Vaginal & vulvar cancer symptoms & treatment

Vaginal and vulvar cancers occur when cells in the vagina or external genitals (vulva) begin to grow out of control. While these cancers are not common, the human papillomavirus (HPV) is the known cause for at least half of the cases each year. HPV is also linked to cervical cancer.

Your Aurora provider can provide the HPV vaccine along with regular gynecological exams to help reduce your risk for these types of cancers. If cancer surgery is needed, you may be able to have minimally invasive laparoscopic surgery, with or without robotic assistance.

Vaginal cancer symptoms

Symptoms of vaginal cancer or vulvar cancer may be similar to those of other conditions. The only way to find out what’s causing your symptoms is to schedule a visit with your OB-GYN.

What are the early signs of vaginal cancer?

Very early vaginal cancer symptoms may include:

• Vaginal bleeding not connected with menstruation
• Pain during sexual intercourse
• Bloody urine or stool
• Unusual or bad-smelling vaginal discharge

Vaginal cancer symptoms that happen after cancer has spread outside your pelvis may include:

• Pain while urinating
• Constipation
• Frequent urge to urinate
• Lower abdominal, back or pelvic pain
• Edema (swelling) in your legs

What does vaginal cancer look and feel like?

Since your vagina is inside your body, you won’t usually see vaginal cancer growths. Rarely, you may see one of these things on your external genitals or the area between your vagina and anus (perineum):

• Flat, skin-like lumps
• Sores
• Wart-like growths

Risk factors for vulvar & vaginal cancer

You may be at higher risk for vaginal or vulvar cancer if you have had:

• HPV infection
• Cervical cancer
• Chronic vulvar itching or burning
• Precancerous cell changes of the cervix, vulva or vagina
• Any condition that makes you immunocompromised such as HIV
• A history of smoking

How we diagnose vulvar cancer & vaginal cancer

Your primary care doctor or OB-GYN may notice potential signs of vaginal or vulvar cancer during your annual physical exam. They’ll will discuss your personal and family medical history with you to determine if you have any risk factors for these cancers.

Next, your doctor will perform a Pap smear and gynecological exam to rule out other causes for your potential vaginal or vulvar cancer symptoms. Your OB-GYN may want you to have testing done. Or they may refer you to a gynecologic cancer specialist for testing, such as having a biopsy to collect cells and examine them under a microscope to check for the presence of vulvar or vaginal cancer.

Tests to help diagnose vulvar or vaginal cancer

Your care team may use these imaging tests to determine if vaginal or vulvar cancer has spread:

• Cystoscopy or proctoscopy checks to see if cancer has spread to the urethra, bladder or rectum.
• CT (computed tomography scan) confirms the presence of a tumor. It can also show the location and size and whether cancer has spread to nearby tissues or organs.
• MRI (magnetic resonance imaging) can help doctors see whether a tumor is cancerous.
• PET scans are combined with the injection of a specific dye into a vein. The scan identifies cancer cells that have absorbed the dye.
• Chest X-ray can show whether cancer has spread to the lungs.

Treatment for vaginal & vulvar cancer

Your treatment plan will depend on the diagnosis and your overall health. Your doctor will discuss the course of treatment that best suits your needs.

Generally, treatment options include surgery, radiation therapy or chemotherapy. Depending on your individual situation, your cancer specialists may recommend surgery followed by chemotherapy or radiation therapy to destroy additional cancer cells. In some cases, they may use chemotherapy or radiation to shrink your tumor before surgery.

If cancer has spread beyond your vulva or vagina, surgery may also be done on your bladder, uterus or other parts of your body.

Surgical options to treat vaginal cancer or vulvar cancer

• Laser surgery: The surgeon uses heat from an energy beam directed to the cancer site to destroy abnormal cells.
• Tumor excision: Using tiny incisions, we insert special surgical instruments to remove the cancer and surrounding tissue, if cancer has spread there.
• Vaginectomy: This minimally invasive procedure surgically removes part or all of the vagina and sometimes the surrounding tissue, if affected by cancer.
• Lymphadenectomy: Your surgeon will remove some of the lymph nodes in your pelvis and abdomen and have them examined under a microscope to see if the cancer has spread.
• Robotic surgery: This minimally invasive gynecologic procedure uses robotic arms along with magnified views and the surgeon's skills to perform a vaginectomy. Learn more about laparoscopy and robotic surgery.

Nonsurgical treatment options for vaginal cancer or vulvar cancer

• External beam radiation, which uses a special machine to send beams of high-energy X-rays to target and destroy cancer cells. Your cancer specialist may recommend radiation therapy by itself or with surgery.
• Brachytherapy, which is a type of radiation therapy that uses small amounts of radioactive material inserted into or around the cancer. It is more targeted, so it affects less healthy tissue than external beam radiation.
• Chemotherapy, which uses pills by mouth or injections through a vein. Chemotherapy drugs travel through your whole body to help control the spread of vulvar or vaginal cancer.
• Immunotherapy: Immunotherapy uses various methods to help your immune system find and destroy cancer cells.

What to expect after treatment for vaginal or vulvar cancer

Cancer treatments may affect your ability to get pregnant or deliver a baby. Before your treatment, let your doctor know if preserving fertility is important to you. They'll recommend a fertility evaluation and discuss options that may help you conceive or carry a child after treatment.

To preserve sexual function, our skilled surgeons can reconstruct your vagina if all or part of it has been removed. They reconstruct your vagina using skin or tissue taken from elsewhere in your body.

Find a cancer clinic near you.