Cancer of the vagina

Overview

Vaginal cancer is a very rare cancer that's found anywhere in the vagina

The vagina is a tube between the vulva and the opening of the womb (cervix)

Vaginal cancer is nearly always caused by an infection from certain types of the human papillomavirus (HPV)

It's often found and prevented by attending cervical screening, which aims to find and treat abnormalities before they turn into cancer

Vaginal cancer usually grows very slowly and how serious it is depends on how big it is, if it has spread and your general health

Main Symptoms of vaginal cancer

The main symptoms of vaginal cancer are usually

A lump in the vagina
Ulcers and other skin changes in or around the vagina

Other symptoms of vaginal cancer include:

Bleeding from the vagina after the menopause
Bleeding after sex or pain during sex
Smelly or bloodstained vaginal discharge
Bleeding between periods
An itch in your vagina that will not go away
Pain when you pee, or needing to pee a lot

Vaginal pain is rare, especially in women under 40

See a GP if:

If you think you might have symptoms of vaginal cancer.

Your symptoms are new and do not go away

These symptoms are very common and can be caused by many different conditions. Having them does not definitely mean you have vaginal cancer. But it's important to get them checked by a GP, this is because if they are caused by cancer, finding it early makes it more treatable.

What happens at your GP appointment

The GP or practice nurse may ask to exmine you.

You can ask for a female doctor or nurse when you book your appointment

You'll be asked to undress behind a screen, from the waist down. You'll be given a sheet to put over you.

Then the GP or nurse may:

Look at the outside of your vagina (vulva)

Feel inside your vagina with 2 fingers while pressing on your tummy (they will be wearing gloves)

It should not be painful, but you might find it uncomfortable. Talk to the GP or nurse it you are feeling uncomfortable.

You can have a friend, family member or other members of staff in the room with you during your exam if you want.

You can ask to stop the exam at any time.

Referral to a specialist

The GP may refer you for more tests or to see a specialist in hospital if they think you have a condition that needs to be investigated. This may be an urgent referral, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.

Main causes of vaginal cancer

More than half of all vaginal cancers are caused by an infection with certain types of human papillomavirus (HPV)

You can get HPV from:

Any skin to skin contact of the genital area
Vaginal, anal or oral sex
Sharing sex toys

Who is more likely to get vaginal cancer

Women and anyone with a vagina can get vaginal cancer including:

Trans and non-binary people with a vagina, or who have parts of their vagina left from gender surgery
People who have had a hysterectomy
You might also be more likely to get vaginal cancer if:
Your have had an HPV infection
Precancerous cells have been found in your cervix (CIN) or vagina (VAIN)
You have had cervical cancer
You are 75 and over - vaginal cancer is more common in older women
You have lupus, a condition that affects your immune system
You have HIV or AIDS
Your mother took the hormonal drug diethylstilbestrol (DES) while pregnant with you - your GP can discuss these risks with you
You have womb cancer, especially if you had radiotherapy

How to lower your chance of getting vaginal cancer

You cannot always prevent vaginal cancer

But as there's a link between vaginal cancer and HPV, cervical screening and HPV vaccination are the best ways to protect yourself.

All women and people with a cervix between the ages of 25 and 64 are invited for regular cervical screening. It helps find and treat any changes in the cells of the cervix before they turn into cancer.

All children aged 12 to 13 are offerd the HPV vaccine. It helps protect against all cancers caused by HPV, as well as genital warts.

There are some things you can do to lower your chance of getting vaginal warts.

Use condoms, which lower your chance of getting HPV - but they do not cover all the skin around your genitals, so you are not fully protected.

Quit smoking, as smoking can weaken your immune system and the chemicals in cigarettes can also cause cervical cancer

Eat a balanced diet to help support your immune system

It's important to get any symptoms of vaginal cancer checked by a GP

Main test for vaginal cancer (colposcopy)

The specialist will have a closer look at your tummy and pelvis, the area between your hips, so they can feel the organs there.

They will also do a test to have a closer look at your vulva and vagina. This is called a colposcopy.

You'll be asked to undress from the waist down behind a screen. You will be given a sheet to put over you.

During a colposcopy:

The specialist nurse will ask you to lie back on the bed, usually with you legs bent, feet together and knees apart.

They will gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant may be used.

