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Vaginal Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Vaginal Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

About the vagina

The vagina or birth canal is the opening through which menstrual blood leaves the body and babies are born. It is part of the female reproductive system. The vagina is connected to the cervix, which is the opening of the uterus or womb, and to the vulva, which are folds of skin around the vaginal opening.

Usually, the vagina is in a collapsed position with its walls touching. The walls have many folds that allow the vagina to open and expand during sexual intercourse and vaginal childbirth. The vaginal lining is kept moist by mucus released from glands in the cervix.

The vaginal walls have a thin layer of cells called the epithelium, which contains cells called squamous epithelial cells. Underneath the epithelium, the vaginal wall is made up of connective tissue, involuntary muscle tissue, lymph vessels, and nerves.

This illustration shows a frontal and sagittal (side) view of a woman’s reproductive system. The frontal section shows the fallopian tubes, 2 small ducts that link the 2 ovaries (1 on each side) to the hollow, pear-shaped uterus. The lower, narrow part of the uterus is called the cervix, which leads to the vagina. The uterus is located in the pelvis, between the bladder and rectum, and the vagina is located behind the urethra, which connects to the bladder. 

About precancerous lesions in the vagina

Vaginal intraepithelial neoplasia (VaIN), or vaginal dysplasia, is a condition in which abnormal cells in the vagina can sometimes become cancer. These abnormal cells are often found with cervical dysplasia, also known as cervical intraepithelial neoplasia (CIN), a precancerous lesion of the cervix. Usually, these lesions are associated with human papillomavirus, also called HPV (see Risk Factors and Prevention).

The treatment for these potentially precancerous lesions includes surgical removal, laser surgery, medications such as topical estrogen, and making lifestyle changes, including stopping cigarette smoking. Laser surgery is the use of a focused beam of light that burns the precancerous lesion off the vaginal wall.

About vaginal cancer

Cancers that occur within the female reproductive system are called gynecologic cancers. Vaginal cancer is an uncommon gynecologic cancer. Vaginal cancer begins when healthy cells in the vagina change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor is a tumor that can grow but will not spread.

About 85% of cancers that involve the vagina have actually spread from other parts of the body, and about half of these are from the cervix or uterus. 

There are 5 primary types of cancer that begin in the vagina.

  • Squamous cell carcinoma. Squamous cell carcinoma can develop in the cells lining the vagina, most often in the area closest to the cervix. Squamous cell carcinoma makes up about 85% of vaginal cancers. It develops slowly through the precancerous condition called vaginal intraepithelial neoplasia or VaIN, described above.

  • Adenocarcinoma. Adenocarcinoma begins in the vaginal gland tissue. It makes up about 5% to 10% of vaginal cancers.

  • Clear cell adenocarcinoma. This cancer occurs in people whose mothers took the drug diethylstilbestrol (DES) during pregnancy between the late 1940s and 1971. It is estimated that 1 out of 1,000 people exposed to DES will develop vaginal cancer.

  • Melanoma. Although it is rare, melanoma can begin in the vagina. Melanomas are usually found on skin in parts of the body commonly exposed to the sun, but it can occasionally develop where there is no sun exposure. Melanoma often appears as a dark-colored lesion with irregular borders. Learn more about melanoma.

  • Sarcomas. There are several types of these rare tumors that can start in the vagina. 

Looking for More of an Introduction?

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with vaginal cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with vaginal cancer each year. You will also read general information about surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with vaginal cancer?

Vaginal cancer is uncommon. In 2023, an estimated 8,470 people in the United States will be diagnosed with vaginal cancer. About 75% of vaginal cancers are caused by human papillomavirus, or HPV (see Risk Factors and Prevention). A person’s risk for vaginal cancer increases with age, and the average age of diagnosis is 67. Vaginal cancer is more common among people who are less likely to have access to screening for cervical cancer. Worldwide, an estimated 17,908 people were diagnosed with vaginal cancer in 2020.

It is estimated that 1,740 deaths from this disease will occur in the United States in 2023. In 2020, an estimated 7,995 people worldwide died from vaginal cancer.

What is the survival rate for vaginal cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from vaginal cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with vaginal cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with vaginal cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rate for vaginal cancer in the United States is 51%.

