Questions to Ask Your Doctor About Vaginal Cancer

A vaginal cancer diagnosis can bring a lot of new information at once. You may have questions about your biopsy, cancer stage, treatment options, side effects, prognosis, and what to expect next. Preparing questions before your appointment can help you understand your diagnosis and participate in decisions about your care.

You do not need to ask every question on this page. Choose the questions that matter most to you, write them down before your visit, and consider bringing a family member or friend to take notes.

Questions about your vaginal cancer diagnosis and biopsy

A biopsy is needed to confirm vaginal cancer. During a biopsy, tissue is removed so a pathologist can look for cancer cells under a microscope.

Ask your doctor:

• What did my biopsy show?

• What type of vaginal cancer do I have?

• Is my cancer squamous cell carcinoma, adenocarcinoma, melanoma, or another type?

• Where in the vagina did my cancer begin?

• How deeply has the cancer grown into the vaginal wall?

• Should my biopsy be reviewed by a pathologist experienced with gynecologic cancers?

• Do I need biomarker or molecular testing?

• Could the cancer have started somewhere else and spread to the vagina?

Most vaginal cancers are squamous cell carcinomas, but there are different types of vaginal cancer. Knowing the exact type can help your healthcare team recommend the most appropriate treatment.

Questions about abnormal cells, HPV, and precancer

Some vaginal cancers are associated with persistent infection with certain types of human papillomavirus (HPV). HPV can cause abnormal cells that may develop into vaginal intraepithelial neoplasia (VaIN), a precancerous condition.

You may want to ask:

• Is my cancer associated with HPV?

• Do I have a history of vaginal precancer or VaIN?

• Does my HPV status affect treatment?

• Should I have an HPV test?

• Does my diagnosis affect my partner?

• Is there anything my partner or I should know about HPV prevention or safe sex?

• Should family members receive the HPV vaccine?

HPV is common, and having an HPV-related cancer does not tell you when or from whom an infection was acquired.

Questions about vaginal cancer stage

The stage describes how far cancer has spread and is one of the most important factors in treatment planning.

Ask:

• What stage is my vaginal cancer?

• Is the cancer limited to the vaginal wall?

• Has it spread into nearby tissues?

• Are any lymph nodes involved?

• Has it reached the bladder, rectum, or another organ?

• Do I need CT, MRI, PET/CT, or other imaging?

• Could my stage change after additional testing?

• How does my stage affect my prognosis?

Your doctor can explain how the stage relates to your individual treatment options rather than relying on stage alone.

Questions about vaginal cancer symptoms

Possible vaginal cancer symptoms include abnormal vaginal bleeding, unusual vaginal discharge, pelvic pain, pain during sex, urinary or bowel changes, or a lump in the vagina.

Consider asking:

• Which symptoms are likely caused by my cancer?

• Which symptoms could be caused by something else?

• What new symptoms should I report immediately?

• What should I do if vaginal bleeding or pelvic pain gets worse?

• Could my symptoms change during treatment?

• What symptoms could indicate that the cancer has returned?

Symptoms alone cannot determine the cancer's stage. Tell your healthcare team about new or changing symptoms so they can decide whether additional testing is needed.

Questions about pelvic examination and other tests

A pelvic examination, biopsy, imaging, and other tests may be used to evaluate vaginal cancer.

Depending on your history, ask:

• Do I need another pelvic examination?

• Will I need a colposcopy?

• Do I need additional imaging?

• Should I continue having a Pap test or other cervical screening test?

• Does my history of cervical abnormalities affect my care?

• How will you check my cervix and vulva during follow-up?

• How often will I need examinations after treatment?

A colposcopy allows a healthcare provider to closely examine the cervix, vagina, and vulva for abnormal areas. Cervical screening is primarily designed to detect changes related to cervical cancer, not to screen average-risk patients specifically for vaginal cancer.

Questions about vaginal cancer treatment

Treatment depends on the stage, cancer type, tumor location, previous treatment, overall health, and other individual factors.

Ask:

• What treatment do you recommend and why?

• What is the goal of treatment?

• What other treatment options are available?

• How soon should treatment begin?

• How long will treatment last?

• How will we know whether it is working?

• Should I get a second opinion?

• How much experience does this cancer center have treating vaginal cancer?

Because vaginal cancer is rare, some patients choose to get a second opinion from a gynecologic oncologist or a center experienced in rare gynecologic cancers.