A microscope with a light at the end is used to look at your vagina and cervix. The microscope stays outside your body

A small sample of cells (biopsy) may be collected to send to a laboratory

The test should take around 15 to 30 minutes

It should not be painful, but you might find it uncomfortable. Talk to the nurse if you are feeling uncomfortable

Find out more :

NHS Colposcopy

Cancer Research UK : Pelvic examination and colposcopy for vaginal cancer

Getting your results

It can take several weeks to get the results of your colposcopy

You may be asked to go to the hospital to get your results, or they may be sent to you in the post

Try not to worry if your results are taking a long time to get to you. It does not definitely mean anything is wrong

You can call the hospital or GP if you are worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you are told you have vaginal cancer

Being told you have vaginal cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, treatment and beyond.

Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.

They are there to listen if you have anything you want to talk about.

Call 0808 808 00 00.

Next Steps

If you have been told you have vaginal cancer, you will usually need more tests.

These, along with the colposcopy, will help the specialists find out the size of the cancer and how far it's spread (called the stage).

Find out more about what cancer stages mean on the Cancer Research UK website

You may need:

Blood tests
Scans, like a CT Scan, MRI Scan, PET Scan, or chest X-Ray
A more detailed internal examination of your vagina and cervix - you will have a general anaesthetic which means you will be asleep during the examination

You may not have all these tests

The specialists will use the results of these tests and work with you to decide on the best treatment plan for you

Treatment for vaginal cancer

The treatment you have will depend on:

The size and type of vaginal cancer you have
Where it is in the vagina
If it has spread
Your general health.

The main treatments for vaginal cancer is Radiotherapy. You may also have surgery and chemotherapy.

The specialist team looking after you will:

Explain the treatments, benefits and side effects
Work with you to do a treatment plan that is best you
Help you manage any side effects

If you have symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your check-up.

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells. It's the main treatment for vaginal cancer.

Radiotherapy for vaginal cancer can be given from outside or inside the body (brachytherapy)

Find out more:

Cancer Research UK: external radiotherapy for vaginal cancer

Cancer Research UK: planning and having internal radiotherapy for vaginal cancer

Surgery

Surgery is usually only used on vaginal cancer that's found early. It's also used if radiotherapy has not worked.

There are several surgeries used to treat vaginal cancer.

Different surgeries involve removing:

Part of the vagina - this is only possible if the cancer is small and is in the upper section of your of your vagina
All of the vagina - sometimes lymph nodes in your pelvis are removed too
The vagina, cervix and womb (hysterectomy) - this can include removal of the ovaries and fallopian tubes

The vagina, cervix, ovaries and fallopian tubes, and all or parts of the bladder, bowel and rectum -this is only offered if the cancer has spread and other treatment is not possible

Vaginal reconstruction

If your vagina has to be removed, you can ask the surgeon about vaginal reconstruction

A vaginal reconstruction uses skin and muscle from other parts of your body to create a new vagina

This means you may be able to have vaginal sex again once you have recovered from the operation

Ask your surgeon about the risks and benefits of vaginal reconstruction. Some people decide they do not want to have additional surgery.

Find Out More

Cancer Research UK: types of surgery for vaginal cancer

Cancer Research UK: vaginal reconstruction

Chemotherapy

Chemotherapy uses medicines to kill cancer cells

It's not often on it's own to treat vaginal cancer

You may have chemotherapy with radiotherapy (chemoradiotherapy)

Find out more

Cancer Research UK: chemotherapy for vaginal cancer

Care after your treatment

A member of your specialist team will be able to give you information on how often you will need check-ups after your treatment.

You will usually be seen every few months for the first few years. And at each visit a doctor or nurse will check if you have any worries or problems .

It can also help to get support from family, friends or a support organisation if you get anxious between appointments.

Eve Appeal has a free specialist health information helpline to answer any questions you may have. Call 0808 802 0019

Macmillan Cancer Support also has a free helpline. Call 0808 808 0000

Where to find help and support

You and your loved ones will be supported throughout your treatment by a grouup of specialists.

The clinical nurse specialist, or another member of your specialist team, will be able to give you information on local support services you may find helpful.

There are also national cancer charities that offer support and information abot vaginal cancer.

Macmillan Cancer Support

Information and support for anyone affected by cancer

Website:www.macmillan.org.uk

Helpline: 0808 880 00 00

Macmillan Cancer Support: online forum

Cancer Research UK:

Information and support for anyone affected by cancer. Website:www.cancerresearchuk.org

Nurse Helpline: 0808 800 4040

Cancer Research UK: online cancer chat forum

Cancer Research UK: find a clinical trial service

Eve Appeal