What Is Vaginal Cancer? A Plain-Language Guide to the Rare Cancer of the Birth Canal
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
TL;DR
Vaginal cancer is a rare cancer that begins as a fast-growing mass of abnormal cells in the vagina, the muscular tube (sometimes called the birth canal) that connects the uterus with the outer genitals. Most cancers found in the vagina actually start somewhere else and spread there, so cancer that truly begins in the vagina is uncommon. The most common warning sign is unusual vaginal bleeding, especially after menopause or after sex. Most cases are linked to human papillomavirus (HPV), a common virus passed through sexual contact. When the cancer is found early, while it is still confined to the vagina, it has the best chance for a cure, which is why seeing a doctor about persistent symptoms matters. Treatment most often starts with radiation and chemotherapy together, with surgery reserved for some small cancers, and a range of supportive care options is available along the way.
Quick Answer
What is it? A rare cancer that begins as a growth of abnormal cells in the vagina, the muscular tube connecting the uterus with the outer genitals.
How does it usually first show up? Vaginal bleeding that is not typical, such as bleeding after menopause or after sex.
What usually causes it? Changes in the DNA of vaginal cells, most often caused by human papillomavirus (HPV).
Who is most at risk? Older adults, smokers, people with HPV exposure, and people whose mother took DES (a miscarriage-prevention medicine) during pregnancy.
How is it treated? Treatment most often starts with radiation therapy and chemotherapy at the same time; very small cancers may be treated first with surgery.
What the research says
HPV is found in most vaginal precancers and squamous cancers. In a study of 5,180 patients who had colposcopy and biopsy, including 251 with vaginal cancer, HPV was detected in 95.5% of those with high-grade vaginal intraepithelial neoplasia (VaIN2/3), 86.0% of those with vaginal squamous cell carcinoma, and 43.8% of those with vaginal adenocarcinoma. The most common types were HPV16, 52, 58, 53, and 18. (Guo et al., J Low Genit Tract Dis, 2026)
Vaginal and vulvar cancers behave differently. In a multicenter study of 218 patients (131 vulvar, 87 vaginal), HPV infection was far more common in vaginal than vulvar cancer (76.1% vs 33.8%). Half of vaginal cancers were found at FIGO stage I (51.7%), and treatment was more varied: 50.6% of vaginal cancer patients had surgery as part of primary treatment, compared with 84.6% for vulvar cancer, and primary surgery was linked to longer survival in vulvar but not in vaginal cancer. (Zhao et al., BMC Public Health, 2026)
Immunotherapy is being tested, with early and very small results. In a phase II trial sub-cohort of 7 evaluable patients with vaginal cancer of differing histology, ipilimumab plus nivolumab produced an objective response rate of 29% and a clinical benefit rate of 43%, with a median overall survival of 11.7 months; grade 3 to 4 adverse events occurred in 57.1% of patients. (Chae et al., J Gynecol Oncol, 2026)
What Is Vaginal Cancer?
Vaginal cancer begins as a growth of cells in the vagina. The vagina is the muscular tube that connects the uterus with the outer genitals. It is sometimes called the birth canal.
In cancer, cells multiply quickly and can invade and destroy healthy body tissue. The abnormal DNA changes in the cells give them different instructions than healthy cells receive. Instead of growing and dying at a set rate, cancer cells are told to make many more cells quickly, and they can keep living when healthy cells would die.
Cancer that begins in the vagina is rare. Most cancer that happens in the vagina starts somewhere else and spreads to the vagina.
The good news is that timing matters a great deal. Vaginal cancer that is diagnosed when it is confined to the vagina has the best chance for a cure. When the cancer spreads beyond the vagina, it is much harder to treat.
What Are the Signs of Vaginal Cancer?
Vaginal cancer may not cause any symptoms at first. As it grows, it may cause signs and symptoms such as the following.
Sign or symptom | What to watch for |
Unusual vaginal bleeding | Bleeding that is not typical, such as after menopause or after sex |
Vaginal discharge | Any discharge that is new or unexplained |
A lump or mass | A lump or mass felt in the vagina |
Painful urination | Burning or pain when passing urine |
Frequent urination | Needing to urinate often |
Constipation | Difficulty with bowel movements |
Pelvic pain | Pain felt in the pelvic area |
When Should You See a Doctor?
Make an appointment with a doctor or other healthcare professional if you have any persistent symptoms that worry you.
What Causes Vaginal Cancer?
Vaginal cancer begins when cells in the vagina develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate, and to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly, and the cells can keep living when healthy cells would die. This causes too many cells.
The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.
What Role Does HPV Play?
