Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer?

Vaginal Cancer starts in the vagina. There are many different types of vaginal cancer, but the most common is called squamous cell carcinoma. It starts in the lining of the vagina.

The vagina

The vagina starts at the cervix (the lower part of the uterus) and opens at the vulva (the external female genitals). The vagina is usually collapsed with its walls touching each other. The vaginal walls have many folds that help the vagina open and expand during sex or the birth of a baby.

Several different types of cells and tissues are found in the vagina:

• The lining of the vagina has a layer of flat cells called squamous cells. This layer of cells is also called epithelium or epithelial lining because squamous cells are a type of epithelial cell.
• The vaginal wall underneath the epithelium is made up of connective tissue, muscle, lymph vessels, and nerves.
• Glands near the opening of the vagina make mucus to keep the vaginal lining moist.

What does 5-year survival rate mean?

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years (and many are cured).

Five-year disease-specific survival rates assume that some people will die of other causes and only count the deaths from the cancer itself. This is a more accurate way to describe the prognosis for patients with a particular type and stage of cancer.

In order to get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. Improvements in treatment since then may result in a more favorable outlook for women now being diagnosed with vaginal cancer.

Survival rates cannot predict what will happen to any one person. Many other factors can affect a person’s outlook, such as their overall health, the treatment they receive, and how well the cancer responds to treatment. Your doctor can tell you how the numbers below may apply to you, as he or she is familiar with your situation.

Survival rates for vaginal cancer, by stage

Survival rates also vary based on the type of vaginal cancer. But this cancer is so rare, different cancer centers may base their numbers on all types of vaginal cancer, while others track only squamous cancers. Because of this, there's no one way to measure survival and survival rates are given as ranges.

Relative survival rates are a more accurate way to estimate the effect of cancer on survival. These rates compare people with cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific type and stage of cancer is 50%, it means that people who have that cancer are, on average, about 50% as likely as people who don’t have that cancer to live for at least 5 years after being diagnosed.

From 2006 to 2012, the relative 5-year survival for all cases of vaginal cancer combined, was about 47%.

Although these numbers are the most updated available, it's important to remember that these numbers are based on cancers that were diagnosed in the past. They may also include various types of vaginal cancer. It's likely that the better treatments used today greatly impact long-term outcomes and survival.

Remember, these survival rates are only estimates – they can’t predict what will happen to any individual person. Talk to your doctor to better understand your specific situation.

Because vaginal cancer is rare, it's has been hard to study it well. Most experts agree that treatment in a clinical trial should be considered for any type or stage of vaginal cancer. This way women can get the best treatment available now and may also get the treatments that are thought to be even better. Many of the new and promising treatments discussed here are only available in clinical trials.

Gene changes

Scientists are learning more about how certain genes called oncogenes and tumor suppressor genes control cell growth and how changes in these genes cause normal vaginal cells to become cancer. They're also studying how the gene changes caused by HPV might be used to target treatment on the cancer cells.

Radiation therapy

Studies are under way to determine the best way to use external beam therapy and brachytherapy to treat vaginal cancer and limit damage to normal tissue. Doctors are also looking for ways to use more focused radiation along with other treatments, like immunotherapy, to treat advanced vaginal cancers.

Reconstructive surgery

Surgeons are looking for new and better ways to repair the vagina after radical surgery.

Chemotherapy

Many clinical trials are looking for better drugs to treat vaginal cancer, as well as if combining chemotherapy with radiation therapy is better than radiation therapy alone.

Side effect management

The vaginal walls can become stiff and tight after radiation. Researchers are looking for ways to prevent this, limit it, and better treat it.

Removing lymph nodes near the cancer can lead to a life-long problem of swelling in the legs called lymphedema. Studies are being done to to see if sentinel lymph node mapping (a process used to identify lymph nodes with cancer) might work for women with vaginal cancer.

If you have any of the signs or symptoms of vaginal cancer, you should see a doctor. If the Pap test shows abnormal cells, or if the pelvic exam results are not normal, more tests will be needed. This may mean referral to a gynecologist (a doctor who specializes in problems of the female genital system).

Medical history and physical exam

The first step is for the doctor to take a complete medical history. Risk factors and symptoms will be discussed. Then your doctor will physically examine you, including a pelvic exam and possibly a Pap test and/or a vaginal biopsy.