Questions about radiation therapy and chemotherapy

Radiation therapy is an important treatment for many vaginal cancers. Chemotherapy may sometimes be given with radiation or used for advanced or recurrent disease.

Ask:

• Will I need external beam radiation, brachytherapy, or both?

• Will I need chemotherapy with radiation?

• Which chemotherapy medicines will I receive?

• How often will I receive treatment?

• What side effects should I expect?

• Could radiation affect my bladder or bowel?

• Could treatment cause vaginal narrowing, dryness, or scar tissue?

• What can we do to prevent or manage these effects?

Understanding the treatment schedule and likely side effects can help you prepare before therapy begins.

Questions about surgery

Surgery may be appropriate for selected vaginal cancers depending on the tumor's size, location, and stage.

Ask your surgeon:

• Is surgery an option for me?

• What operation do you recommend?

• How much vaginal tissue will be removed?

• Will I need a vaginectomy or hysterectomy?

• Will lymph nodes need to be removed?

• Could surgery affect my bladder, rectum, uterus, or cervix?

• Is vaginal reconstruction an option?

• What will recovery be like?

• How could surgery affect sexual or urinary function?

Ask how frequently your surgeon performs the recommended procedure, particularly if extensive pelvic surgery is being considered.

Questions about sexual health and fertility

Vaginal cancer treatment can affect intimacy, sexual function, fertility, and body image.

Consider asking:

• How could treatment affect my sex life?

• When will it be safe to have sex?

• Could treatment make sex painful?

• Should I use a vaginal dilator?

• Would pelvic floor physical therapy help?

• Could treatment affect my fertility?

• Could treatment cause early menopause?

• Should I see a fertility or sexual health specialist before treatment?

Sexual and reproductive health are legitimate parts of cancer care. You can raise these concerns even if your doctor does not ask about them.

Questions about prognosis and recurrence

It is normal to want to understand what your diagnosis means for the future.

Ask:

• What is my prognosis?

• Which factors most affect my outlook?

• What is the likelihood that treatment will control or eliminate the cancer?

• What is the risk that my cancer will return?

• Where is vaginal cancer most likely to recur?

• How will you monitor me after treatment?

• Which signs or symptoms of recurrence should I watch for?

Survival statistics describe groups of people and cannot predict exactly what will happen to an individual patient.

Questions about clinical trials and cancer research

Because vaginal cancer is rare, cancer research and clinical trials are particularly important.

Ask:

• Are there clinical trials appropriate for me?

• Should I consider a trial before beginning standard treatment?

• Are there studies specifically for vaginal cancer?

• Could I qualify for a study of HPV-associated or gynecologic cancers?

• Could biomarker testing identify additional treatment options?

• Would I need to travel for a clinical trial?

• Could participating affect my future treatment options?

The National Cancer Institute and other cancer research organizations provide information about ongoing clinical trials.

Questions about palliative care and support

Palliative care can be provided alongside cancer treatment and focuses on relieving symptoms and improving quality of life.

Consider asking:

• Would palliative care help with my symptoms or treatment side effects?

• Who can help me manage pain or fatigue?

• Is an oncology social worker or patient navigator available?

• Are there vaginal or gynecologic cancer support groups?

• Who can help with treatment costs, insurance, transportation, or lodging?

• What mental health resources are available?

• Are there resources for my caregiver or family?

Organizations such as the American Cancer Society may also provide patient information and support resources.

Questions about vaginal cancer risk factors and prevention

You may wonder why vaginal cancer developed and whether you could have prevented it. The development of cancer is complex, and having a risk factor does not mean that it directly caused your cancer.

You may want to ask:

• Do I have any known vaginal cancer risk factors?

• Could HPV have contributed to my cancer?

• Does smoking affect my risk or treatment?

• Should I stop smoking before treatment?

• Is there anything I can do to reduce the risk of recurrence?

• Does my diagnosis increase cancer risk for family members?

A history of cervical precancer or cancer can also be relevant. Other gynecologic cancers, such as vulvar cancer and endometrial cancer, are separate diseases and have different risk factors and treatment approaches.

Preparing for your next appointment

Before your appointment, write down your most important questions and put them in order of priority. Bring an updated medication list and consider taking notes or bringing someone you trust.

If something is unclear, ask your doctor to explain it differently. You can also request copies of your biopsy and pathology reports, imaging reports, treatment plan, and other medical records.

Reliable sources such as the National Cancer Institute and American Cancer Society can help you learn more between appointments, but your healthcare team is best positioned to explain how general information applies to your specific diagnosis.