The survival rates for vaginal cancer vary based on several factors. These include the stage of cancer, a person’s age and general health, and how well the treatment plan works.

If the cancer is found at the earliest stage before it has spread outside the vaginal wall, the 5-year relative survival rate is 69%. If the cancer has spread to surrounding tissues or organs and/or to the regional lymph nodes, the 5-year relative survival rate is 57%. If the cancer has spread to a distant part of the body, the 5-year relative survival rate is 26%.

Experts measure relative survival rate statistics for vaginal cancer every 5 years. This means the estimate may not reflect the results of advancements in how vaginal cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s (ACS) publication, Cancer Facts & Figures 2023, and the websites of the ACS, the International Agency for Research on Cancer, and the National Cancer Institute. (All sources accessed March 2023.)

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by vaginal cancer. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find drawings of the main body parts affected by vaginal cancer. Use the menu to see other pages.

This illustration shows a frontal and sagittal (side) view of a woman’s reproductive system. The frontal section shows the fallopian tubes, 2 small ducts that link the 2 ovaries (1 on each side) to the hollow, pear-shaped uterus. The lower, narrow part of the uterus is called the cervix, which leads to the vagina. The uterus is located in the pelvis, between the bladder and rectum, and the vagina is located behind the urethra, which connects to the bladder. 

Copyright 2022 American Society of Clinical Oncology. Robert Morreale.

The next section in this guide is Risk Factors and Prevention. It describes what factors may increase the chance of developing vaginal cancer. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find out more about the factors that increase the chance of developing vaginal cancer. Use the menu to see other pages.

What are the risk factors for vaginal cancer?

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person's risk of developing vaginal cancer:

  • Age. Squamous cell carcinoma most often occurs between the ages of 50 and 70 years old. The average age of people diagnosed with squamous cell carcinoma is 67 years old, and about 80% are older than 50.

  • Human papillomavirus (HPV). Research shows that infection with HPV is a risk factor for vaginal cancer. Sexual activity with someone who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. Research links some HPV strains more strongly with certain types of cancers. HPV vaccines can prevent people from developing certain cancers. Learn more about HPV and cancer.

  • Smoking. Smoking tobacco may increase the risk of developing vaginal cancer.

  • Cervical cancer. A previous diagnosis of cervical cancer or a cervical precancerous condition can increase the risk of vaginal cancer.

  • Previous radiation therapy. Previous radiation therapy in the vaginal area can increase the risk of vaginal cancer.

  • Diethylstilbestrol (DES). People whose mothers took this drug during their pregnancy between the late 1940s and 1971 have an increased risk of clear cell adenocarcinoma of the vagina. The average age of diagnosis is 19. Because most people whose mothers who took DES are now between 50 and 70 years old, the number of cases has decreased substantially. Now, this is a rare tumor. The other long-term risks of DES exposure are not known.

Are there ways to prevent vaginal cancer?

The HPV vaccine Gardasil is approved by the U.S. Food and Drug Administration (FDA) for prevention of vaginal cancer. It is also approved to prevent vaginal precancer (see Introduction). Gardasil helps prevent infection from the most common types, called strains, of HPV. The vaccine is given as 2 shots spread 6 months apart for people 9 to 14 years old. For people 15 years and older, 3 shots are recommended.

Regular gynecologic examinations can help detect cancer or precancerous conditions at an early stage in people with risk factors for vaginal cancer. During a gynecologic exam, the doctor will take a family medical history and perform a general physical examination of the pelvis, during which the doctor will feel the uterus, vagina, cervix, and other reproductive organs to check for any unusual changes.

In addition, research has shown that certain actions can help prevent HPV and vaginal cancer:

  • Delaying first sexual intercourse until the late teens or older

  • Avoiding sexual intercourse with multiple partners

  • Avoiding sexual intercourse with someone who has had many partners

  • Practicing safe sex, including condom use, although condoms cannot fully protect against HPV

  • Having regular Pap tests (see Diagnosis) to find and treat precancerous conditions

  • Not starting to smoke

  • Quitting smoking, if you currently smoke

Different factors cause different types of cancer. Researchers continue to look into what factors cause vaginal cancer, including ways to prevent it. Although there is no proven way to completely prevent vaginal cancer, you may be able to lower your risk. Talk with your health care team for more information about your personal risk of cancer.