Colposcopy

If certain symptoms suggest cancer or if the Pap test shows abnormal cells, you will need a test called colposcopy. In this procedure you lie on the exam table and a speculum is placed in your vagina to keep it open -- just like a pelvic exam. The doctor will use a colposcope to examine the cervix and vagina. The colposcope stays outside the body and has magnifying lenses (like binoculars). When the doctor looks through the colposcope, he or she can see the vaginal walls and the surface of the cervix closely and clearly. Sometimes a weak solution of acetic acid (much like vinegar) or iodine is used to make any abnormal areas easier to see. Using a colposcope to look at the vagina is called vaginoscopy.

Colposcopy itself is no more painful than a regular pelvic exam and can be done safely even if you're pregnant. If an abnormal area is seen on the cervix or vagina, a biopsy will be done. The biopsy can be slightly painful and may some cause pelvic cramping.

Biopsy

Certain signs and symptoms may strongly suggest vaginal cancer, but many of them can be caused by other problems. The only way to be certain that it's cancer is to do a biopsy. In this procedure, a small piece of tissue from the suspicious area is removed. A doctor specializing in diagnosing diseases with lab tests (a pathologist) will then look at the tissue sample under a microscope to see if cancer or a pre-cancerous condition is present and, if so, what type it is.

Imaging tests

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests may be done after a diagnosis of vaginal cancer to learn more about the cancer and see if it has spread.

Chest x-ray

A plain x-ray of your chest may be done to see if the cancer has spread to your lungs.

Computed tomography (CT) scan

The computed tomography scan, most often called a CT or CAT scan, is an x-ray test that makes detailed cross-sectional images of your insides. Instead of taking one picture, like a standard x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body. A CT scan can provide information about the size, shape, and position of a tumor, and can be helpful to see if the cancer has spread to other organs. It can also help find enlarged lymph nodes that might have cancer cells.

CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into a suspected tumor. To do this, the patient lies on the CT scanning table, while a doctor moves a biopsy needle through the skin and toward the tumor. CT scans are repeated until the tip of the needle is inside the tumor. A small piece of the tumor is removed and looked at under a microscope. This isn't done to biopsy vaginal tumors, but it may be used to biopsy possible sites of cancer spread (metastases).

Magnetic resonance imaging (MRI) scan

Magnetic resonance imaging (MRI) scans use radio waves and strong magnets instead of x-rays to make images of the inside of your body. The energy from the radio waves is absorbed by your body and then released in a specific pattern formed by the type of tissue and by certain diseases. A computer translates the pattern into a detailed image of parts of the body. Like a CT scanner, this produce cross-sectional slices of your body. An MRI can also produce slices that are parallel with the length of your body.

MRI images are particularly useful in examining pelvic tumors. They may show enlarged lymph nodes in the groin. They are also helpful in finding cancer that has spread to the brain or spinal cord. (This rarely happens with vaginal cancer.)

Positron emission tomography (PET) scan

A positron emission tomography or PET scan uses a mildly radioactive sugar that's put into your blood. Because cancer cells use sugar at a higher rate than normal cells, they absorb more of the radioactive sugar. The areas of radioactivity can be seen with a special camera.

The picture is not finely detailed like a CT or MRI scan, but it provides helpful information about your whole body. PET scans are not often used in women with early vaginal cancer, but they may be helpful in finding areas of cancer spread in more advanced cancers.

Endoscopic tests

These endoscopy procedures are not used often for women with vaginal cancer, but they may be needed in certain cases.

Proctosigmoidoscopy

This test may be done if the vaginal cancer is large and/or in the part of the vagina next to the rectum and colon. Proctosigmoidoscopy looks at the rectum and part of the colon. It’s done to check for spread of vaginal cancer to these organs. In this procedure a thin, flexible, lighted tube is put into the rectum. The doctor can look closely and the inside of the rectum and the last part of the colon to look for cancer spread. Any areas that look suspicious will be biopsied. This test may be somewhat uncomfortable, but it should not be painful.

Cystoscopy

Cystoscopy may be recommended if a vaginal cancer is large and/or is in the front wall of the vagina, near the bladder. This procedure allows the doctor to look at the inside of the bladder. It’s done to check for spread of vaginal cancer to the bladder. It can be done in the doctor’s office or clinic. You might be given an intravenous (IV) drug to make you drowsy. A thin tube with a lens and light is put into the bladder through the urethra. If suspicious areas or growths are seen, a biopsy will be done.

