Vaginal cancer

What is vaginal cancer?

Vaginal cancer is one of the rarest gynaecological cancers in Australia.

There are 2 main types of vaginal cancer:

• Primary vaginal cancer, which starts in the vagina. This is rare.
• Secondary vaginal cancer, which spreads to the vagina from other parts of the body (usually the cervix). This is more common than primary vaginal cancer.

There are different types of primary vaginal cancer:

• Squamous cell carcinoma (SCC) – this is the most common vaginal cancer and accounts for 85% of cases. It starts in the thin, flat (squamous) cells that line the vagina. It usually affects people aged between 50 and 70.
• Adenocarcinoma – this cancer starts in the mucus-producing (glandular) cells of the vagina. It usually affects people under 20 years of age.
• Vaginal (mucosal) melanoma – this is a rare form of vaginal cancer that starts in the cells that give skin its colour (melanocytes). Note that this cancer is not related to UV radiation from the sun.
• Sarcoma – this cancer is also rare. It starts in the muscle, fat and other tissue deep in the wall of the vagina.

Symptoms of vaginal cancer

See your doctor if you notice any unusual symptoms. They may be due to other conditions, but it’s important to check.

Many people don’t have any symptoms in the early stages of vaginal cancer. But you may notice:

• unusual lumps or swelling inside your vagina
• bloody discharge that’s not related to your period
• painful sex (dyspareunia)
• bleeding after sex
• pain in your pelvic area or rectum
• blood in your wee, a change in the colour of your wee (usually a brown-ish colour), weeing often or weeing more than usual at night.

What causes vaginal cancer?

We don’t know the exact cause of vaginal cancer, but it may be associated with:

• human papillomavirus (HPV)
• having a precancerous condition called ‘vaginal intraepithelial neoplasia’ (VIN), where abnormal cells develop in the lining of the vagina
• having cervical cancer, or a pre-cancerous cervical condition, in the past
• smoking
• exposure to a drug diethylstilbestrol (DES) in utero – this drug was given to some women from the 1940s to 1970s to prevent miscarriage.

How is vaginal cancer diagnosed?

Your doctor will ask about your symptoms, medical history and family health history. They may also:

• check the inside of your vagina for lumps and swelling
• do a cervical screening test to check cells inside your vagina and cervix
• take a tissue sample (biopsy) of the abnormal area of your vagina and send it to a pathology lab for testing
• check your groin, pelvic area and rectum for swollen glands.

If your examination and test results suggest you may have vaginal cancer, your doctor will refer you to a gynaecological oncologist straight away.

You may need more tests to check if the cancer has spread (metastasised) to other parts of your body. You might have the following tests:

• A colposcopy – a magnifying instrument (colposcope) is used to look closely at your vagina, cervix and vulva and a sample (biopsy) may be taken.
• A cystoscopy – a procedure to check your bladder and urethra.
• A proctoscopy – a procedure to check inside your rectum.
• A chest X-ray.
• Blood tests.
• Imaging tests such as CT and MRI scans.

Treatments for vaginal cancer

Treatment for vaginal cancer depends on the extent of the cancer. It may include:

• surgery
• radiotherapy
• chemotherapy
• palliative treatment.

Medical treatment, such as chemotherapy and radiotherapy, can cause menopause. Learn more about medically induced menopause.

Reducing the risk of vaginal cancer

While we don’t have a screening test for vaginal cancer, you can lower your risk by:

• not smoking
• having regular cervical screening tests
• getting immunised against HPV.

When to see your doctor

It’s important to see your doctor if you notice any symptoms of vaginal cancer. In most cases, early detection and diagnosis lead to good outcomes.

Related resources

More information about vaginal cancer can be found on the Cancer Australia website and the Cancer Council website.

If you would like to speak to a nurse for general information and support, call Cancer Council on 13 11 20 (9 am to 5 pm, Monday to Friday).