Learn more about cancer prevention and healthy living.

The next section in this guide is Symptoms and Signs. It explains what changes or medical problems vaginal cancer can cause. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find out more about the changes and medical problems that can be a sign of vaginal cancer. Use the menu to see other pages.

What are the symptoms and signs of vaginal cancer?

People with vaginal cancer may experience one or more of the following symptoms or signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with vaginal cancer do not have any of the symptoms and signs described below. Or, the cause of a symptom or sign may be a medical condition that is not cancer.

Precancerous conditions, such as vaginal intraepithelial neoplasia (VaIN; see Introduction), and early-stage vaginal cancer do not often cause symptoms. Cancer in later stages can cause symptoms. Many cases of VaIN and early vaginal cancer can be found through regular gynecologic examinations or Pap tests (see Diagnosis).

The most common symptom of vaginal cancer is abnormal vaginal bleeding. Vaginal bleeding during or after menopause may be the sign of a problem and should be discussed with your doctor. Other symptoms of vaginal cancer include:

  • Abnormal vaginal discharge

  • Difficulty or pain when urinating

  • Pain during sexual intercourse

  • Pain in the pelvic area (the lower part of the abdomen between the hip bones)

  • Pain in the back or legs

  • Swelling in the legs

  • Abnormal bowel function

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will try to understand what is causing your symptom(s). They may do an exam and order tests to understand the cause of the problem, which is called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called "palliative and supportive care," which is not the same as hospice care given at the end of life. You can receive palliative and supportive care at any time during cancer treatment. This type of care focuses on managing symptoms and supporting people who face serious illnesses, such as cancer. Learn more in this guide’s section on Coping with Treatment.

Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They do tests to learn if cancer has spread to a different part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How vaginal cancer is diagnosed

There are different tests used for diagnosing vaginal cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose vaginal cancer:

  • Pelvic examination. The doctor examines the vagina, the rest of the reproductive tract, bladder, and rectum to check for any unusual changes.

  • Pap test. During a Pap test, the doctor gently scrapes the outside of the cervix and vagina and takes a sample of cells for testing. During the test, you will usually feel some pressure as the doctor takes the sample of the cells, but there is usually no pain. Human papillomavirus (HPV) testing is usually part of the Pap test after age 29, based on guidelines from the American College of Obstetricians and Gynecologists (ACOG).

  • Colposcopy. The doctor may do a colposcopy to check the vagina and cervix for any abnormalities, especially when Pap or HPV tests return abnormal results. A colposcope is a special instrument, similar to a microscope, that magnifies the surface of the cervix and vagina. The colposcope gives the doctor a lighted, magnified view of the tissues of the vagina and the cervix. The colposcope is not inserted into the body. The examination is not painful, can be done in the doctor’s office, and has no side effects. This examination can be performed during pregnancy.

  • Biopsy. A biopsy is the only way to make a definite diagnosis, even if other tests can suggest that cancer is present. During biopsy, a small amount of tissue is removed for examination under a microscope. A pathologist analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The type of biopsy performed will depend on the location of the tissue being biopsied.

    If the biopsy indicates vaginal cancer, the doctor will refer the patient to a gynecologic oncologist, which is a doctor who specializes in treating gynecologic cancers. The specialist may suggest imaging tests to see if the cancer has spread beyond the vagina.

  • Ultrasound. An ultrasound creates a picture of the internal organs using sound waves.

  • Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated as the tube is inserted through the mouth, anus, vagina, urethra, or a small surgical opening. Sedation is giving medication to become more relaxed, calm, or sleepy.

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail in the image. This dye can be injected into a patient’s vein or taken as a pill or liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI produces detailed images of the inside of the body using magnetic fields, not x-rays. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or taken as a pill or liquid to swallow.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is a way to create pictures of organs and tissues inside the body. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. Other conditions, such as infection or other causes of inflammation, can increase the uptake of the sugar as well. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results help the doctor describe extent of the cancer. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Stages

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

READ MORE BELOW:

What is cancer staging?

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment, and it can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For vaginal cancer, the staging system developed by FIGO, the International Federation of Obstetrics and Gynecology (Federation Internationale de Gynecologie et d'Obstetrique), is most commonly used.

