Vaginal Cancer Symptoms

Vaginal cancer may not cause noticeable symptoms in its early stages. Some cases are discovered during a routine pelvic exam or while a healthcare provider is evaluating another gynecologic concern.

When symptoms do develop, abnormal vaginal bleeding is one of the most common signs. Other symptoms can include unusual vaginal discharge, a lump or mass in the vagina, pelvic pain, pain during sex, or changes in urination or bowel movements.

Most of these symptoms are much more likely to be caused by conditions other than cancer. However, new, persistent, or unexplained symptoms should be evaluated by a healthcare provider.

What are the most common symptoms of vaginal cancer?

Possible vaginal cancer symptoms include:

• Vaginal bleeding after menopause

• Bleeding between menstrual periods

• Bleeding after sex

• Unusual or persistent vaginal discharge

• A lump or mass in the vagina

• Pelvic pain or pressure

• Pain during sex

• Pain or difficulty when urinating

• Frequent urination

• Constipation or other changes in bowel habits

Having one or more of these symptoms does not mean you have vaginal cancer. Many noncancerous gynecologic conditions can cause similar symptoms.

Is abnormal vaginal bleeding a symptom of vaginal cancer?

Abnormal vaginal bleeding is an important symptom of vaginal cancer. This may include bleeding after menopause, between periods, or after sexual intercourse.

Any vaginal bleeding after menopause should be evaluated, even if it only happens once. Abnormal bleeding can have many causes, but an examination can help determine where the bleeding is coming from and whether additional testing is needed.

Bleeding can also occur with other gynecologic cancers, including cervical cancer and vulvar cancer, as well as many noncancerous conditions.

Can vaginal discharge be a sign of vaginal cancer?

Some people with vaginal cancer experience unusual vaginal discharge. The discharge may be watery, blood-tinged, or different from what is normal for you.

Changes in vaginal discharge are common and are usually not caused by cancer. Infections, hormonal changes, and other gynecologic conditions are much more common causes.

However, persistent or unexplained discharge, particularly when it occurs with bleeding, pain, or another new symptom, should be discussed with your healthcare provider.

Can vaginal cancer cause pelvic pain or pressure?

Vaginal cancer can sometimes cause pain or a feeling of pressure in the pelvis, particularly as a tumor becomes larger or affects nearby tissues.

Some patients experience pain during sexual intercourse. A vaginal mass or lump may also be noticeable.

Pelvic pain has many possible causes involving the vagina, cervix, uterus, vulva, bladder, bowel, or other pelvic structures. Persistent pelvic pain should be evaluated rather than assumed to be cancer.

What other symptoms can vaginal cancer cause?

Other symptoms may develop if a vaginal tumor begins affecting nearby structures.

These can include pain or difficulty urinating, needing to urinate more frequently, constipation, or other changes in bowel habits. Symptoms vary depending on the tumor's size and location.

More advanced cancer can sometimes cause additional symptoms, but symptoms alone cannot determine how advanced a cancer is.

Do early-stage vaginal cancers always cause symptoms?

No. Early vaginal cancer may cause few or no symptoms.

This is one reason some cases are found during a pelvic examination or evaluation for another medical concern. A healthcare provider may notice an abnormal area even when a patient has not experienced symptoms.

Vaginal cancer is rare, and there is no routine screening program specifically for vaginal cancer in average-risk people. This makes awareness of persistent or unexplained symptoms particularly important.

Do vaginal cancer symptoms differ by cancer type?

The most common type of vaginal cancer is squamous cell carcinoma, which develops in the cells lining the vagina. Other, much rarer types of vaginal cancer can also occur.

Symptoms can overlap between different types. Bleeding, discharge, pelvic discomfort, or a vaginal mass may occur regardless of the specific cancer type.

A biopsy, rather than symptoms alone, is needed to determine whether an abnormal area contains cancer and what type of cancer it is.

When should I make an appointment about vaginal cancer symptoms?

Make an appointment with your healthcare provider if you experience persistent or unexplained vaginal bleeding, unusual discharge, pelvic pain, pain during sex, a vaginal lump, or urinary or bowel changes.

You should also contact your healthcare provider if you develop vaginal bleeding after menopause. Do not wait for additional symptoms to appear before having postmenopausal bleeding evaluated.

Before your appointment, it can help to write down when your symptoms began, how often they occur, and whether anything makes them better or worse.

What happens during a vaginal cancer diagnosis and tests?

If your symptoms could be related to vaginal cancer, your healthcare provider will usually ask about your medical history and perform a physical and pelvic exam.

The vagina and surrounding structures may be examined for abnormal areas. If a suspicious area is found, additional diagnosis and tests may include colposcopy, imaging, and a biopsy.

A biopsy removes a small tissue sample so a pathologist can examine it for cancer cells. It is needed to confirm a vaginal cancer diagnosis.

Do risk factors change how vaginal cancer symptoms are evaluated?

Your healthcare provider may consider your symptoms along with your risk factors and medical history.

Persistent infection with high-risk types of human papillomavirus (HPV) is an important risk factor for vaginal cancer. A history of cervical precancer or cervical cancer, smoking, vaginal precancer, a weakened immune system, and older age can also affect risk.

Your provider may also ask about previous procedures, including a hysterectomy, and your history of abnormal cervical or vaginal tests.

The HPV vaccine can help prevent infections with HPV types responsible for many HPV-related cancers, but vaccination does not eliminate the need to have concerning symptoms evaluated.

What happens after a vaginal cancer diagnosis?

If a biopsy confirms vaginal cancer, additional testing may be needed to determine the cancer's stage and plan vaginal cancer treatment.

Treatment depends on factors such as the cancer's type, size, location, stage, and your overall health. Options can include radiation therapy, surgery, chemotherapy, or combinations of treatments.

Extensive procedures such as pelvic exenteration are reserved for uncommon, carefully selected situations and are not typical treatment for someone simply experiencing vaginal cancer symptoms.

Who provides vaginal cancer care?

Because vaginal cancer is rare, patients may be referred to a gynecologic oncologist—a doctor who specializes in cancers of the female reproductive system.

Your vaginal cancer care team may include gynecologic oncologists, radiation oncologists, medical oncologists, pathologists, nurses, and other specialists. Experienced vaginal cancer providers can help determine the most appropriate tests and treatment for your individual diagnosis.

Organizations such as the National Cancer Institute also provide information about vaginal cancer, treatment, and available research.

Are clinical trials part of vaginal cancer care?

Because vaginal cancer is uncommon, clinical trials are important for learning more about the disease and developing new treatments.

If you receive a vaginal cancer diagnosis, you can ask your healthcare team whether a clinical trial is appropriate for you. Trials may investigate new medications, immunotherapies, radiation approaches, or combinations of treatments.

Clinical trials are generally considered after cancer has been diagnosed, rather than as part of evaluating symptoms.

What should I do if I have vaginal cancer symptoms?

Having symptoms associated with vaginal cancer does not mean you have cancer. Vaginal cancer is rare, and many of its symptoms have much more common explanations.

However, persistent or unexplained vaginal bleeding, discharge, pelvic pain, pain during sex, urinary or bowel changes, or a vaginal lump should not be ignored.

Your healthcare provider can evaluate your symptoms and determine whether further testing is needed. If cancer is found, establishing an accurate diagnosis is the first step toward developing an appropriate cancer care plan.