After a woman is diagnosed with vaginal cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

Vaginal cancer stages range from stage I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.

How is the stage determined?

The 2 systems used for staging vaginal cancer, the FIGO (International Federation of Gynecology and Obstetrics) system and the AJCC (American Joint Committee on Cancer TNM staging system) are basically the same.

They both use 3 key pieces of information to stage (classify) this cancer :

• The extent (size) of the tumor (T): How large is the cancer and has it grown into the vaginal wall? Has the cancer reached nearby structures like the wall of the pelvis? (The pelvis is the internal cavity that contains the internal female reproductive organs, rectum, bladder, and parts of the large intestine.)
• The spread to nearby lymph nodes (N): Has the cancer spread to the lymph nodes in the pelvis or groin (inguinal) area?
• The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs?

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage.

The staging system in the table primarily uses the clinical stage. This is based on the results of a physical exam, biopsy, and imaging tests done before surgery. Surgical staging is determined by examining tissue removed during an operation. For more on this, see Cancer Staging.

The system described below is the most recent AJCC system, effective as of January 2018.

These systems are not used to stage vaginal melanoma, which is staged like melanoma of the skin. Information about melanoma staging can be found in Melanoma Skin Cancer.

Vaginal cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.

The following additional categories are not listed in the table above:

• TX: Main tumor cannot be assessed due to lack of information.
• T0: No evidence of a primary tumor.
• NX: Regional lymph nodes cannot be assessed due to lack of information. 

When vaginal cancer is small and only in the cells lining the vagina, it may not cause symptoms. Invasive vaginal cancer tends to be bigger and has spread into nearby tissues, like deeper into the wall of the vagina. Most women with invasive vaginal cancer have one or more symptoms, such as:

• Abnormal vaginal bleeding (often after sex)
• Abnormal vaginal discharge
• A mass or lump in the vagina that can be felt
• Pain during sex

Advanced vaginal cancer has spread beyond the vagina to nearby structures and lymph nodes. Symptoms of advanced vaginal cancer may be:

• Painful urination
• Constipation
• Pain in the pelvis or low in the belly
• Back pain
• Swelling in the legs

Having these symptoms does not always mean that you have cancer. In fact, these symptoms are more likely to be caused by something besides cancer, like an infection. The only way to know what’s causing these problems is to see a health care professional.

If you have any of these symptoms, discuss them with a doctor right away. Remember, the sooner the problem is correctly diagnosed, the sooner you can start treatment, and the better the treatment will work.

Cancer survivors can be affected by a number of health problems, but often their greatest concern is facing cancer again. If a cancer comes back after treatment it's called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer. No matter what type of cancer you have had, it's still possible to get another (new) cancer, even after surviving the first.

Being treated for cancer doesn’t mean you can’t get another cancer. And people who have had cancer can still get the same types of cancers that other people get. In fact, certain types of cancer and cancer treatments can be linked to a higher risk of certain second cancers.

Survivors of vaginal cancer can get any type of second cancer, but they have an increased risk of:

• Vulvar cancer
• Esophagus cancer
• Cancer of the ureter (the tube that connects the kidney to the bladder)

They may have an increased risk of lung cancer. The risk of bladder cancer is also increased in women who were treated with radiation.

These cancers are all linked to smoking, which is also a risk factor for vaginal cancer. And both vaginal and vulvar cancer are linked to infection with human papilloma virus (HPV).

Follow-up after treatment

After completing treatment for vaginal cancer women will see their doctors regularly to look for signs of their cancer coming back, as well as signs of a new cancer of the vagina. Experts do not recommend extra testing to look for second cancers in women without symptoms. Let your doctor know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or second cancer.

Survivors of vaginal cancer should follow the American Cancer Society guidelines for the early detection of cancer and stay away from tobacco products. Smoking increases the risk of many cancers, including the second cancers most often seen in women treated for vaginal cancer.

To help maintain good health, survivors should also:

• Get to and stay at a healthy weight
• Adopt a physically active lifestyle
• Eat a healthy diet, with an emphasis on plant foods
• Limit alcohol to no more than 1 drink per day

These steps may also lower the risk of some cancers.

See Second Cancers in Adults for more on the causes of second cancers.