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FIGO stages in vaginal cancer

Doctors assign the stage of the cancer by evaluating the tumor and whether the cancer has spread to lymph nodes and other parts of the body.

Stage I: The tumor is only in the vagina. It has not spread through the vaginal wall or to other parts of the body.

Stage II: The tumor has spread through the vaginal wall but not to the walls of the pelvis.

Stage III: Either of these conditions applies:

  • Cancer has spread to the lymph nodes in the pelvis.

  • Cancer has spread to the pelvic wall.

Stage IVA: Cancer has spread to the bladder, rectum, or beyond the pelvis. The lymph nodes may or may not be involved.

Stage IVB: Cancer has spread to a distant part of the body.

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Recurrent vaginal cancer

Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

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Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with vaginal cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for vaginal cancer. “Standard of care” means the best treatments known. Information in this section is based on medical standards of care for vaginal cancer in the United States. Treatment options can vary from one place to another.

Clinical trials may also be an option for you, which is something you can discuss with your doctor. A clinical trial is a research study that tests a new approach to treatment. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How vaginal cancer is treated

In cancer care, different types of doctors who specialize in cancer, called oncologists, often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, occupational therapists, and others. Learn more about the clinicians who provide cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of conversations are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is important for vaginal cancer because there are different treatment options. Learn more about making treatment decisions.

The common types of treatments used for vaginal cancer are described below. Vaginal cancer is often treated with 1 treatment or a combination of treatments: surgery, radiation therapy, and/or chemotherapy. The approaches used to treat vaginal cancer are very similar to those used to treat cervical cancer, particularly for cancers associated with the human papillomavirus (HPV). Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

READ MORE BELOW:

Concerns about sexual health and having children

A vaginal cancer diagnosis may bring concerns about if or how cancer treatment may affect sexual health and fertility, or the ability to become pregnant. These topics should be discussed with the health care team before treatment begins. If the patient has not yet experienced menopause and is still potentially able to get pregnant, talking with a reproductive endocrinologist (REI) about how to preserve fertility may be helpful. This discussion should include what options for fertility preservation are covered by your health insurance. There may also be charitable funds available to help with the costs of this type of care. 

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Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. The type of surgery used depends on the stage of the cancer and other factors. A gynecologic oncologist is a doctor who specializes in treating vaginal cancer using surgery.

Surgery may be the only treatment needed for a very small vaginal cancer.

Surgical options for vaginal cancer include:

  • Vaginectomy. This is the removal of part or all of the vagina, which may include the pelvic lymph nodes. In some people, the operation is called a radical or modified radical vaginectomy because tissues next to the vagina also need to be surgically removed. A gynecologic or reconstructive surgeon can repair the vagina or create a new vagina with grafts of tissue from other parts of the body. Sexual intercourse may still be possible after this type of surgery, but a lubrication aid may be needed.

  • Hysterectomy. In many cases when surgery is performed, the uterus and the other internal reproductive organs must be removed to help with the complete removal of vaginal cancer. In addition to the uterus, the ovaries, fallopian tubes, and lymph nodes may be removed. Sometimes, the operation is called a radical or modified hysterectomy and may be performed in conjunction with a radical or modified vaginectomy.

Learn more about the basics of cancer surgery.

Coping with surgery for vaginal cancer

Many people experience a range of feelings after vaginal surgery, such as loss, sadness, or anxiety. Some people may feel that they have lost their identity. Others have questions about whether sexual intercourse can continue after surgery.

Before surgery, it is important to ask the surgeon about the procedure, the possible side effects, and when sexual intercourse can begin again. Talk with the health care team about finding additional information or support in coping with this surgery. Learn more about emotional concerns and physical concerns.

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Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. Radiation therapy may be used alone, in combination with chemotherapy, or after surgery. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.

Internal radiation therapy. When radiation treatment is given using implants, it is called internal radiation therapy, also known as brachytherapy. Types of brachytherapy include intracavitary radiation therapy and interstitial radiation therapy techniques.

Brachytherapy is very useful for treating vaginal cancer and is often used in combination with external-beam radiation therapy. A recent study showed that people with vaginal cancer who received brachytherapy lived longer.