Most DNA changes that lead to vaginal cancers are thought to be caused by human papillomavirus, also called HPV. HPV is a common virus that is passed through sexual contact.
For most people, the virus never causes problems. It usually goes away on its own. For some, though, the virus can cause changes in the cells that may lead to cancer.
What Are the Types of Vaginal Cancer?
Vaginal cancer is divided into different types based on the type of cells affected.
Type | Where it begins | How common |
Vaginal squamous cell carcinoma | Thin, flat cells called squamous cells that line the surface of the vagina | The most common type |
Vaginal adenocarcinoma | The glandular cells on the surface of the vagina | Rare; linked to DES, a medicine once used to prevent miscarriage |
Vaginal melanoma | The pigment-producing cells called melanocytes | Very rare |
Vaginal sarcoma | The connective tissue cells or muscle cells in the walls of the vagina | Very rare |
What Increases the Risk of Vaginal Cancer?
Several factors may increase your risk of vaginal cancer.
Risk factor | Why it matters |
Increasing age | Risk increases with age; vaginal cancer happens most often in older adults |
HPV exposure | HPV is passed through sexual contact; for some, it causes cell changes that increase cancer risk |
Smoking | Smoking tobacco increases the risk of vaginal cancer |
DES exposure before birth | If your mother took DES while pregnant, your risk might be increased; DES is linked to a type called clear cell adenocarcinoma |
What Happens If Vaginal Cancer Spreads?
Vaginal cancer can spread to other parts of the body. It most often spreads to the lungs, liver, and bones. When cancer spreads, it is called metastatic cancer.
Can Vaginal Cancer Be Prevented?
There is no sure way to prevent vaginal cancer. However, you may lower your risk if you follow the steps below.
Prevention step | How it helps |
Seek regular pelvic exams and Pap tests | These tests look for signs of cervical cancer; sometimes vaginal cancer is found during them. Ask your healthcare team how often you should be screened and which tests are best for you. |
Consider the HPV vaccine | A shot that prevents HPV infection may lower the risk of vaginal cancer and other HPV-related cancers. Ask your healthcare team whether an HPV vaccine is right for you. |
How Is Vaginal Cancer Diagnosed?
Tests and procedures used to diagnose vaginal cancer include the following.
Test or procedure | What it involves |
Pelvic exam | The doctor carefully inspects the outer genitals, inserts two fingers of one hand into the vagina, and presses on the belly with the other hand to feel the uterus and ovaries. A device called a speculum is inserted to open the vaginal canal so the doctor can look for changes in the vagina and cervix. Changes could be signs of cancer or other problems. |
Colposcopy | An exam that uses a special lighted magnifying instrument to look at the vagina. Colposcopy magnifies the surface of the vagina to look for changes that might be cancerous. |
Biopsy | A procedure to remove a sample of tissue to test for cancer cells. Often done during a pelvic exam or colposcopy. The tissue sample is sent to a lab for testing. |
How Is the Stage of Vaginal Cancer Determined?
If you are found to have vaginal cancer, your healthcare team may recommend tests to find the extent of the cancer. The size of the cancer and whether it has spread is called the cancer's stage. The stage indicates how likely the cancer is to be cured. It helps the healthcare team create a treatment plan.
Tests used to find the stage include imaging tests (X-rays, CT, MRI, or PET) and procedures that use tiny cameras to see inside the body. Looking inside the bladder is called cystoscopy. Looking inside the rectum is called proctoscopy.
The stages of vaginal cancer range from 1 to 4. The lowest number means the cancer is only in the vagina. As the cancer becomes more advanced, the stages get higher. A stage 4 vaginal cancer may have grown to involve nearby organs or spread to other parts of the body.
Stage | What it means |
Stage 1 | The cancer is only in the vagina |
Stages 2–3 | The cancer is becoming more advanced beyond the vagina walls |
Stage 4 | The cancer may have grown into nearby organs or spread to other parts of the body |
How Is Vaginal Cancer Treated?
Treatment for most vaginal cancers often starts with radiation therapy and chemotherapy at the same time. For very small cancers, surgery might be the first treatment.
Your treatment options depend on several factors, including the type of vaginal cancer you have and its stage. You and your healthcare team work together to decide what treatments are best for you. Your team considers your goals for treatment and the side effects you are willing to accept.
Vaginal cancer treatment is usually coordinated by a doctor who specializes in treating cancers that affect the female reproductive system. This doctor is called a gynecologic oncologist.
How Does Radiation Therapy Work?
Radiation therapy uses powerful energy beams to kill cancer cells. The energy comes from X-rays, protons, or other sources.
