Researchers don’t know for sure what causes vaginal cancer. Still, as with cervical cancer, there’s likely a relationship between vaginal cancer and high-risk strains of HPV. Studies have shown that many people diagnosed with vaginal cancer have also tested positive for antibodies associated with the types of HPV linked to cervical cancer.
Vaginal cancer cells behave as all cancer cells do. Instead of growing, multiplying and eventually dying like a normal cell, cancer cells continue to grow. The cells multiply until they form tumors. Over time, these tumors may spread to other parts of your body (metastasize) and invade healthy tissue.
Your healthcare provider will begin your examination by asking about your symptoms. You’ll most likely receive several tests to check for cancer or precancerous cells. Imaging procedures can help your provider see if your cancer has spread, a process called staging.
You’ll likely have a pelvic exam and a Pap smear (Pap test). If your provider finds abnormal cells, you may need further tests, like a colposcopy and a vaginal biopsy. A biopsy is the only test that can confirm a cancer diagnosis.
Pelvic exam: Your provider will visually inspect your vulva and insert two fingers inside your vagina to feel for any abnormalities. They’ll use a tool called a speculum to widen your vagina so that it’s easier to see your vaginal canal and cervix.
Pap smear: While holding your vagina open with a speculum, your provider will use a spatula-like tool and a brush to scrape cells from your cervix. These cells will get tested in a lab for signs of cancer or HPV.
Colposcopy: In this procedure, your doctor uses a lighted instrument called a colposcope to look for abnormal cells in your vagina and cervix.
Biopsy: A biopsy often accompanies colposcopy. Your provider will take a tissue sample that will be sent to a lab and tested for cancer cells.
Staging allows your provider to determine how advanced your cancer is. Vaginal cancer is staged in three ways, based on how far the tumor has progressed in your vagina, whether it has spread to your lymph nodes, and whether it has spread to other parts of your body. These three categories are called T (tumor), N (nodes), and M (whether it has spread, or metastasized).
Vaginal Cancer During PregnancyYour provider can stage your cancer by using information from the test results and by performing procedures that allow them to see inside your body.
Imaging procedures used to stage cancer include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. MRIs provide details about a tumor’s size. PET scans can show abnormal lymph nodes.
Cystoscopy can show if cancer has spread to your bladder. A small lighted tube with a camera is inserted into your bladder for this procedure.
Proctoscopy can show if cancer has spread to your small intestine or rectum. A small lighted tube with a camera is inserted into your rectum for this procedure.
Treatment for vaginal cancer depends on the type of cancer, cancer stage, and your age. Depending on your age, your treatment may also depend on whether you’d like to have children.
In general, laser surgery and topical treatments are used to treat precancerous cells. Invasive vaginal cancer will often require surgery, radiation and chemotherapy. You may receive a variety of treatments.
Wide local excision: Your healthcare provider removes the tumor along with some of the healthy tissue surrounding it.
Vaginectomy (partial or radical): Your provider removes all or part of your vagina depending on tumor size and location. Depending on how far the cancer has spread, your provider may recommend removing your lymph nodes (lymph node dissection) and your uterus and cervix (hysterectomy).
Pelvic exenteration: This surgery removes multiple organs from your pelvis, including the bottom part of your colon (rectum), bladder, uterus, cervix, vagina, ovaries and nearby lymph nodes. Your provider will make an opening in your abdomen that will allow you to pee and poop (called a stoma or ostomy bag). This type of surgery may be an option if you have recurring cancer.
Radiation uses targeted energy beams, like X-rays, to destroy cancer cells or keep them from dividing.
External radiation therapy: A machine outside your body directs beams of high-energy radiation at your tumor.