One way of giving intracavitary radiation therapy involves placing hollow tubes in the vagina next to the tumor so that a precise dose of radiation can be inserted into the tubes and directly applied to the tumor. The radioactive substance is left in place in the vagina for several minutes, and patients must stay in bed during this time. This is most often done as an outpatient procedure, meaning there is no overnight stay in the hospital.

Another method is interstitial radiation therapy, in which radioactive material is inserted with special needles directly into the tumor. For this procedure, patients are admitted into the hospital.

Side effects of radiation therapy. Side effects from radiation therapy depend on the dose used, the area targeted, and the type of radiation therapy. Side effects may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most of these side effects go away soon after treatment is finished. Other side effects may include the narrowing of the vagina, damage to healthy vaginal tissue, dryness of the vagina, and irritation of the intestines. The vagina may shorten and narrow so much that sexual intercourse is not possible. To prevent this, the vagina may need to be stretched with a plastic tube called a vaginal dilator several times a week. Talk with your health care team about the possible side effects of your specific radiation therapy and how they can be managed.

Learn more about the basics of radiation therapy. For more information on radiation therapy for gynecologic cancers, see the American Society for Therapeutic Radiology and Oncology's pamphlet, Radiation Therapy for Gynecologic Cancers (PDF; please note that this link takes you to a separate, independent website).

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Chemotherapy

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications to take at home, be sure to ask your health care team about how to safely store and handle them.

The type of systemic therapy used for vaginal cancer is chemotherapy. Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. The goal of chemotherapy can be to destroy cancer remaining after surgery, slow tumor growth, or reduce symptoms related to the cancer. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.

Although chemotherapy can be given orally (by mouth), most drugs are given intravenously (IV) for vaginal cancer. IV chemotherapy is either injected directly into a vein or through a catheter, a thin tube temporarily put into a large vein to make injections easier. Intravaginal chemotherapy (drugs that are put directly into the vagina) may be used to treat early-stage vaginal cancer.

Typically, when radiation therapy (see above) to the pelvis is used, a low dose of chemotherapy, such as cisplatin (available as a generic drug), is given to make the radiation therapy more effective. This combination of treatment is referred to as "chemoradiation."

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished. Other potential side effects include the inability to become pregnant and symptoms of early menopause. Learn more about sexual health and reproductive health concerns.

Learn more about the basics of chemotherapy.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

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Physical, emotional, social, and financial effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative and supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative and supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative and supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative and supportive care options. Talking with a pelvic physical therapist may be helpful to relieve vaginal side effects, including pain and sexual function. Many patients also benefit from talking with a social worker and participating in support groups for help with coping with this diagnosis. Ask your doctor about these resources, too.

Cancer care is often expensive, and navigating health insurance can be difficult. Ask your doctor or another member of your health care team about talking with a financial navigator or counselor who may be able to help with your financial concerns.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative and supportive care in a separate section of this website.

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Treatment by stage of vaginal cancer

Different treatments may be recommended for each stage of vaginal cancer. The general options by stage are described below. For more detailed descriptions of each treatment approach, see “How vaginal cancer is treated,” above. Your doctor will work with you to develop a specific treatment plan for you based on your specific diagnosis and needs. Clinical trials may also be a treatment option for each stage.

Stage I or II

  • Surgical removal of the tumor, including part or all of the vagina and possible removal of pelvic lymph nodes, and in select patients, followed by radiation therapy with or without low-dose chemotherapy

  • Internal radiation therapy with or without external-beam radiation therapy

Stage III or IVA

  • Combined internal radiation therapy and external-beam radiation therapy, often with concurrent low-dose chemotherapy

  • Systemic chemotherapy in specific patients 

Stage IVB

  • Radiation therapy

  • Systemic chemotherapy

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Metastatic vaginal cancer

If cancer spreads to a different part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating metastatic vaginal cancer. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Stage IV vaginal cancer is the most advanced stage of the disease. At this stage, the cancer has spread beyond the vagina to the bladder, rectum, lymph nodes of the pelvis, or other organs, such as the bones or lungs. The symptoms of advanced vaginal cancer can include:

  • Unusual vaginal bleeding

  • Abnormal vaginal discharge

  • Difficulty or pain when urinating

  • Pain during sexual intercourse

  • Pain in the pelvic area

  • Pain in the back or legs

  • Nausea and vomiting

  • Abnormal bowel function

People with vaginal cancer that has spread to the bladder and rectum may receive internal radiation therapy and external-beam radiation therapy and/or surgery. Palliative and supportive care will be important to help relieve symptoms and side effects.