Vaginal cancer is very rare. Only about 1 of every 1,100 women will develop vaginal cancer in her lifetime. The American Cancer Society’s estimates for vaginal cancer in the United States for 2018 are:

• About 5,170 new cases will be diagnosed.
• About 1,330 women will die of this cancer.

Visit the American Cancer Society’s Cancer Statistics Center for more key statistics.

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But having a risk factor, or even many, does not mean that you will get the disease. And some people who get the disease may not have any known risk factors.

Scientists have found that certain risk factors make a woman more likely to develop vaginal cancer. But many women with vaginal cancer don’t have any clear risk factors. And even if a woman with vaginal cancer has one or more risk factors, it’s impossible to know for sure how much that risk factor contributed to causing the cancer.

Age

Squamous cell cancer of the vagina occurs mainly in older women. It can happen at any age, but few cases are found in women younger than 40. Almost half of cases occur in women who are 70 years old or older.

Diethylstilbestrol (DES)

DES is a hormone drug that was used from 1940 and 1971 to prevent miscarriage. Women whose mothers took DES when pregnant with them develop clear-cell adenocarcinoma of the vagina or cervix more often than would normally be expected. There's about 1 case of this type of cancer in every 1,000 daughters of women who took DES during their pregnancy. This means that about 99.9% of DES daughters do not develop this cancer.

DES-related clear cell adenocarcinoma is more common in the vagina than the cervix. The risk appears to be greatest in those whose mothers took the drug during their first 16 weeks of pregnancy. Their average age when they are diagnosed is 19 years. Since the use of DES during pregnancy was stopped by the FDA in 1971, even the youngest DES daughters are older than 45 – past the age of highest risk. But a woman is not safe from a DES-related cancer at any age. Doctors don't know exactly how long women remain at risk.

DES daughters have an increased risk of developing clear cell carcinomas, but women don’t have to be exposed to DES for clear cell carcinoma to develop. In fact, women were diagnosed with this type of cancer before DES was invented.

DES daughters are also more likely to have high grade cervical dysplasia (CIN 3) and vaginal dysplasia (VAIN 3) when compared to women who were never exposed.

You can learn more in DES Exposure: Questions and Answers.

Vaginal adenosis

Normally, the vagina is lined by flat cells called squamous cells. In about 40% of women who have already started having periods, the vagina may have one or more areas lined instead by glandular cells. These cells look like those found in the glands of the cervix, the lining of the body of the uterus (the endometrium), and the lining of the fallopian tubes. These areas of gland cells are called adenosis. This occurs in nearly all women who were exposed to DES during their mothers’ pregnancy. Having adenosis increases the risk of developing clear cell carcinoma, but this cancer is still very rare. The risk of clear cell carcinoma in a woman who has adenosis that's not related to DES is very, very small. Still, many doctors feel that any woman with adenosis should have very careful screening and follow-up.

Human papillomavirus

HPV is short for human papillomavirus. HPVs are a large group of related viruses. Each virus in the group is given a number, which is called an HPV type.

Certain HPV types have been linked with cancers of the cervix and vulva in women, cancer of the penis in men, and cancers of the anus and throat (in men and women). They've also been linked to VAIN, and HPV is found in most cases of vaginal cancer. These types are known as high-risk types of HPV and include HPV 16 and HPV 18, as well as others. Infection with a high-risk HPV may produce no visible signs until pre-cancerous changes or cancer develops.

Vaccines have been developed to help prevent infection with some types of HPV. See HPV for more information.

Cervical cancer

Having cervical cancer or pre-cancer (cervical intraepithelial neoplasia or cervical dysplasia) increases a woman’s risk of vaginal squamous cell cancer. This is most likely because cervical and vaginal cancers have much the same risk factors, such as HPV infection and smoking.

Some studies suggest that treating cervical cancer with radiation therapy may increase the risk of vaginal cancer, but this was not seen in other studies, and the issue remains unresolved.

Smoking

Smoking cigarettes more than doubles a woman’s risk of getting vaginal cancer.

Alcohol

Drinking alcohol might affect the risk of vaginal cancer. A study of alcoholic women found more cases of vaginal cancer than expected. But this study was flawed because it didn’t look at other factors that can alter risk, such as smoking and HPV infection. A more recent study that did take these other risk factors into account found a decreased risk of vaginal cancer in women who do not drink alcohol at all.

Human immunodeficiency virus

Infection with HIV (human immunodeficiency virus), the virus that causes AIDS, increases the risk of vaginal cancer.

