Vaginal cancer is when abnormal cells in the vagina start to divide and grow in an uncontrolled way.
The vagina is the elastic, muscular passage that leads from the neck of the womb (cervix) to the vulva. It is about 7.5 to 10 cms long. The cervix is at the bottom of the womb. The vulva is on the outside of the body and forms the skin folds around the entrance to the vagina.
The vagina is the opening that allows blood to drain out each month during your menstrual period. The walls of the vagina are normally in a relaxed state. They touch each other and contain many folds. The vagina opens and expands during sexual intercourse.
Small glands in the cervix produce mucus to keep the vaginal lining moist. The vagina stretches during childbirth to allow the baby to come out.
This video shows more detail about the vagina and the rest of the female reproductive system.
The female reproductive system includes a number of parts. The ovaries hold the eggs which are released each month during child bearing age. They also produce sex hormones which control periods. The fallopian tubes connect the ovaries to the womb (also called the uterus).
When an egg is released it travels down the fallopian tube towards the womb. At this time, sperm from the male can pass into the fallopian tube where it may meet the egg and fertilise it. Fertilised eggs pass down the fallopian tube to the womb, which holds and protects the baby during pregnancy. The lining of the womb is called the endometrium. It thickens during the menstrual cycle ready for pregnancy. If you don’t become pregnant you have a period which is when the lining sheds.
The cervix is the lower part of the womb. It is the opening into the vagina. During a period or menstruation blood passes from the womb through the cervix and then to the vagina. The vagina also opens and expands during sexual intercourse and stretches during childbirth to allow a baby to come out.
On the outside of the body is the vulva. It is made up of two pairs of lips. Between these is the opening of the vagina. Above the vagina is the urethra: a short tube that carries urine from the bladder to outside of the body and above the urethra is the clitoris: a very sensitive area that gives sexual pleasure.
For more information about cancers that can start in the female reproductive system, go to cruk.org/cancer-types
Where cancer starts
The vagina is made up of tissue layers, including:
- epithelial tissue – a thin layer made up of squamous cells that line the vaginal wall
- connective tissue – a layer underneath the epithelium, made of fibrous tissue with muscle, lymph vessels and nerves
The most common type of vaginal cancer starts in the squamous cells. About 90 out of every 100 (about 90%) of vaginal cancers are this type. It is called squamous cell carcinoma. A rarer type starts in the gland cells in the lining of the vagina. This is called adenocarcinoma.
Cancers that start in the connective tissue of the vagina are extremely rare. They are called sarcomas. Other rare types include vaginal melanoma and vaginal lymphoma.
Nearby lymph nodes
There are lymph nodes around the vagina (also called lymph glands). They’re small bean shaped glands that are part of the lymphatic system. They drain fluid from the tissues around the vagina and help to control infection by trapping and killing bacteria and viruses. The nearest lymph nodes are usually the first place that cancer cells reach when they break away from a tumour.
Your specialist may remove some of the lymph nodes during surgery. These will be closely looked at under a microscope to see if they contain cancer cells. This helps your specialist stage the cancer, so they can decide on the most suitable treatment for you.
How common it is
Vaginal cancer is very rare. Around 250 women are diagnosed in the UK each year.
Cancer starting in another place in the body can spread to the vagina, such as:
- cancer of the cervix
- womb cancer
- bowel cancer
- vulval cancer
This isn’t the same as cancer starting in the vagina.
Cancer starting in the vagina is known as primary vaginal cancer. Cancer that has spread from another place in the body is called secondary cancer.
Who gets it?
We don't know the exact causes of vaginal cancer. It is more common in older women. Almost 40 out of 100 (almost 40%) of new cases are in females aged 75 and over. It is very rare in women younger than 40.
Risk factors include:
- HPV infection
- abnormal changes to the cells in the inner lining of the vagina (VAIN)
- weakened immune system