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Overview of vaginal cancer treatment

Women discussing vaginal cancer

This page gives you an overview of the treatments for vaginal cancer.

 

A quick guide to what's on this page

Overview of vaginal cancer treatment

The two main ways of treating cancer of the vagina are radiotherapy and surgery. You might also have chemotherapy alongside radiotherapy. You are not likely to have chemotherapy on its own for vaginal cancer, but your specialist may suggest it for particular situations.

The treatment that is best for you will depend on the type of vaginal cancer you have, the stage of your cancer, and your general health.

Choosing your treatment

You may have a choice of the type of operation, or whether to have radiotherapy or surgery. You can discuss your treatment options with your doctor. You may also want to get a second opinion before you have your treatment. It can be a good idea to get the advice of more than one doctor experienced in treating this type of cancer. A second opinion can give you more information. It can also help you to feel more confident about the treatment plan that your doctor suggests. Most doctors are happy to refer you to another specialist for a second opinion if you would find this helpful.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating vaginal cancer section.

 

 

The main treatments

The two main ways of treating cancer of the vagina are radiotherapy and surgery. You might also have chemotherapy alongside radiotherapy. You are not likely to have chemotherapy on its own for vaginal cancer, but your specialist may suggest it for particular situations.

As with many types of cancer, the earlier the stage of your cancer, the easier it is to get it under control and possibly cure it. On the next page there is a description of the likely treatment for each stage of vaginal cancer.

Usually a team of doctors and other health professionals work together to consider your case and decide together on the best treatment for you. They specialise in different aspects of treatment, but work together as a multi disciplinary team (MDT). The team may include

  • A surgeon who specialises in cancer of the womb, ovaries, cervix and vagina
  • One or more specialists in chemotherapy and radiotherapy (medical or clinical oncologist)
  • A gynaecology specialist nurse
  • Physiotherapists
  • Psychologists or counsellors
  • Social workers

The treatment that is best for you will depend on

  • The type of vaginal cancer you have
  • The stage of your cancer
  • Which part of your vagina is affected by cancer
  • Your general health

Your doctors may suggest a single type of treatment or a combination of treatments, depending on your circumstances.

You can read more about the type and the stage of your cancer.

 

Radiotherapy

Doctors use radiotherapy in a number of ways to treat vaginal cancer. You may have external radiotherapy or internal radiotherapy or both.

You may have radiotherapy on its own to try to cure your cancer and avoid the side effects of surgery. Or your doctors may suggest radiotherapy after surgery to kill off any cancer cells that could have been left behind. The aim of this treatment is to lower the risk of the cancer coming back.

In some situations your doctor might recommend chemotherapy treatment alongside radiotherapy (chemoradiation).

You can read more about external radiotherapy and internal radiotherapy

 

Surgery

You may have surgery for early stage vaginal cancer, particularly if you have adenocarcinoma or a squamous cell cancer at the top of your vagina. There are a number of different operations for vaginal cancer. These include

  • Vaginectomy – removal of your vagina along with surrounding tissues
  • Radical hysterectomy – removal of your womb, cervix, upper part of your vagina, and the surrounding tissues
  • Pelvic exenteration – this involves a hysterectomy plus removal of your vagina, bladder, rectum (back passage), and part of your bowel

The operation that is right for you will depend mostly on the size and position of your cancer. There is more about this and what the operations involve on the types of surgery for vaginal cancer page.

If you need to have your vagina removed, you may be able to have the vagina rebuilt (a surgical reconstruction). It is best to talk to your surgeon about this early on. You will need a referral to a plastic surgeon for this type of specialist operation.

 

Removing lymph nodes

If you have surgery, your surgeon will examine the vagina and surrounding area during your operation. They will remove some of the lymph nodes from around your vagina, usually from your lower abdomen (pelvis) or groin. This is called lymphadenectomy. The surgeon takes out these lymph nodes because they may contain cancer cells that have broken away from the main cancer. They send the lymph nodes to the lab so that a pathologist can check them under a microscope. Knowing whether there are cancer cells in your lymph nodes or not helps your doctor to work out the stage of your cancer. Then they can decide which treatment is best for you.

 

Chemotherapy

You are not likely to have chemotherapy on its own as a first choice of treatment for cancer of the vagina because surgery or radiotherapy tend to work best. But you might have chemotherapy alongside the radiotherapy treatment (chemoradiation).

Your doctor may suggest chemotherapy on its own if your cancer is advanced, or has come back after treatment with radiotherapy or surgery. Chemotherapy for advanced cancer may relieve symptoms and slow the growth of your cancer but it will not cure it.

You can also have chemotherapy as a cream that goes directly onto the skin (topical chemotherapy). Doctors sometimes use this to treat stage 0 vaginal cancer (vaginal intraepithelial neoplasia - VAIN), but it is not used very often.

You can read more about chemotherapyradiotherapy and surgery for vaginal cancer. 

 

Choosing your treatment

In some situations, it will be very clear which is the best treatment for you and you will not be offered a choice. Your specialist may advise you that radiotherapy, or surgery, or both, is your best option for cure. 

If different treatments work equally well for your type and stage of cancer, you may have a choice of treatments. For example, you may be able to choose

  • The type of operation
  • Whether to have surgery or radiotherapy
  • Whether to have radiotherapy or chemoradiation.

You can discuss these options with your doctor. You may also want to get a second opinion before you have your treatment. It can be a good idea to ask the advice of more than one doctor experienced in treating this type of cancer. A second opinion can give you more information and help you feel more confident about the treatment plan that your doctor suggests. Most doctors are happy to refer you to another specialist for a second opinion if you would find this helpful.

It is important to know that a second opinion means that another doctor gives an opinion about your treatment. It doesn't necessarily mean that the second doctor will take over your care. Your original specialist may still manage your treatment.

At the end of this section there is a list of questions for your doctor that you may find helpful.

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Updated: 18 September 2015