There are several different types of primary vaginal cancer:

• Squamous cell carcinoma – Develops in the flat, thin cells (known as squamous cells) that line the vagina. It’s the most common type of vaginal cancer, comprising about 85–90% of vaginal cancers1,²
• Adenocarcinoma – Develops from cells of the vagina that produce mucus (known as glandular cells)²
• Sarcoma – A less common type of vaginal cancer that develops in muscle and tissue in the vaginal wall.²

Vaginal cancer may not always present with obvious symptoms. If symptoms are present, they may include:²

• Bloody vaginal discharge unrelated to periods which may be malodorous
• Pain during sex or bleeding after sex
• A lump or swelling in the vagina
• Pain in the pelvic area or rectum
• Bladder problems such as blood in the urine or needing to urinate a lot

Having any of these symptoms doesn’t mean you have vaginal cancer, but you should see your doctor for a check-up.²

HPV (human papillomavirus) infections are one of the most common cause of vaginal cancer.³ HPV is a sexually transmitted infection.² However, not everyone with HPV will develop vaginal cancer.²

Cervical screening tests (formerly PAP smears) can help identify HPV infections. It’s recommended that people with a cervix have 5-yearly tests from the age of 25 to 74.⁴

Other factors that can increase the risk of vaginal cancer may include:

• Smoking²
• Presence of abnormal cells in the lining of the vagina²
• Previous diagnosis of gynaecological cancer²
• People whose mother was given diethylstilboestrol (DES) during pregnancy. This artificial form of oestrogen was used between 1939 and 1971^2,5

The HPV vaccine is one way to help protect against many HPV strains, however it is not the only cause of vaginal cancer, so will not always prevent against this type of cancer.^1,2,5

It’s currently given free in Australian secondary schools to children aged 12–13 as part of the National Immunisation Program.⁶ Ask your GP for more information.

Your GP may ask to examine your vagina and your pelvic area.² They may also refer you to a specialist for further testing or investigation.

Tests may include:

• Cervical Screening Test – A doctor or nurse will insert a speculum into your vagina to hold it open and then take a swab of cells for analysis in a laboratory.
• Colposcopy – Your doctor will use a magnifying device called a colposcope to examine your cervix, vagina and vulva. As with cervical screening, the doctor will insert a speculum into your vagina to hold it open, but the colposcope does not enter your body.
• Biopsy – While the doctor performs a colposcopy, they may also do a biopsy. This procedure involves taking tissue samples from your vagina, usually with a local anaesthetic, and generally takes a few minutes. The samples will be sent to a laboratory for analysis.

If you are diagnosed with vaginal cancer, your doctor will explain which of the four stages you have and how far your cancer has progressed.

Stage 1 is the least advanced, and Stage 4 is the most advanced.2 Vaginal cancer may be graded from 1 to 3 according to how quickly it may be expected to grow.²

Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments. In vaginal cancers, it may be given concurrently with radiation therapy.²

Radiation therapy may be offered in the early stages of cancer treatment, or after it has started to spread. Radiation therapy may be used for vaginal cancer where surgery is not possible. It may be delivered as external radiation followed by brachytherapy (internal or adjacent radiation). Chemotherapy may also be given concurrently with external radiation.²

In some cases, all or part of the vagina, uterus, cervix or surrounding tissue can be surgically removed. As well as your clinical circumstances, your doctor is likely to consider your personal preferences when determining whether surgical intervention is suitable for you.²

All cancer treatments may have side effects.² The type and severity of side effects will vary between individuals.² 

You can ask your doctor for detailed information about the side effects that you may experience with any treatment recommended for you.

• Get as much rest as possible²
  
• Aim for a wholefood, varied diet, but we also encourage you to eat foods that interest you rather than what you think you should eat⁷
• Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent meals or snacks⁷
• Drink lots of water⁷
• Reach out to support groups and others who have had chemotherapy²
• Ask your team about topical treatments for your skin if you have irritation or pain²
• Stay out of the sun as much as possible throughout your treatment²
• Record your side effects in a diary or journal
• Speak to your doctor about incorporating some gentle exercise into your weekly routine²
• It is important to acknowledge when you are fatigued and rest when you need to2
• Ask for and accept help from family, friends and neighbours²
• Be open with employers about your treatment and discuss flexible working options if you need them²