Key Points for This Section

Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina. Age and exposure to the drug DES (diethylstilbestrol) before birth affect a woman’s risk of developing vaginal cancer. Possible signs of vaginal cancer include pain or abnormal vaginal bleeding. Tests that examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal cancer. Certain factors affect prognosis (chance of recovery) and treatment options.

Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina.

The vagina is the canal leading from the cervix (the opening of uterus) to the outside of the body. At birth, a baby passes out of the body through the vagina (also called the birth canal).

Vaginal cancer is not common. When found in early stages, it can often be cured. There are two main types of vaginal cancer:

• Squamous cell carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the vagina. Squamous cell vaginal cancer spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer. It is found most often in women aged 60 or older.
• Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the vagina make and release fluids such as mucus. Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes. It is found most often in women aged 30 or younger.

Age and exposure to the drug DES (diethylstilbestrol) before birth affect a woman’s risk of developing vaginal cancer.

Anything that increases your risk of getting a disease is called a risk factor. Risk factors for vaginal cancer include the following:

• Being aged 60 or older.
• Being exposed to DES while in the mother's womb. In the 1950s, the drug DES was given to some pregnant women to prevent miscarriage (premature birth of a fetus that cannot survive). Women who were exposed to DES before birth have an increased risk of developing vaginal cancer. Some of these women develop a rare form of cancer called clear cell adenocarcinoma.
• Having human papilloma virus (HPV) infection.
• Having a history of abnormal cells in the cervix or cervical cancer.

Possible signs of vaginal cancer include pain or abnormal vaginal bleeding.

Vaginal cancer often does not cause early symptoms and may be found during a routine Pap test. When symptoms occur they may be caused by vaginal cancer or by other conditions. A doctor should be consulted if any of the following problems occur:

• Bleeding or discharge not related to menstrual periods.
• Pain during sexual intercourse.
• Pain in the pelvic area.
• A lump in the vagina.

Tests that examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal cancer.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
• Pap smear: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap test.
• Biopsy: The removal of cells or tissues from the vagina and cervix so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a Pap smear shows abnormal cells in the vagina, a biopsy may be done during a colposcopy.
• Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) and checked under a microscope for signs of disease.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) depends on the following:

• The stage of the cancer (whether it is in the vagina only or has spread to other areas).
• The size of the tumor.
• The grade of tumor cells (how different they are from normal cells).
• Where the cancer is within the vagina.
• Whether there are symptoms.
• The patient's age and general health.
• Whether the cancer has just been diagnosed or has recurred (come back).

Treatment options depend on the following:

• The stage, size, and location of the cancer.
• Whether the tumor cells are squamous cell or adenocarcinoma.
• Whether the patient has a uterus or has had a hysterectomy.
• Whether the patient has had past radiation treatment to the pelvis.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Cancer that begins in cells that line certain internal organs and that have gland-like (secretory) properties.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope).

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

A rare type of tumor, usually of the female genital tract, in which the inside of the cells look clear when viewed under a microscope. Also called clear cell carcinoma and mesonephroma.

A lighted magnifying instrument used to examine the vagina and cervix.

Examination of the vagina and cervix using a lighted magnifying instrument called a colposcope.

To heal or restore health; a treatment to restore health.

A spoon-shaped instrument with a sharp edge.

Diethylstilbestrol. A synthetic form of the hormone estrogen that was prescribed to pregnant women between about 1940 and 1971 because it was thought to prevent miscarriages. DES may increase the risk of uterine, ovarian, or breast cancer in women who took it. It also has been linked to an increased risk of clear cell carcinoma of the vagina or cervix in daughters exposed to DES before birth. Also called diethylstilbestrol.

The process of identifying a disease by the signs and symptoms.

In medicine, a fluid that comes out of the body. Discharge can be normal or a sign of disease. Discharge also means release of a patient from care.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

The developing offspring from 7 to 8 weeks after conception until birth.

Liquid.

An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.

The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.

A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of human papillomavirus increases the risk of developing cervical cancer. Also called HPV.

Surgery to remove the uterus and, sometimes, the cervix. When the uterus and part or all of the cervix are removed, it is called a total hysterectomy. When only the uterus is removed, it is called a partial hysterectomy.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

The monthly cycle of hormonal changes from the beginning of one menstrual period to the beginning of the next.

A thick, slippery fluid made by the membranes that line certain organs of the body, including the nose, mouth, throat, and vagina.

A health professional trained to care for people who are ill or disabled.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

A procedure in which cells are scraped from the cervix for examination under a microscope. It is used to detect cancer and changes that may lead to cancer. A Pap test can also show noncancerous conditions, such as infection or inflammation. Also called a Pap smear.

A doctor who identifies diseases by studying cells and tissues under a microscope.

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

A physical examination in which the health care professional will feel for lumps or changes in the shape of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The health care professional will also use a speculum to open the vagina to look at the cervix and take samples for a Pap test. Also called an internal examination.

The lower part of the abdomen, located between the hip bones.

An exam of the body to check for general signs of disease.

The likely outcome or course of a disease; the chance of recovery or recurrence.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The last several inches of the large intestine. The rectum ends at the anus.

To come back or to return.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

An instrument used to widen an opening of the body to make it easier to look inside.

Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

Cancer that forms in the tissues of the vagina (birth canal). The vagina leads from the cervix (the opening of the uterus) to the outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which starts in the thin, flat cells lining the vagina. Another type of vaginal cancer is adenocarcinoma, cancer that begins in glandular cells in the lining of the vagina.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the uterus.