What should you know about melanoma vaginal cancer?

Melanoma begins in melanocytes, the cells that make pigment. In the vagina, it may appear as a dark, pale or unevenly coloured area, a raised lesion, or tissue that bleeds easily; colour alone cannot confirm the diagnosis. Some people notice vaginal bleeding, watery or blood-stained discharge, a lump, discomfort, or pain during sex, while others have no early symptoms.

A clinician usually examines the vagina and cervix and may use a magnifying instrument to inspect an abnormal area. A biopsy, in which a small tissue sample is examined in a laboratory, is needed to identify melanoma. Further scans or examinations may be advised to assess the local area and check whether disease has spread. This is different from melanoma that has travelled to the vagina from skin or another site, so the team will consider the whole clinical picture.

Arrange an appointment with a gynaecologist or another clinician experienced in vaginal conditions if you have unusual bleeding, a persistent lump, or a changing lesion. Take note of when the symptom began, whether it is changing, and any medicines that affect bleeding. Do not apply creams or attempt to remove tissue before examination unless a clinician recommends it.

If biopsy results confirm melanoma, care may involve a gynaecological cancer team with pathology, surgery, medical oncology and radiation oncology expertise. Treatment can include surgery when the tumour can be removed safely, medicines that stimulate or restore immune responses, or radiotherapy. Brachytherapy places a radiation source close to the tumour; radiotherapy can also be delivered from outside the body. The plan depends on the tumour's position, size, spread, biopsy findings and your overall health.

Seek prompt medical assessment for bleeding after menopause, bleeding after sex, repeated bleeding between periods, a new vaginal lump, or discharge that is bloody or persistently unusual. These symptoms can have causes other than cancer, but they should not be ignored.

Use urgent care for heavy bleeding that does not settle, dizziness or fainting, severe pelvic pain, fever with worsening pain, or difficulty passing urine. Bring a list of medicines and relevant previous biopsy or scan reports if available.

Ask what the biopsy shows, whether the melanoma started in the vagina or reached it from elsewhere, and which scans or examinations are needed next. You can also ask which treatment goal applies to you, how treatment may affect sexual comfort, fertility or bladder and bowel function, and whom to contact if bleeding or pain changes.