If the bladder is removed (in a surgery called a cystectomy), a small piece of intestine will be attached to the abdominal wall, allowing the person to periodically drain urine by placing a slim, hollow tube into a surgically created opening. A plastic bag worn at the front of the stomach can be used for continual draining.

If the rectum or part of the colon is removed, a person with vaginal cancer may need to have a colostomy. This is a surgical opening, or stoma, through which the colon is connected to the abdominal surface to provide a pathway for waste to exit the body. The waste is collected in a pouch worn by the patient. Learn more about colostomies.

For many people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of your health care team. It may be helpful to talk with other patients, such as through a support group or other peer support program.

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Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may be called having “no evidence of disease” or NED.

A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

If a recurrence happens, a new cycle of testing will begin to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often, the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace.

Surgery may be performed to remove the cervix, uterus, lower colon, rectum, and/or bladder, depending on where the recurrence began and the type of surgery previously performed. When there is a recurrent pelvic cancer after radiation therapy to the pelvis and if no metastatic disease is found outside the pelvis, a very extensive operation called a "pelvic exenteration" might be considered to provide a chance to cure the cancer. The operation removes the vagina and often the bladder and rectum. Radiation therapy and/or chemotherapy may be used for treatment.

Your doctor may suggest clinical trials that are studying new ways to treat recurrent vaginal cancer. Whichever treatment plan you choose, palliative and supportive care will be important for relieving symptoms and side effects.

People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

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If treatment does not work

Recovery from vaginal cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

Planning for your future care and putting your wishes in writing is important, especially at this stage of disease. Then, your health care team and loved ones will know what you want, even if you are unable to make these decisions. Learn more about putting your health care wishes in writing.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with your doctor or a member of your palliative care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help cope with the loss. Learn more about grief and loss.

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The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with vaginal cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of vaginal cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Others volunteer for clinical trials because these studies are a way to contribute to the progress in treating vaginal cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with vaginal cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. Clinical trials may only be offered in certain locations and therefore may require travel. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. These may include that the new treatment is not working or there are serious side effects. Clinical trials are closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for vaginal cancer, learn more in the Latest Research section.

Cancer.Net offers more information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

There are many resources and services to help you search for clinical trials for vaginal cancer, including the following services. Please note that these links will take you to separate, independent websites:

  • ClinicalTrials.gov. This U.S. government database lists publicly and privately supported clinical trials.

  • World Health Organization (WHO) International Clinical Trials Registry Platform. The WHO coordinates health matters within the United Nations. This search portal gathers clinical trial information from many countries’ registries.

Read more about the basics of clinical trials matching services.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest Research. It explains active areas of scientific research for vaginal cancer. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will read about the scientific research being done to learn more about vaginal cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about vaginal cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • Human papillomavirus (HPV) research. Researchers are working to learn more about the link between HPV and vaginal cancer.

  • Enhanced surgical and radiation techniques. Advances are being made in surgery and radiation therapy to increase cure rates and reduce treatment side effects. This includes vaginal reconstructive surgery after advanced surgery to treat the cancer.

  • New chemotherapy. Researchers continue to investigate new drugs and new combinations of existing treatments for vaginal cancer, such as combining chemotherapy with radiation therapy.

  • Palliative and supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current vaginal cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in vaginal cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance on how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

READ MORE BELOW:

Treatment for cancer can take a long time. Regular visits for radiation therapy, systemic therapy, and follow-up appointments after surgery can take up a lot of time and money. It is important to prepare for these demands on your resources, and if you have any concerns, be sure to discuss them with your health care team.  

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative and supportive care. It is an important part of your treatment plan, regardless of age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for vaginal cancer are described in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health. These effects may include changes to your sexual health and fertility.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to talk about any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, side effects can last after treatment ends. Doctors call these long-term side effects. Side effects that occur months or years after treatment are called late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-Up Care section of this guide or talking with your doctor.

