Vaginal cancer

Your family doctor (GP) will talk to you about your symptoms. They will probably need to examine the area. This may include an internal exam. An instrument called a speculum is gently put into your vagina (like when you have a smear test) to open it slightly so that the doctor can do a thorough examination.  

Your GP will refer you to hospital if they think you need more tests. Other tests you might have include:

You may need further tests to give your doctors more information about your general health and about the cancer.  For example:

• Examination under anaesthetic (EUA): Your doctor looks at your vagina while you are asleep under general anaesthetic. This is done to see if the cancer is found only in your vagina. A sample of vaginal cells (biopsy) can be taken during an EUA.
• MRI scan: A scan that uses magnetic energy to build up a picture of the tissues inside your body. 
• CT scan: A type of X-ray that gives a detailed picture of the tissues inside your body.
• PET - CT scan: A radioactive injection that will show up any cancer spread to other parts of your body on a CT scan picture. 
• Chest X-ray: An X-ray to check for any problems in the chest bones that may be related to the vaginal cancer or caused from something else. It can also help the medical team see if there are any problems in the lungs.

The tests you have can help to:

• Stage your cancer. This means finding out the size and position of the cancer. 
• Grade your cancer. Grading describes how quickly the cancer may grow and spread and how it might respond to treatment.

Some tests may be used see how you are responding to treatment. 

Grading describes the cancer cells - what they look like and how fast they might grow and spread.

Low-grade cancer is more slow growing while high-grade cancer is usually faster-growing. 

Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you.

The stages of vaginal cancer are usually numbered 1 to 4 and can be further subdivided into A and B. A higher number, such as stage 4, means a more advanced cancer.

• Pre-cancer – VAIN (vaginal intraepithelial neoplasia): This means there are abnormal cells in the vagina. These cells are not cancerous but can in time lead to an invasive cancer.
• Stage 1: Cancer is in the wall of the vagina but has not spread anywhere else.
• Stage 2: Cancer has begun to spread outside the wall of the vagina into the surrounding tissues, but has not yet reached the internal walls of the pelvis. 
• Stage 3: Cancer has spread from the vaginal wall into the surrounding tissues and has reached the walls of the pelvis. Cancer may also be present in the surrounding lymph nodes.
• Stage 4a: The cancer has spread from the vagina into the bladder and/or back passage (rectum).
• Stage 4b: The cancer has spread from the vagina into distant organs like the lungs or liver.