Vaginal Cancer Diagnosis & Prognosis

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

In addition to asking about your personal and family health history and doing a physical exam, your doctor may perform the following tests and procedures:

• Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also 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. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

• Pap test: 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 smear.
•  Human papillomavirus (HPV) test: A laboratory test used to check DNA or RNA for certain types of HPV infection. Cells are collected from the cervix and DNA or RNA from the cells is checked to find out if an infection is caused by a type of HPV that is linked to cervical cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal cervical cells.
• 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) or a brush and checked under a microscope for signs of disease.
• 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 test shows abnormal cells in the vagina, a biopsy may be done during a colposcopy. 

You may want to get a second opinion to confirm your vaginal cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes or another treatment approach, or provide more information about your cancer.

Learn more about choosing a doctor and getting a second opinion at Finding Cancer Care. You can contact NCI’s Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor, hospital, or getting a second opinion. For questions you might want to ask at your appointments, visit Questions to Ask Your Doctor About Cancer. 

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

The prognosis 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 look from normal cells under a microscope).
• Where the cancer is within the vagina.
• Whether there are signs or symptoms at diagnosis.
• Whether the cancer has just been diagnosed or has recurred (come back).

Treatment options depend on the following:

• The stage and size of the cancer.
• Whether the cancer is close to other organs that may be damaged by treatment.
• Whether the tumor is made up of squamous cells or is an adenocarcinoma.
• Whether the patient has a uterus or has had a hysterectomy.
• Whether the patient has had past radiation treatment to the pelvis.