The vagina is a three- to four-inch tube that goes from the cervix (bottom section of the uterus or womb) to the vulva (the outside part of female genitals).
Vaginal cancer is classified by the type of cell where it begins.
Squamous cell carcinoma: Most vaginal cancers are squamous cell carcinomas, which start in the vagina lining. These cancers develop slowly, sometimes over many years. Often, they begin as vaginal intraepithelial neoplasia (VAIN), which is a precancerous condition. VAIN is found most often in women who have had a hysterectomy (removal of the uterus), cervical cancer or cervical pre-cancer.
Adenocarcinoma: This cancer starts in the gland cells of the vagina and is most often found in women over 50.
Melanoma: This type of vaginal cancer is rare and starts in the cells that give skin color.
Sarcoma: A small number of vaginal cancers are sarcomas, which start within the wall of the vagina. The most common type is rhabdomyosarcoma, which usually is found in children.
Sometimes cancer that begins in other parts of the body spreads (metastasizes) to the vagina. When this happens, the cancer is named after the body part where it started. Cancer of the cervix and vagina is called cervical cancer. Cancer of the vulva and vagina is called vulvar cancer.
Vaginal cancer risk factors
Anything that increases your chance of getting vaginal cancer is a risk factor. These include:
- DES (diethylstilbestrol): This drug was given between 1940 and 1971 to some pregnant women to help prevent miscarriage.
- Vaginal adenosis: In some women, especially those whose mothers took DES, the cells in the vagina change from squamous cells to endometrium (or glandular) cells.
- Human papillomavirus (HPV): Some vaginal cancers are caused by HPV. HPV infections are very common and rarely lead to cancer. In cases of vaginal cancer caused by HPV, the HPV virus integrates into cells and causes changes that can lead to cancer development. The virus is no longer infectious. Learn more about HPV.
- Cervical cancer or pre-cancer: Women who have had cervical cancer have a higher risk of developing vulvar cancer.
- Smoking
- Drinking alcohol in excess
- HIV (Human immunodeficiency virus)
Not everyone with risk factors gets vaginal cancer. However, if you have risk factors, you should discuss them with your doctor.
Learn more about vaginal cancer:
Gynecologic oncologist: Why I’m passionate about cancer care at MD Anderson
I’ve always sought out opportunities to advocate for women and women’s health. That’s what drew me to the field of gynecologic oncology.
As a gynecologic oncologist at MD Anderson, I treat cancers of the female reproductive system, including endometrial cancer, cervical cancer, ovarian cancer, vulvar cancer and vaginal cancer. My passion aligns with MD Anderson’s mission to end cancer. I’m thankful I get to work with so many incredible people who share my passion and dedication to Making Cancer History® and improving the lives of our patients.
Connecting with patients is crucial to personalized care
As an oncologist, I’ve learned that there’s no one-size-fits-all approach to treating cancer.
Cancer treatment is a personal experience. As cancer care evolves, we often have multiple ways to approach a challenge. We need to understand how the cancer is affecting the person in front of us so we can make a treatment plan that will get them through treatment and beyond.
That’s why I start by asking questions. I want to get to know my patients and their caregivers. I want to understand what their goals are. After that, I can determine what diagnostic tests we need to do. Then we can create a treatment plan that aligns with best practices and meets the needs of the patient and their support system.
MD Anderson’s multidisciplinary care sets us apart from other institutions. We offer the best specialized care, whether it's medical oncology, surgical oncology or radiation oncology. Having multiple specialists review your care plan before we start treatment means that you're going to receive the right care at the right time and have the best chance for a positive outcome.
Why I value my team at MD Anderson
When you become a gynecologic oncology patient at MD Anderson, you have an entire team supporting you, including nurses, advanced practice providers, medical assistants or my colleagues in the operating room.
I'm always inspired when I come to work because I know that my team is incredible, they're energized and they care about our patients as much as I do.
I think the key to having an effective team is respecting and trusting one another. For example, I know that if I need to have a difficult conversation with one of my patients, I can rely on my team to handle everything outside of that room so that I’m able focus on the patient and their loved ones.
I hear from my patients all the time about how much they love their care team and feel like they can always turn to them with questions or concerns.
My guiding principle when caring for each patient is, ‘Would I be doing the same if this patient was my family member?’ We get to know our patients so well – through surgery, chemotherapy, surveillance and survivorship. We do consider them family. We’re there through the highs and lows of treatment, and it’s a privilege to be able to offer support and guidance to them during that time.
Clinical trials help us better treat patients
Clinical trials are a critical part of our work to end cancer. There’s so much that we need to understand, learn and improve on to conquer a disease that is always changing. Clinical trials help us do that.
It's important for patients to have access to clinical trials, so we can offer them the very best cancer treatments. In addition, we may be able to extend their life and improve their quality of life.
MD Anderson is doing a lot of research in the field of gynecologic oncology. I encourage all patients to ask their doctors about clinical trials to see if they would be a good option for you.
Why you should come to MD Anderson for cancer treatment
MD Anderson only focuses on cancer, so we're able to provide the best comprehensive care to patients from the moment they're diagnosed through their treatment and onto survivorship. You won't be a number here or just another patient. We'll develop a multidisciplinary treatment plan that's right for you.
Because we focus only on cancer, we understand the highs and lows our patients go through better than anyone else. We focus on cancer care, we specialize in cancer care, and I believe we provide the very best cancer care there is.
Jolyn Taylor, M.D., is a gynecologic oncologist at MD Anderson.
