Vaginal Cancer

Vaginal cancer is a rare cancer of vaginal tissue that can cause bleeding, discharge, or pelvic symptoms.

Vaginal cancer begins in the cells lining or supporting tissues of the vagina. It is distinct from cancers that start in the cervix, vulva, uterus, or bowel, although nearby disease can affect the same area. The tumour’s cell type and position guide investigation and care.

Bleeding after sex is a common presentation of vaginal cancer. Bleeding after menopause is also a common presentation. Other possible changes include watery or unpleasant discharge, a vaginal lump, pelvic pain, painful sex, or difficulty passing urine. These symptoms often have causes other than cancer, but bleeding that is new, repeated, or unexplained needs medical assessment.

Vaginal cancer develops when cells acquire changes that make their growth abnormal. HPV infection can contribute to some cancers, while other cases arise through changes that are not linked to one identifiable exposure. It is not caused by personal fault.

The course depends on where the tumour started, how deeply it has grown, and whether it involves the cervix, vulva, pelvic tissues, lymph nodes, or distant organs. Examination and imaging help map these relationships. The care team uses this information to match treatment intensity to the disease.

Factors associated with vaginal cancer include HPV infection, previous cervical or vaginal cell changes, smoking, and a weakened immune system. Previous pelvic radiation or certain medicines may also affect risk. Having a risk factor does not mean cancer will develop, and cancer can occur without one.

A clinician asks about bleeding, discharge, pain, sexual health, menopause, and previous screening or treatment. A pelvic examination may identify a visible or palpable lesion. Colposcopy can provide a closer view, and a biopsy is used to confirm the cell diagnosis. Imaging may show local spread, lymph nodes, or other areas that need assessment.

Treatment is chosen according to the tumour’s site, size, cell type, spread, and your health and preferences. Radiotherapy may treat the vagina and nearby tissues. Brachytherapy places a radiation source close to the tumour for focused treatment and may be combined with external radiotherapy. Surgery is considered for selected tumours, while more extensive disease may need a combined plan. The team discusses effects on sexual function, fertility, bladder, bowel, and comfort.

Treatment can affect intimacy, body image, fertility, vaginal comfort, bladder, bowel, and energy. Pelvic-health physiotherapy, moisturising or dilator advice when prescribed, sexual counselling, and emotional support can help. Tell the team about pain, dryness, bleeding, or changes in relationships so support can be adapted.

The cancer may cause bleeding, anaemia, pain, discharge, urinary symptoms, or bowel symptoms. Treatment can cause skin irritation, fatigue, vaginal narrowing, dryness, or changes in bladder and bowel function. Seek urgent care for heavy bleeding, faintness, fever, or inability to pass urine.

HPV vaccination, avoiding tobacco, and attending recommended cervical-health checks can reduce some related risks, though they cannot prevent every vaginal cancer. Report unusual bleeding or discharge rather than waiting for a routine visit. Use condoms or other barrier protection to reduce HPV exposure, while recognising that protection is not complete.

Care may include a gynaecological oncologist, radiation oncologist, pathologist, radiologist, specialist nurse, pelvic-health physiotherapist, and sexual-health or psychological support professional. Ask who will coordinate care and how treatment may affect intimacy, fertility, bladder, and bowel function.