Vaginal cancer

What causes vaginal cancer?

There are certain things that can increase the chance of developing vaginal cancer. These are called risk factors.

The main risk factor for vaginal cancer is HPV (human papilloma virus).

Having one or more risk factors doesn’t mean you’ll get vaginal cancer. Also, having no risk factors doesn’t mean you’ll not develop vaginal cancer.

Macmillan Cancer Support have more information about the possible causes of vaginal cancer.

If you have symptoms of vaginal cancer, you will usually start by seeing your GP practice. They will then refer you to a specialist doctor called a gynaecologist at the hospital. The gynaecologist may arrange some of the following tests.

Internal (vaginal) exam

An internal, or vaginal, examination is when the doctor gently checks the inside of the vagina for any lumps or swellings.

Taking a sample of cells from the cervix

This is the same test that is used for cervical screening. It checks for any abnormal cells in the cervix.

Colposcopy

A colposcopy uses a microscope called a colposcope to look closely at your vagina. The doctor will take a small sample of tissue, called a biopsy, from any areas that look abnormal.

Examination under anaesthetic (EUA)

An EUA is an examination of the vagina and cervix carried out under a general anaesthetic. It allows your doctor to examine you thoroughly without any discomfort to you.

Further tests for vaginal cancer

If the tests show that you have vaginal cancer, you will need further tests. Most of these are done to find out whether the cancer has spread to the pelvis or to other parts of the body. This helps your doctors plan the best treatment for you, and they will explain more about the tests you need. These may include the following.

Blood tests

You will have blood tests to check your general health.

Chest X-ray

You may have a chest X-ray to check that your lungs are healthy.

CT scan

A CT scan takes a series of X-rays that build up a detailed picture of the inside of the body.

MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body.

PET-CT scan

A PET-CT scan combines a CT scan and a positron emission tomography, or PET, scan. The CT scan takes a series of X-rays to build up a detailed picture, while the PET scan uses low-dose radiation to measure how active the cells are in different parts of the body.

Waiting for test results can be a difficult time. Macmillan Cancer Support have more information that can help.

Staging and grading of vaginal cancer

The stage of the vaginal cancer describes its size and whether it has spread. The grade describes how quickly it may develop.

The cancer is given a number between 1 and 4, depending on:

• its growth in the vagina and surrounding tissues
• whether it has spread to lymph nodes or other organs

Your cancer doctor will tell you the stage of the cancer once they have all your test results. Knowing the stage of the cancer helps your doctors advise you on the best treatment.

Macmillan Cancer Support have more information about staging and grading of vaginal cancer.

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team, or MDT.

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk with you about things to consider when making treatment decisions.

You may be offered some treatments as part of a clinical trial. The treatment you have will depend on different factors. These include:

• the stage of the cancer
• where it is in the vagina
• your general health

Some cancer treatments can affect whether you can get pregnant. If you're worried about this, it's important to talk with your doctor before you start treatment. Macmillan Cancer Support have more information about fertility.

Treatment for vaginal cancer may include the following.

Radiotherapy

Radiotherapy treats cancer using high energy rays. This is the most common treatment for vaginal cancer.

Chemotherapy

Chemotherapy uses anti cancer drugs to destroy cancer cells. Chemotherapy is often given with radiotherapy. It may also be given to treat vaginal cancer that has spread to other parts of the body. Sometimes it's given before surgery, but this is not common.

Chemoradiation

Radiotherapy is often given with chemotherapy to treat vaginal cancer. This is called chemoradiation. The combination of treatments can be more effective than radiotherapy on its own. The chemotherapy drug most commonly used is cisplatin, given as a drip, known as an IV infusion. You'll usually have it once a week throughout your radiotherapy.

Surgery

Surgery is usually only used for small stage 1 cancers and for cancers that were not cured by radiotherapy.

After vaginal cancer treatment

After your treatment, you'll have regular follow up appointments with your cancer doctor or specialist nurse. Let them know as soon as possible if you have any problems or notice new symptoms between these appointments.

You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation. Macmillan Cancer Support also has further information to support you. You can:

• phone the Macmillan Support Line on 0808 808 00 00
• chat to Macmillan specialists online
• use the Macmillan vaginal cancer forum, where you can talk to others affected by vaginal cancer, ask questions and share your experience

Late effects of radiotherapy

Radiotherapy for vaginal cancer can sometimes cause side effects that don't go away, or that develop months or years later. If these happen, there are lots of ways they can be managed or treated. Macmillan Cancer Support have more information about late effects of pelvic radiotherapy.

Sex life

You may not feel like having sex for a while after treatment. If you have a partner, you may both need time to get used to any changes. You can still share your feelings for each other through cuddling, massage, kissing and stroking.

After treatment, you may find that your sex life slowly improves. Changes may get better over time, but sometimes they're permanent. If you have any problems or are worried about this, talk to your doctor or nurse. They can explain what to expect. There are often things that can help too. Macmillan Cancer Support have more about cancer and sex. This includes information about coping with changes during and after treatment. Find out more about cancer and body changes.

Your feelings

It's common to have many different emotions when you're told you have cancer. These include:

• anger
• shock
• guilt
• anxiety
• fear

These are all normal feelings. There are lots of different reactions to cancer. There's no right or wrong way to feel. You'll cope with things in your own way.

Talking to family, friends or other people affected by cancer may help. Or you may prefer to get help from people who don't know you well. Sometimes you may not want to talk about how you're feeling. There's no right or wrong way to cope, but help is available if you need it.

Macmillan Cancer Support's cancer support specialists can give you information about counselling in your area. Phone 0808 808 0000 for advice. Macmillan's Online Community is also a good place to meet people who may be in a similar situation.

Even if you already live a healthy lifestyle, you may still want to make some positive changes after treatment. Simple steps like eating well and staying active can improve your health and wellbeing and help your body recover.