Request an appointment at MD Anderson online or call 1-877-632-6789.
When should you worry about your menstrual cycle?
Abnormal vaginal bleeding can be a symptom of several gynecologic cancers, including cervical, endometrial (uterine) and vaginal. But if you’ve never had a regular menstrual period, you might not know what "abnormal" means.
What constitutes a “normal” menstrual period? How many days should you expect to bleed, and how much time should elapse between each cycle? And, when should you be concerned enough about any irregularities to see a doctor?
Read on for the answers to these questions and more.
How long should a ‘normal’ menstrual period last?
Generally speaking, you should expect to bleed for between two and seven days during each period. Even if you stop and start within that timeframe — say, with a heavy flow for the first two, a steady tapering off for the next three, and then some moderate spotting on the last two (when you thought you were done) — that’s probably OK. But all of the bleeding should occur within that range.
How much time should elapse between your cycles?
The average is around 28 days, which is right at four weeks. But if you can count between 21 and 35 days between each period, that would still be considered normal.
Should I be concerned about heavy periods?
Not necessarily. Among other things, heavy periods could be due to:
- Uterine fibroids: These benign tumors are also known as leiomyoma.
- Adenomyosis: This is another benign condition in which endometrial tissues grow into the uterine wall.
- Endometriosis: This is a benign but painful condition in which endometrial tissue grows outside the uterus.
What’s “normal” will vary from person to person, of course, but your periods should at least be similar from one month to the next.
What about menstrual cramps? Where do they fit in?
Menstrual cramps in and of themselves are not worrisome. But if you suddenly start to have them after never having had them before, that’s concerning. In that case, you should see a doctor.
That being said, no one should have to live with debilitating pain. If you have severe menstrual cramps regularly, seek medical advice. There are many medications available that can help you feel better.
When else should I see a doctor about my menstrual cycle?
If you haven’t begun menstruating yet by age 16, you haven’t established a fairly regular monthly cycle by then, or you are older than 55 and still experiencing vaginal bleeding, consult a gynecologist.
You should also see a doctor if:
- You’re bleeding every week for a couple of days.
- You’re bleeding in bizarre patterns.
- You’re bleeding only once every three or four months.
None of these scenarios is considered normal, so they need to be investigated.
That’s especially true since we’ve been seeing an increase in the number of endometrial cancer diagnoses, especially in women under age 50.
Many of these women are only in their late 20s or early 30s, and they’ve never had normal periods. That means they’ve already logged about 15 years of irregular menstruation, depending on when they started. Often, the reason is because they are anovulatory — or not ovulating — and it’s never been recognized before or dealt with. That can increase your risk of both gynecologic cancers and precancerous conditions, so it’s important to get checked out.
Why is not ovulating a problem?
Ovulation is a normal part of the menstrual cycle that triggers a cascade of other processes in the body, including the shedding of the uterine lining. If your body doesn’t shed that lining regularly, it just keeps growing and building up. And, whether it’s due to polycystic ovarian syndrome or something else, that’s when you can start seeing precancerous changes or even actual uterine cancer develop.
Don’t some contraceptives, such as birth control pills, IUDs and implants, prevent ovulation, too?
Yes. But those devices also contain progesterone, a hormone that shuts down the endometrium. Progesterone thins out the existing lining, too, so it’s very protective against endometrial cancer.
Can anything be done to reduce my risk of developing cancer due to menstrual irregularities?
Yes. Advocate for yourself. If you’re not having regular menstrual cycles, look into why not, and don’t stop until you get some answers.
Something can usually be done to reduce your risk of developing cancer through proper hormone management. But you have to speak up for your doctors to know you have a problem.
Larissa Meyer, M.D., is a gynecologic oncologist who specializes in the treatment of female cancers.
Request an appointment at MD Anderson online or call 1-877-632-6789.
Why choose MD Anderson for vaginal cancer treatment?
When you come to MD Anderson's Gynecologic Oncology Center for vaginal cancer care, a team of experts focuses on you. These nationally known physicians customize your therapy to include the most advanced vaginal cancer treatments while minimizing side effects.
Your care team works together closely, communicating and collaborating often to be sure you receive the most comprehensive and efficient care. The group may include surgical, medical, radiation and gynecological oncologists; reconstructive surgeons; diagnostic radiologists and pathologists. A specially trained support staff joins them in delivering your care for vaginal cancer.
MD Anderson treats more women each year with this complex type of cancer than most oncologists in the nation. This gives us a level of experience and expertise that is rare and translates to more successful outcomes for many women with vaginal cancer.
Surgical skill
Surgery is one of the methods used to treat vaginal cancer. Our skilled surgeons – who include some of the top reconstructive surgeons in the country – are known for innovative techniques and excellent outcomes.
We consider your quality of life one of our top priorities. That's why we offer the most advanced surgical methods for vaginal cancer, including procedures that allow some women to keep the ability to have children.
Pioneering vaginal cancer research
We are constantly researching newer, safer, more-advanced vaginal cancer treatments. This translates to a number of clinical trials of new treatments for vaginal cancer.
At MD Anderson you are surrounded by the strength of one of the nation’s largest and most experienced comprehensive cancer centers, which has all the support and wellness services needed to treat the whole person—not just the disease.
I just want to do my best to brighten patients' days and let them know I'm here for them.
MD Anderson vaginal cancer patients can get treatment at the following locations.
The Gynecologic Oncology Center at MD Anderson