Vaginal irritation

In some women, stretched pelvic ligaments may let the uterus sag into the vagina or even extend outside the vagina. This is called uterine prolapse. It can be treated with surgery or by wearing a pessary, a device to keep the uterus in place. Some studies suggest that long-term (chronic) irritation of the vagina in women using a pessary may slightly increase the risk of squamous cell vaginal cancer. But this is very rare, and no studies have clearly proven that pessaries cause vaginal cancer.

The exact cause of most vaginal cancers is not known. But scientists have found that it is linked to a number of conditions described in Risk Factors for Vaginal Cancer Research is being done to learn more about how these risk factors cause cells of the vagina to become cancer.

Research has shown that normal cells make substances called tumor suppressor gene products to keep from growing too rapidly and becoming cancers. High-risk HPV (human papillomavirus) types (like 16 and 18) produce 2 proteins (E6 and E7) that can change the way known tumor suppressor gene products work.

Women exposed to diethylstilbestrol (DES) as a fetus (that is, their mothers took DES during pregnancy) are at increased risk for developing clear cell carcinoma. DES also increases the likelihood of vaginal adenosis (gland-type cells in the vaginal lining rather than the usual squamous cells). Most women with vaginal adenosis never develop vaginal clear cell carcinoma. Still, those with a rare type of adenosis called atypical tuboendometrial adenosis do have a higher risk of developing this cancer.

The best way to reduce the risk of vaginal cancer is to avoid known risk factors and to find and treat any vaginal pre-cancers. But since many women with vaginal cancer have no known risk factors, it's not possible to completely prevent this disease.

Avoid HPV infection

Infection with human papillomavirus (HPV) is a risk factor for vaginal cancer. HPV infections occur mainly in younger women and are less common in women over 30. The reason for this is not clear.

HPV is passed from one person to another during skin-to-skin contact with an infected area of the body. HPV can be spread during sexual activity – including vaginal, anal, and oral sex – but sex doesn’t have to occur for the infection to spread. All that's needed is skin-to-skin contact with a part of the body infected with HPV. The virus can be spread through genital-to-genital contact. It’s even possible for a genital infection to spread through hand-to-genital contact.

An HPV infection also seems to be able to be spread from one part of the body to another. This means that an infection may start in the cervix and then spread to the vagina and vulva.

HPV is very common, so having sex with even one other person can put you at risk. In most cases the body is able to clear the infection on its own. But in some cases the infection doesn't go away and becomes chronic. Over time, chronic infection, especially with high-risk HPV types, can cause certain cancers, including vaginal cancer and pre-cancer.

Condom use

Condoms (“rubbers”) provide some protection against HPV. Condoms cannot protect completely because they don’t cover every possible HPV-infected area of the body, such as skin on the genital or anal area. Still, condoms do provide some protection against HPV, and also protect against HIV and some other sexually transmitted diseases.

HPV vaccines

There are vaccines that protect against infection with certain types of HPV. These vaccines can only be used to prevent HPV infection – they don't help treat an existing infection. To work best, the vaccines should be given before a person is exposed to HPV (such as through sexual activity). These vaccines are approved to help prevent vaginal cancers and pre-cancers. They are also approved to help prevent others cancers, as well as anal and genital warts.

For more information about HPV and HPV vaccines, see HPV (Human Papillomavirus).

Don’t smoke

Not smoking is another way to lower vaginal cancer risk. Women who don’t smoke are also less likely to develop a number of other cancers, such as those of the lungs, mouth, throat, bladder, kidneys, and several other organs.

Find and treat pre-cancers

Most vaginal squamous cell cancers are believed to start out as pre-cancerous changes, called vaginal intraepithelial neoplasia or VAIN. VAIN may be present for years before turning into a true (invasive) cancer. Screening for cervical cancer (such as with a Pap test or HPV test) can sometimes pick up these pre-cancers. If a pre-cancer is found, it can be treated, stopping cancer before it really starts.

Still, since vaginal cancer and VAIN are rare, doctors seldom do other tests to look for these conditions in women who don't have symptoms or a history of pre-cancer or cancer of the cervix, vagina, or vulva. 

