The two main treatments for vaginal cancer are radiotherapy and surgery. You may also have chemotherapy alongside radiotherapy.
This page is about the treatment of vaginal cancer. Your treatment could be different if you have abnormal cells in the inner lining of the vagina. This is called vaginal intraepithelial neoplasia or VAIN.
Your team of health professionals
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
- specialists in chemotherapy and radiotherapy (medical or clinical oncologist)
- gynaecology specialist nurse
- 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
- any previous treatment you might have already had
- your general health
Your medical team may suggest a treatment on its own, or a combination of treatments, depending on your circumstances.
Choosing your treatment
In some situations, the best treatment is clear and you won't be offered a choice. Your specialist may advise 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. For example, you might 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 and specialist nurse.
A second opinion
Some people might want to get a second opinion before starting treatment. You can ask your specialist or GP to refer you to a doctor specialising in vaginal cancer. It can be better to arrange a second opinion through your specialist because they can send all your notes and test results with you.
Having a second opinion doesn't usually mean that the new doctor takes over your treatment and care. They discuss with you and your current doctor which they feel is the best treatment for you.
It can take time to arrange a second opinion, which might mean that your treatment is delayed for a while. Remember also that several specialists will be involved in your care as part of your multi disciplinary team. Between them, they discuss the best way to treat your cancer.
You might have radiotherapy in one of the following situations:
- as your main treatment
- to treat a cancer if you can't have surgery
- to help stop cancer coming back after surgery
- to treat a cancer that couldn't be completely removed with surgery
- as a combination treatment with chemotherapy (chemoradiation)
You might have external radiotherapy or internal radiotherapy, or both, for vaginal cancer.
You might have surgery for early stage vaginal cancer. This is particularly the case if you have a type called adenocarcinoma or 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 type of operation you have depends mostly on the size and position of the cancer.
If you need to have your vagina removed, you might be able to have a new vagina made using tissue from other parts of your body. This is called vaginal reconstruction. Talk to your surgeon early on if this is something you would like to consider. You will need a referral to a plastic surgeon for this specialist operation.
Removing lymph nodes
During the operation your surgeon might remove some of the lymph nodes from around your vagina, usually from your lower abdomen (pelvis) or groin.
A pathologist checks the lymph nodes to see if they contain cancer cells. Knowing whether cancer is present helps your doctor work out the stage of your disease. They can then decide which treatment is best for you.
You are unlikely to have chemotherapy on its own as a first treatment for your cancer. This is because surgery or radiotherapy tend to work best. You might have chemotherapy alongside the radiotherapy treatment (chemoradiation).
Your doctor might suggest chemotherapy on its own if your cancer is advanced, or has come back after treatment with radiotherapy or surgery. This may help to relieve symptoms and slow the growth of your cancer, but unfortunately it won’t cure it.