Vaginal Cancer

Usually there are no symptoms at all but can include:

• Abnormal smear is the commonest presentation as sometimes the vaginal cells are picked up on a cervical smear
• Persistent vaginal itch
• Smelly or blood tinted vaginal discharge
• Pain when urinating
• A vaginal lump

Vaginal cancer is often linked to long-term infection with high-risk types of human papillomavirus (HPV). Other risk factors include smoking, older age, a history of cervical or vulval cancer, and conditions like vaginal intraepithelial neoplasia (VAIN).

Diagnosis typically involves a pelvic examination, colposcopy, and a biopsy to confirm the presence of cancerous cells. Imaging scans such as MRI or CT may be used to assess the extent of disease.

Much like other gynaecological cancers, treatment depends on where the cancer is located and how far it has spread. Possible treatments include internal or external radiotherapy dependent on the location of the cancer, surgery, or chemotherapy.

Treatment usually is combination of radiotherapy and chemotherapy and rarely is surgery, dependant on stage and access to the tumour.

Not always. Treatment depends on the stage, location, and size of the cancer. Early-stage cancers may be treated with surgery, while advanced cancers are often treated with radiotherapy and/or chemotherapy.

It is important to assess whether the cancer has arisen from the vagina or spread from other pelvic organs (such as womb or cervix) to the vagina. Treatment strategy will depend on this assessment. The outlook of vaginal cancer varies and individualised, holistic care is vital.

No. Although they share some risk factors (like HPV), vaginal and cervical cancers are separate conditions affecting different tissues. Their diagnosis, treatment, and follow-up may differ.

Vaginal cancer may be cured if caught early (stage 1). If the cancer is not diagnosed in an early stage, many treatments are available to relieve the symptoms for several years.

You may be at increased risk of vaginal cancer if:

• You have had a persistent HPV (human papillomavirus) infection

• Precancerous cells have been found in your cervix (CIN) or vagina (VAIN)

• You have previously been diagnosed with cervical or womb cancer

• You received pelvic radiotherapy in the past

• You are aged 75 or over — vaginal cancer is more common in older women

• You have a weakened immune system, such as with lupus, HIV, or AIDS

• Your mother took diethylstilbestrol (DES), a hormonal medicine, during pregnancy — your GP can discuss this risk with you

It’s important to note that vaginal cancer can still occur after a hysterectomy.

In the UK the HPV vaccine is offered to girls in year 8 (age 12 and 13) to protect them against cervical cancer. The vaccine provides a high degree of protection against cervical cancer however it does not provide full protection. The new vaccine (Gardasil 9) prevents 90% and the old vaccine prevents 70% of all cervical cancer.

Therefore, it is very important that women still attend regular screening even if they have been vaccinated to reduce their risk and have maximum protection.

Smear tests identify potentially harmful cells before they become cancerous and ensure women get the correct treatment as soon as possible. Because of this, regular screening can help stop cervical cancer before it starts.

Women over the age of 25 should have a smear test every 3 years. Cervical cancer takes a long time to develop (approximately 15 years) which means that one would have five opportunities (smear tests) for detecting any abnormalities. This makes it safe to have a smear test every three years.

Having said that, sometimes a smear test can be falsely negative as it is a screening test and not a diagnostic test. A negative smear test means ‘low risk’ and not ‘no risk’. It is therefore important that women see their GP, gynaecologist or practice nurse if they have any of the symptoms mentioned above.