Diagnosis & Staging
The vagina is a 7-10 cm (3-4 inch) long muscular tube that connects the uterus with the vulva (outer genitals).
The vagina is usually in a collapsed position with the vaginal walls touching each other.
There are folds on the vaginal wall which allow the vagina to open and expand during sexual intercourse and vaginal childbirth.
The vagina is lined with a thin layer of flat squamous or epithelial cells. Glands release mucus to keep the vaginal lining moist.
Vaginal cancer is also called vaginal carcinoma or carcinoma of the vagina.
People with early stage vaginal cancer often do not have any symptoms.
As the cancer advances, some common symptoms are:
- Vaginal discharge (more than is normal for you).
- Spotting or bleeding between menstrual periods.
- Bladder discomfort or irritation.
- Vaginal lesion or lump.
- Pain in the pelvis, back or legs.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose vaginal cancer include:
- Pelvic exam: a doctor or nurse practitioner feels your uterus, ovaries, cervix and vagina to look for anything unusual.
- Colposcopy: a specialist doctor uses a microscope called a colposcope to look for abnormal cells in your cervix and vagina. This test is used to confirm the diagnosis from a pelvic exam.
- Barium enema: a chalky liquid (barium) is used so that body parts show up better on imaging tests. This test will check if the cancer has spread to your rectum.
- Biopsy: a small amount of tissue is removed. A specialist (pathologist) will examine the tissue.
- CT (computed tomography) scan of the pelvis and abdomen: to see if the cancer has spread to other organs or tissues.
- MRI (magnetic resonance imaging): to see if the cancer has spread to other organs or tissues.
- PET (positron emission tomography) scan: to see if the cancer has spread to other organs or tissues.
- Most common type. About 85% (85 out of 100) of vaginal cancers.
- Grow slowly.
- When normal cells begin to change in the surface layer of the vagina (epithelium) they are called pre-cancerous. This condition is called vaginal intraepithelial neoplasia (VAIN).
- Starts in the gland cells of the lining of the vagina.
- About 15% (15 out of 100) of vaginal cancers.
- Clear cell adenocarcinoma: Usually seen in young women who were exposed to the drug diethylstilbestrol (DES) while they were in the womb.
- Forms on the skin of the vagina. It usually affects the lower or outer part of the vagina.
- Forms deep in the wall of the vagina, not on the surface.
- This is not cancer. It is a precancerous condition.
- Can become cancer if not treated.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
- Stage 0: Carcinoma in situ or vaginal intraepithelial neoplasia (VAIN).
- Stage 1: Tumour is only in the wall of the vagina.
- Stage 2: Tumour has grown into the subvaginal tissue but not the pelvic wall.
- Stage 3: Tumour has grown into the pelvis wall and may have spread to nearby lymph nodes.
- Stage 4: The tumour has grown into the bladder, rectum or other tissues outside the pelvis or has spread to other parts of the body (distant metastasis) such as the lungs, liver or bone.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing. A pathologist will give the cancer a grade after looking at the cells under a microscope.
Vaginal cancer can be grade 1, 2 or 3. The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and a more likely to spread.
The grade of the cancer can help your health care team plan your treatment.
For more information about staging, see About Cancer