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Coping with emotional and social effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, fear, or anger, or managing stress. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

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Coping with the stigma of vaginal cancer

Vaginal cancer, like other cancers that affect the sex organs, can be difficult to discuss. People with many different types of cancer, such as vaginal, cervical, testicular, penile, and vulvar cancers, can experience feelings of embarrassment when discussing these “sensitive” areas of their bodies. However, this should never stop you from requesting and receiving the emotional support you deserve, and your treatment team will never be embarrassed by discussing these issues with you. Your team can help you feel comfortable talking about this with others as well.

Because vaginal cancer is associated with human papillomavirus (HPV), patients may feel that they will not receive as much support or help from people around them because they believe that others may think that their behavior caused the disease. Although many vaginal cancers are caused by HPV, it is important to remember that most genital HPV infections will not cause cancer. Vaginal cancer can affect anyone.

Living with this stigma can make patients feel guilty, hopeless, embarrassed, ashamed, and isolated. Patients and their families should tell the health care team if they are affected by any of these emotions. There are resources to help those living with vaginal cancer. Some patients feel comfortable discussing their disease and experiences with their doctor, nurse, family, and friends. Other people find help through a support group or other support options.

Learn more about counseling and finding a support group.

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Coping with the costs of cancer care

Cancer treatment can be expensive. It may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care keeps them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

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Coping with barriers to care

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called “cancer disparities.” Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, adults older than 65, and people who live in rural areas or other underserved communities.

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.

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Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should I call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

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Caring for a loved one with vaginal cancer

Family members and friends often play an important role in taking care of a person with vaginal cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

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Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on anxiety and depression, constipation, diarrhea and rash that provide a tracking sheet to record details about the side effect. These free fact sheets are available as a PDF, so they are easy to print, fill out, and give to your health care team.

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The next section in this guide is Follow-Up Care. It explains the importance of checkups after you finish cancer treatment. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead.

Although there are no specific guidelines, you should visit your doctor regularly for physical and pelvic examinations and a Pap test. Follow-up care is very important for people who have finished vaginal cancer treatment. The doctor may recommend other tests, including x-rays, computed tomography (CT) scans, ultrasounds, or magnetic resonance imaging (MRI) scans. Tell your doctor about any new symptoms.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. The American Society of Clinical Oncology (ASCO) offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

For some, the term “survivorship” itself does not feel right, and they may prefer to use different language to describe and define their experience. Sometimes long-term treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment.

Survivors may experience a mixture of feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenges you face

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Learn more about coping with challenges after treatment for gynecologic cancer.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from vaginal cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-Up Care) to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Guide to Cancer Survivorship: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. Suggested questions to ask are below, and the Cancer.Net Blog also offers a list of questions specific to gynecologic cancers. These suggestions are a starting point to help you learn more about your cancer care and treatment. You are encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • What type of vaginal cancer do I have?

  • Can you explain my pathology report (laboratory test results) to me?

  • What is the stage of my cancer? What does this mean?

  • What are my treatment options?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What types of research are being done for vaginal cancer in clinical trials? Do clinical trials offer additional treatment options for me?

  • What treatment plan do you recommend? Why?

  • Who will be part of my health care team, and what does each member do?

Questions to ask about choosing a treatment and managing side effects

  • If surgery is recommended, who will be doing the surgery? How experienced is this surgeon with vaginal cancer?

  • Who will be leading my overall treatment?

  • Will I need reconstructive surgery?

  • What are the possible side effects of treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • How will this treatment affect my sex life, and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • How can I keep myself as healthy as possible during treatment?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects of having this surgery?

  • What can be done to prevent or relieve the side effects?

Questions to ask about having radiation therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect from the radiation therapy?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects of having this treatment?

  • What can be done to prevent or relieve the side effects?

Questions to ask about having chemotherapy

  • What type of chemotherapy is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home?

  • What side effects can I expect from the chemotherapy?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects?

  • What can be done to prevent or relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • When should I return to my primary care doctor for regular medical care?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Vaginal Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Vaginal Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are some links to help you explore other parts of Cancer.Net

This is the end of Cancer.Net’s Guide to Vaginal Cancer. Use the menu to choose a different section to read in this guide.