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Stage 4

Read about stage 4A and 4B vaginal cancer and the treatment options. 

Different staging systems

There are different ways of staging vaginal cancers. Most gynaecologists prefer to use the FIGO system, developed by the International Federation of Gynaecology and Obstetrics.

The TNM staging system is starting to be used more often. TNM stands for Tumour, Node, Metastasis:

  • T describes the size of the tumour (cancer)
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

There are 4 stages. Stage 1 is the earliest stage and stage 4 is the most advanced stage.

Stage 4

This stage is advanced vaginal cancer. The cancer has spread to other body organs outside the vagina.

Stage 4A is when the cancer has spread to your bladder or back passage (rectum).

Diagram showing stage 4a vaginal cancer

Stage 4B is when the cancer has spread to organs further away, such as the lungs.

Diagram showing stage 4b vaginal cancer

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
  • any previous treatment you might have already had
  • your general health

Treatment for stage 4a

Stage 2, 3 and 4A vaginal cancer are all treated in a similar way.

Radiotherapy is the main treatment. You usually have both internal radiotherapy and external radiotherapy. External beam radiotherapy directs radiation at a cancer from a machine outside of the body. Internal radiotherapy uses a radioactive source or implant that is placed inside the vagina.

In rare cases, your doctor may suggest that you have an operation to move the bowel out of the radiotherapy treatment area. This is to protect the bowel during radiotherapy and minimise side effects. You would normally only need to have this done in the following situations:

  • you need particularly high radiotherapy doses
  • you have had surgery to your bowel in the past, which has left you with internal scar tissue called adhesions
  • you have a lot of bowel symptoms before starting radiotherapy

You might also have chemotherapy treatment alongside radiotherapy. This enhances the effects of radiotherapy. 

Your doctor might recommend surgery (instead of radiotherapy) if you have had previous radiotherapy treatment to the pelvic area. There is a limit to the amount of radiotherapy you can have to any one part of the body. Too much can cause damage to healthy tissues. 

Treatment for stage 4B

This stage is not usually curable. But radiotherapy can relieve symptoms such as pain, swelling or bleeding. Your specialist may suggest chemotherapy if you are fit enough to have the treatment. 

If there is a suitable clinical trial running, your specialist may ask you to take part. Vaginal cancer is rare and so it is quite difficult to research. Taking part in the trial might help to improve treatment in the future for other women with vaginal cancer.

Last reviewed: 
13 Apr 2018
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