• The vagina is a muscular tube that extends from the opening of the womb (cervix) to the folds of skin (vulva) between a woman's legs.

• There are two main types of vagina cancer: Primary vaginal cancer (starting in the vagina itself), and secondary vaginal cancer (cancer that has spread into the vagina from another part of the body).

There are two types of primary vaginal cancer:

• Squamous cell: The most common type of vaginal cancer is called squamous cell. This is usually found in the upper part of the vagina.

• Adenocarcinoma: This type of vaginal cancer usually affects women under 20, but may occasionally occur in other age groups.

(Other very rare types include melanoma, small cell carcinoma, sarcoma, and lymphoma.)

Secondary vagina cancer is more common. Normally situated around the neck of the womb (cervix), the lining of the womb (endometrium), or coming from nearby organs such as the bladder or bowel.

What causes cancer of the vagina?

The causes of vagina cancer is unknown, but there are factors that increase the risk of developing vagina cancer:

• Vaginal warts

• Previous radiation treatment

What are the symptoms?

The most common symptoms of vagina cancer are:

• A blood-stained vaginal discharge

• Bleeding after sexual intercourse

• Pain after sexual intercourse

• Problems with passing urine (blood in the urine, the need to pass urine frequently, the need to pass urine at night).

• Pain in the back passage (rectum).

TIP: If you have any of these symptoms you should have them checked by a doctor - but remember, they are common to many illnesses other than vagina cancer.

How is it diagnosed?

After visiting a GP a referral will probably be made to a hospital for some tests.

These may include:

• Internal vaginal examination: A specialist doctor will do a full pelvic examination. This includes examining the inside of the vagina (checking for any lumps or swelling) and will also feel the groin and pelvic area (checking for swollen glands) and may also check the back passage (rectum).

• Cervical smear: This a smear test to see if there are any abnormalities in the cells of the cervix.

• Colposcopy: A closer examination of the vagina using a colposcope, which is a small, low-powered microscope. Usually carried out in the hospital outpatient department (don’t take pyjamas) and takes about 10–15 minutes. Is slightly uncomfortable but shouldn’t be painful.

• Biopsy

• Chest X-Ray

• Blood Test

• MRI scan: Uses magnetism instead of x-rays to form a series of cross-sectional pictures of the inside of the body.

TIP: The person conducting the smear test/examinations should explain the procedure and you should feel able to ask questions at any time.

If the results of the test show vagina cancer, another referral will be made to a doctor who specialises in the treatment of the reproductive organs (called a gynaecologist).

Staging

The stage of a cancer is a term used to describe its size and whether or not it has spread beyond its original site. There are four stages for vagina cancer:

• Stage 1: Cancer is only in the vagina and has not begun to spread.

• Stage 2: Cancer has begun to spread through the wall of the vagina, but has not spread to the bones of the pelvis.

• Stage 3: Cancer spread to the pelvis and may also be in the lymph nodes close to the vagina.

• Stage 4: Cancer spread to  bladder or the bowel or other parts of the body, such as the lungs.

Grading

Grading refers to the appearance of the cancer cells under the microscope and gives an idea of how quickly the cancer may develop. Ranging from low grade to high grade.

How is it treated?

A team of doctors and other staff at the hospital will plan the treatment. It will depend on the size of the tumour and where it is.

Treatment may be coordinated by an oncologist (a doctor who specialises in treating cancer with chemotherapy) a gynaecologist (a surgeon who specialises in reproductive organs) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve:

• Chemotherapy

• Radiotherapy

• Surgery

Most people have chemotherapy to shrink to size of the tumour and to get rid of any cancer cells around the body. This is usually followed with surgery to remove the tumour. More chemotherapy and radiotherapy usually follows.

Chemotherapy for  cancer of the vagina

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. This treatment is often given to people with vagina cancer to shrink the tumour prior to surgery. This means that the surgery will be less invasive. Often chemo starts again after surgery to kill any remaining cancer cells and stop them from spreading. This is called adjunct chemotherapy.

For more information about chemotherapy, go to our chemotherapy fact sheet.

Surgery for cancer of the vagina

The aim of surgery is to remove the vagina cancer. Depending on the amount removed, the remaining vaginal tissue may be able to stretch so that you can still have sexual intercourse.

Other vagina cancer surgeries include:

• Vaginectomy: A larger operation which removes the whole of the vagina.

• Radical hysterectomy: May be necessary to remove the womb (uterus), cervix, ovaries, and fallopian tubes. To increase the chances of success the lymph nodes in the pelvis may also be removed.

For more information about surgery, go to our surgery fact sheet.

TIP: It is possible to make a new vagina (vaginal reconstruction) using tissue from other parts of the body.

Radiotherapy for cancer of the vagina

For some, radiotherapy is considered the most suitable treatment, as it is the least intrusive of all therapies.

Depending on age, a combination of chemotherapy and radiotherapy (chemo-radiotherapy) is considered best. Radiotherapy is the use of high energy X-rays to shrink and destroy the vagina cancer cells. There are two main types of radiotherapy used against vagina cancer:

• External radiotherapy: Beams of radiation being directed at the cancer from outside the body. Usual treatment regime, is five days a week, for 4–6 weeks. Chemotherapy may also be given once a week during the radiotherapy treatment (chemo-radiotherapy).

• Internal radiotherapy An applicator (similar to a tampon) containing a radioactive substance being inserted into the vagina, for a short period of time (several minutes to a few hours depending on the strength).

TIP: Make sure you ask as many questions as you need. Don’t be brave, be inquisitive!

For more information about radiotherapy, go to our radiotherapy fact sheet.

Side effects of treatment

There are some side effects of the treatments for vagina cancer which can be found in our side effects fact sheet.

More information

You may want to check out the fact sheets on the left hand side for more information on other cancers and related topics.

Check out our community pages to chat with other young people about vagina cancer, its treatment….or anything really.