Causes

Most cancerous vaginal tumors occur when another cancer, such as cervical or endometrial cancer, spreads. This is called secondary vaginal cancer.

Primary vaginal cancer is very rare. Most primary vaginal cancers start in skin cells called squamous cells. The rest are adenocarcinoma (6%), melanoma (3%), and sarcoma (3%).

The cause of squamous cell carcinoma of the vagina is unknown. However, up to 30% of patients have had cervical cancer.

About 75% of patients with squamous cell cancer of the vagina are over 50. Adenocarcinomas of the vagina more commonly affect younger women. The average age at which adenocarcinoma of the vagina is diagnosed is 19.

Women whose mothers took diethylstilbestrol (DES, which was prescribed to prevent miscarriages) during the first 3 months of pregnancy are at increased risk for developing adenocarcinoma.

Sarcoma botryoides of the vagina is a rare type of cancer that mainly occurs in infancy and early childhood.

Symptoms

• Bleeding after sexual intercourse
• Painless vaginal bleeding and discharge
• Pain in the pelvis or vagina

About 5 - 10% of patients have no symptoms.

Exams and Tests

In patients with no symptoms, the cancer may be found during a routine pelvic examination and Pap smear.

Other tests to diagnose vaginal tumors include:

• Biopsy
• Colposcopy

Other tests that may be done include:

• Chest x-ray
• CT scan of the abdomen and pelvis

Treatment

Treatment of vaginal cancer depends on the type of cancer, and how far the disease has spread.

Surgery is sometimes used to remove the cancer, but most patients are treated with radiation. If the tumor is cervical cancer that has spread to the vagina, then radiation and chemotherapy are both given.

Sarcoma botryoides may be treated with a combination of chemotherapy, surgery, and radiation.

Support Groups

You can ease the stress of illness by joining a support group whose members share common experiences and problems. You can find these support groups by searching the Internet or contacting the American Cancer Society.

Outlook (Prognosis)

How well patients with vaginal cancer do depends on the stage of disease and the specific type of tumor.

Possible Complications

Vaginal cancer may spread to other areas of the body. Complications can occur from radiation, surgery, and chemotherapy.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you notice bleeding after intercourse or have persistent vaginal bleeding or discharge.

Prevention

There are no definite ways to prevent this cancer. You can increase your chances of early detection by getting regular yearly pelvic examinations and Pap smears.

Alternative Names

Vaginal cancer; Cancer - vagina; Tumor - vaginal

References

Dotters DJ, Katz VL. Malignant diseases of the vagina: intraepithelial neoplasia, carcinoma, sarcoma. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007:chap 31.

Jhingran A, Russell AH, Seiden MV, et al. Cancers of the cervix, vulva, and vagina. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 91.

Update Date: 1/31/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.