancer or vulvar cancer, and later spreads to the vagina is classified according to where the cancer originally started rather than as vaginal cancer.

Most vaginal cancers are squamous cell carcinomas. Other, less common types include vaginal adenocarcinoma, melanoma, and sarcoma. Treatment and prognosis depend on the type of cancer, its stage, where the tumor is located, and whether it has spread.

Vaginal cancer statistics

Vaginal cancer is one of the rarest gynecologic cancers. According to the American Cancer Society, only a small percentage of cancers of the female reproductive system begin in the vagina.

Because there are relatively few vaginal cancer cases each year, research and cancer statistics are more limited than they are for common cancers such as breast, colorectal, or lung cancer.

Information from organizations such as the American Cancer Society, National Cancer Institute, and Centers for Disease Control and Prevention helps researchers track HPV-associated cancers and understand how vaginal cancer affects different populations.

What are the types of cancer that develop in the vagina?

Several types of cancer can begin in the vagina. The type is determined by which cells become cancerous.

Squamous cell carcinoma

Squamous cell carcinoma is the most common type of vaginal cancer. It develops from the thin, flat cells that line the vagina.

These cancers may develop slowly from precancerous changes in the vaginal wall called vaginal intraepithelial neoplasia (VaIN).

Vaginal adenocarcinoma

Vaginal adenocarcinoma begins in glandular cells in the vaginal lining and is much less common than squamous cell carcinoma.

A rare form called clear cell adenocarcinoma has been associated with exposure before birth to diethylstilbestrol (DES), a medication that was once given to some pregnant women.

Vaginal melanoma and sarcoma

Melanoma can rarely develop from pigment-producing cells in the vagina. Vaginal sarcomas are also rare and begin in connective, muscle, or other supporting tissues.

Because these cancers behave differently from squamous cell carcinoma, their treatment may also differ.

What are the main risk factors for vaginal cancer?

Important vaginal cancer risk factors include persistent infection with high-risk types of HPV, older age, smoking, a history of cervical precancer or cervical cancer, and vaginal intraepithelial neoplasia.

People exposed to DES before birth also have an increased risk of clear cell adenocarcinoma of the vagina. Conditions that weaken the immune system may make it harder for the body to clear HPV and can also increase the risk of HPV-related cancers.

Having a risk factor does not mean you will develop vaginal cancer. Some people who develop the disease have no known risk factors.

What are the most common vaginal cancer symptoms?

Early vaginal cancer may not cause noticeable symptoms. When vaginal cancer symptoms occur, abnormal vaginal bleeding is one of the most important signs.

Other possible symptoms include unusual vaginal discharge, a lump in the vagina, pelvic pain, pain during sex, constipation, or pain or difficulty when urinating.

These symptoms can be caused by many conditions other than cancer. However, unexplained vaginal bleeding, particularly bleeding after menopause or after sex, should be discussed with a healthcare provider.

How does a biopsy diagnose vaginal cancer?

If an abnormal area or tumor is found during a pelvic examination or other evaluation, a biopsy is needed to confirm whether cancer is present.

During a biopsy, a small tissue sample is removed and examined by a pathologist. The pathologist looks for cancer cells and determines what type of vaginal cancer is present.

Additional imaging may then be used to determine whether cancer has grown into surrounding tissues or spread elsewhere in the pelvis or body.

What are the vaginal cancer stages?

Vaginal cancer stages describe how far cancer has spread. Vaginal cancer is generally classified from stage I through stage IV.

Stage I cancer is limited to the vaginal wall. As the stage increases, cancer may grow into nearby tissues, reach the pelvic wall, involve organs such as the bladder or rectum, or spread to distant parts of the body.

Unlike some gynecologic cancers, vaginal cancer staging is primarily clinical rather than based on surgical staging. Examination, biopsy, and imaging findings help doctors determine the extent of disease and plan treatment.

What are the main vaginal cancer treatment options?

Vaginal cancer treatment depends on the cancer's type, stage, size, and location, as well as the patient's health and previous treatments.

Radiation therapy is an important treatment for many vaginal cancers and may include external beam radiation and internal radiation, called brachytherapy. Chemotherapy may sometimes be given with radiation or used for advanced or recurrent disease.

Surgery may be appropriate for selected patients. Depending on the location and extent of cancer, procedures can range from removing the tumor and surrounding tissue to a partial or radical vaginectomy. A very extensive operation called pelvic exenteration may be considered in uncommon, carefully selected situations.

Are clinical trials available for vaginal cancer?

Because vaginal cancer is rare, clinical trials are especially important for improving treatment. Trials may study new medications, immunotherapies, radiation approaches, or combinations of existing treatments.

People with newly diagnosed, advanced, or recurrent vaginal cancer can ask their healthcare team whether a clinical trial may be appropriate. The National Cancer Institute also maintains information about ongoing cancer clinical trials.

What should you know after a vaginal cancer diagnosis?

Learning you have a rare cancer can make it difficult to know where to start. Your healthcare team can help you understand the type and stage of your cancer, available treatments, expected side effects, and what your diagnosis means for you.

Because vaginal cancer is uncommon, consider asking whether you should see a gynecologic oncologist or receive care at a center experienced in treating rare gynecologic cancers.