How Pap tests and pelvic exams might help find VAIN

Vaginal intraepithelial neoplasia (VAIN; pre-cancer of the vagina) may not be visible during a routine exam of the vagina. But it may be found with a Pap test. Because cervical cancer is much more common than vaginal cancer, Pap test samples are scraped or brushed from the cervix. But some cells of the vaginal lining are usually also picked up at the same time. That allows cases of VAIN to be found in women whose vaginal lining is not intentionally scraped. Still, the main goal of a Pap test is to find cervical pre-cancers and early cervical cancers, not vaginal cancer or VAIN.

In women whose cervix has been removed by surgery to treat cervical cancer or pre-cancer, Pap test samples may be taken from the lining of the upper vagina to look for cervical cancer that has come back, and to look for early vaginal cancer or VAIN. Vaginal cancer and VAIN are more common in women who have had cervical cancer or pre-cancer.

Many women with VAIN may also have a pre-cancer of the cervix (known as cervical intraepithelial neoplasia or CIN). If abnormal cells are seen on a Pap test, the next step is a procedure called colposcopy, in which the cervix, the vagina, and at times the vulva are closely examined with a special instrument called a colposcope.

Sometimes vaginal cancer can be found early, when it's small and hasn't spread. It can cause symptoms that lead women to seek medical attention. But many vaginal cancers don't cause symptoms until they've grown and spread.

Pre-cancerous areas of vaginal intraepithelial neoplasia (VAIN) don't usually cause any symptoms.

Still, routine well-woman exams and cervical cancer screening can sometimes find cases of VAIN and early invasive vaginal cancer.

It’s important to have honest, open talks with your cancer care team. They want to answer all of your questions, no matter how minor you might think they are. Here are some of the questions you might want to ask:

• What kind of vaginal cancer do I have?
• Has the cancer spread beyond my vagina?
• What’s the stage of the cancer? What does this mean to me?
• What treatment choices do I have? What do you recommend? Why?
• What risks and side effects can I expect from treatment?
• Will I be able to have children after treatment?
• What should I do to be ready for treatment?
• Should I follow a special diet?
• Based on what you’ve learned about my cancer, what’s my prognosis (chances of survival)?
• What are the chances my cancer will recur (come back) with the treatment plans we have discussed?
• How long will it take me to recover from treatment?
• Will I be able to have sex after treatment? What reconstructive surgery, if any, will I need?
• When can I go back to work after treatment?
• How many patients with vaginal cancer do you treat each year?
• Should I get a second opinion?
• Are there any clinical trials I should think about?

You will no doubt have other questions, too. Write them down so that you remember to ask them. Keep in mind, too, that doctors aren't the only ones who can provide you with information. Other health care professionals, such as nurses and social workers, may be able to answer your questions.

For many women with vaginal cancer, treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, yet it’s hard not to worry about cancer coming back. This is very common if you’ve had cancer.

For other women, the cancer might never go away completely. Some women may get regular treatment with chemotherapy or other treatments to try and help keep the cancer in check. Learning to live with cancer that doesn't go away can be difficult and very stressful. 

Life after cancer means returning to some familiar things and also making some new choices.

Follow-up care

When treatment ends, your doctors will still want to watch you closely. It’s very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you are having and may do pelvic exams and Pap tests, as well as colposcopy and lab tests to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.

Treatment can leave vaginal tissue fragile and prone to injury. Follow-up will require checking these tissues for injury or tightening and scarring. Some women will be advised to use vaginal dilators, which a woman inserts in her vagina to gently stretch her vaginal tissue, gradually making it more elastic and normal over time. You can learn more in Treating Sexual Problems for Women With Cancer.

Ask your doctor for a survivorship care plan

Your survivorship care plan might include: 

• A suggested schedule for follow-up exams and tests
• A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
• A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
• Diet and physical activity suggestions
• Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care 

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

Can I lower my risk of the vaginal cancer progressing or coming back?

If you have (or have had) vaginal cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.

Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of vaginal cancer or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of vaginal cancer progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If the cancer does come back or recur at some point, your treatment options will depend on where the cancer is located, what treatments you’ve had before, and your overall health. For more information on how recurrent cancer is treated, see Treatment Options for Vaginal Cancer by Stage and Type.

For more general information on recurrence, you may also want to see Understanding Recurrence.

Could I get a second cancer after treatment?

People who’ve had vaginal cancer can still get other cancers. In fact, vaginal cancer survivors are at higher risk for getting some other types of cancer. Learn more in Can I Get Another Cancer After Having Vaginal Cancer?

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.