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Vaginal Cancer Diagnosis

The experts at MD Anderson use the most-advanced technology and techniques to pinpoint vaginal cancer. They specialize in diagnosing vaginal cancer, and they have a high degree of expertise and skill.

Vaginal Cancer Diagnostic Tests

If you have symptoms that may signal vaginal cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking and drinking habits; and your family history.

One or more of the following tests may be used to find out if you have vaginal cancer and if it has spread. These tests also may be used to find out if treatment is working.

Biopsy

The only way to tell for sure if you have vaginal cancer is a biopsy. A small piece of tissue is removed, and then it is looked at under a microscope. Your doctor may use a colposcope to magnify the area and make it easier to remove the tissue. The doctor then looks at the area using colposcope, which is like binoculars with magnifying lenses, or a magnifying glass. A small piece of the suspicious area will be removed.

Imaging tests, which may include:

  • CT or CAT (computed axial tomography) scans
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans
  • Chest X-ray

Endoscopic tests, which may include:

Proctosigmoidoscopy: An endoscope is inserted into the rectum to look at the rectum and colon. Biopsies can be done during the procedure.

Cystoscopy: An endoscope is inserted into the bladder through the urethra. Biopsies can be done during the procedure.

Why Choose MD Anderson?

  • High level of expertise in vaginal cancer
  • Innovative vaginal cancer surgery methods; techniques that allow some women to keep the ability to have children, including trachelectomy
  • Skilled reconstructive surgeons
  • Combined therapies for advanced vaginal cancer
  • Range of clinical trials of new treatments for vaginal cancer

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Treatment at MD Anderson

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Vaginal Cancer Staging

If you are diagnosed with vaginal cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer. Once the staging classification is determined, it stays the same even if treatment works or the cancer spreads.

Vaginal Cancer Stages

(source: National Cancer Institute)

The stage of most vaginal cancers is most often described using the FIGO (International Federation of Gynecology and Obstetrics) System of Staging combined with the American Joint Committee on Cancer (AJCC) TNM system. This system classifies the diseases in Stages 0 through IV depending on the extent of the tumor (T), whether the cancer has spread to lymph nodes (N) and whether it has spread to distant sites (M for metastasis).

Tumor extent (T)

  • Tis: Cancer cells are only in the most superficial layer of cells of the vagina without growth into the underlying tissues. This stage is also called carcinoma in situ (CIS) or vaginal intraepithelial neoplasia 3 (VAIN 3). It is not included in the FIGO system.
  • T1: The cancer is only in the vagina.
  • T2: The cancer has grown through the vaginal wall, but not as far as the pelvic wall.
  • T3: The cancer is growing into the pelvic wall.
  • T4: The cancer is growing into the bladder or rectum or is growing out of the pelvis.

Lymph node spread of cancer (N)

  • N0: The cancer has not spread to lymph nodes
  • N1: The cancer has spread to lymph nodes in the pelvis or groin (inguinal region)

Distant spread of cancer (M)

  • M0: The cancer has not spread to distant sites
  • M1: The cancer has spread to distant sites.

Stage Grouping

Once the T, N, and M categories have been assigned, this information is combined to assign an overall stage in a process called stage grouping. The stages identify tumors that have a similar outlook and are treated in a similar way.

Stage 0 (Tis, N0, M0): In this stage, cancer cells are only in the top layer of cells lining the vagina (the epithelium) and have not grown into the deeper layers of the vagina. Cancers of this stage cannot spread to other parts of the body. Stage 0 vaginal cancer is also called carcinoma in situ (CIS) or vaginal intraepithelial neoplasia 3 (VAIN 3). This stage is not included in the FIGO system.

Stage I (T1, N0, M0): The cancer has grown through the top layer of cells but it has not grown out of the vagina and into nearby structures (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).

Stage II (T2, N0, M0): The cancer has spread to the connective tissues next to the vagina but has not spread to the wall of the pelvis or to other organs nearby (T2). (The pelvis is the internal cavity that contains the internal female reproductive organs, rectum, bladder, and parts of the large intestine.) It has not spread to nearby lymph nodes (N0) or to distant sites (M0).

Stage III: Either of the following:

  • T3, any N, M0: The cancer has spread to the wall of the pelvis (T3). It may (or may not) have spread to nearby lymph nodes (any N), but it has not spread to distant sites (M0), OR
  • T1 or T2, N1, M0: The cancer is in the vagina (T1) and it may have grown into the connective tissue nearby (T2). It has spread to lymph nodes nearby (N1), but has not spread to distant sites (M0).

Stage IVA (T4, Any N, M0): The cancer has grown out of the vagina to organs nearby (such as the bladder or rectum) (T4). It may or may not have spread to lymph nodes (any N). It has not spread to distant sites (M0).

Stage IVB (Any T, Any N, M1): Cancer has spread to distant organs such as the lungs (M1).

Getting a Second Opinion at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging every type and stage of vaginal cancer. We welcome the opportunity to provide second opinions for vaginal cancers.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center