Vaginal cancer

There are several different types of primary vaginal cancer:

• Squamous cell carcinoma – develops in the flat, thin cells (squamous cells) that line the vagina. It is the most common type, accounting for about 85–90% of vaginal cancers^1-3
• Adenocarcinoma – develops from the glandular cells in the vagina that produce mucus^2,3
• Sarcoma – a rare type of vaginal cancer that develops in the muscle or connective tissue of the vaginal wall.^2,3

Vaginal cancer may not always cause obvious symptoms. When symptoms are present, they may include:^2,3

• Bloody or unusual vaginal discharge not related to periods, which may have an odour
• 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 frequently

If you experience any of these symptoms, it does not necessarily mean that you have vaginal cancer. It is recommended that you speak with your GP or specialist about any concerns or questions you may have..^2,3

Human papillomavirus (HPV) infection is one of the most common causes of vaginal cancer.⁴ 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 is recommended that people with a cervix have these tests every five years, from ages 25 to 74.⁴

Other factors that may increase the risk of vaginal cancer include:^2,5

• Smoking
• Abnormal cells in the lining of the vagina
• Previous diagnosis of a gynaecological cancer
• Exposure to diethylstilboestrol (DES) – an artificial form of oestrogen prescribed to some pregnant women between 1939 and 1971

Does the HPV vaccine prevent vaginal cancer?

The HPV vaccine helps protect against many HPV strains, but because HPV is not the only cause of vaginal cancer, vaccination does not eliminate all risk.^1,2,5

It is currently given free to children aged 12–13 through Australian secondary schools 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 tests or investigations.

Tests may include:

• Cervical screening test – this test replaced the Pap smear in Australia. A doctor or nurse will insert a speculum into your vagina to gently hold it open and take a swab of cells for laboratory analysis.
• Colposcopy – your doctor uses a magnifying device called a colposcope to examine your cervix, vagina, and vulva. As with cervical screening, a speculum is inserted to hold the vagina open, but the colposcope itself does not enter the body.
• Biopsy – during a colposcopy, your doctor may also take a small tissue sample from your vagina under local anaesthetic. The procedure usually takes a few minutes, and the sample is sent to a laboratory for analysis.

If you are diagnosed with vaginal cancer, your doctor will explain the stage of the cancer and how far it has progressed.

Stage 1 is the least advanced, and Stage 4 is the most advanced.² Vaginal cancer may also be graded from 1 to 3, depending on how quickly the cancer cells are 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