Radiation type | How it works |
External radiation (external beam) | A large machine directs beams of radiation at precise points on the body |
Internal radiation (brachytherapy) | Radioactive devices such as seeds, wires, or cylinders are placed in the vagina or near it; they may be removed after a set amount of time; often used after external radiation |
Most vaginal cancers are treated with a combination of radiation therapy and low-dose chemotherapy medicines. Chemotherapy is a treatment that uses strong medicines to kill cancer cells. Using a low dose of chemotherapy during radiation treatments makes the radiation more effective.
Radiation can also be used after surgery to kill any cancer cells that might be left behind.
When Is Surgery an Option?
Surgery type | When it might be used |
Vaginectomy (removal of the vagina) | Removes some or all of the vagina; an option for small cancers that have not grown beyond the vagina, typically when the cancer is small and not near important structures such as the tube that carries urine out of the body |
Pelvic exenteration (removal of many pelvic organs) | Used if cancer comes back or does not respond to other treatments; the surgeon may remove the bladder, ovaries, uterus, vagina, and rectum; openings are created in the abdomen to allow urine and waste to leave the body |
If the vagina is completely removed, you may choose to have surgery to make a new vagina. Surgeons use sections of skin or muscle from other areas of your body to form a new vagina.
A reconstructed vagina allows you to have vaginal intercourse. Sex may feel different after surgery. A reconstructed vagina lacks natural lubrication, and it may lack feeling due to changes in the nerves.
What Other Treatment Options Exist?
Option | When it might be used |
Chemotherapy | If the cancer has spread to other parts of the body or comes back after other treatments |
Immunotherapy | Medicine that helps the immune system kill cancer cells, which normally hide from it; an option if the cancer is advanced and other treatments have not helped; often used to treat vaginal melanoma |
Clinical trials | Experiments to test new treatment methods; a chance to try the latest advances, though a cure is not guaranteed; discuss with your healthcare team |
What Is Palliative Care?
Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. It is provided by a team that can include doctors, nurses, and other specially trained professionals. Their goal is to improve the quality of life for you and your family.
Palliative care specialists work with you, your family, and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments such as surgery, chemotherapy, or radiation therapy. When palliative care is used along with all the other appropriate treatments, people with cancer may feel better and live longer.
How Do People Cope With a Vaginal Cancer Diagnosis?
How you respond to your cancer diagnosis is unique. You might want to surround yourself with friends and family, or you may ask for time alone to sort through your feelings.
Coping strategy | What it involves |
Learn enough about your cancer | Write down the questions to ask at your next appointment. Ask a friend or family member to come and take notes. Ask your healthcare team for further sources of information. Knowing more makes it easier to make decisions about your treatment. |
Maintain intimacy with your partner | Treatments are likely to cause side effects that make sexual intimacy more difficult. Find new ways of being intimate, such as quality time and meaningful conversations that build emotional intimacy. Take physical intimacy slowly. If sexual side effects are hurting your relationship, talk to your healthcare team. |
Create a support network | Lean on friends and family. Social workers and psychologists are other sources of support. Talk with your pastor, rabbi, or other spiritual leader. Consider joining a support group; contact the American Cancer Society for more information. |
Preparing for Your Appointment
Start by making an appointment with your usual doctor, gynecologist, or other healthcare professional if you have any symptoms that worry you. If you are found to have vaginal cancer, you may be referred to a gynecologic oncologist, a doctor who specializes in cancers of the female reproductive system.
How to prepare | What to do |
Write down symptoms | Include any that may seem unrelated to the reason for the appointment |
Note key personal information | Include major stresses or recent life changes |
List medications | Include all medications, vitamins, and supplements you take |
Bring a companion | Ask a family member or friend to come; someone who accompanies you may remember something you missed |
Write down questions | List them from most important to least important in case time runs out |
Some basic questions to ask include: What is the most likely cause of my symptoms? What kinds of tests do I need? What treatments are available, and what side effects and sexuality effects can I expect? What is the best course of action, and what are the alternatives? Has my cancer spread, and what stage is it? What is my prognosis?
Be prepared to answer questions such as: When did symptoms begin? Are they continuous or occasional? How severe are they? What improves or worsens them? Did your mother take DES during pregnancy? Do you have a personal history of cancer? Have you ever been told you have HPV? Have your Pap test results ever showed something concerning?
The Bottom Line
Vaginal cancer is a rare cancer that starts as a growth of abnormal cells in the vagina, the muscular tube connecting the uterus with the outer genitals. It often causes no symptoms at first, then may show up as unusual bleeding, discharge, or a mass. Most cases are linked to HPV, and risk rises with age, smoking, and DES exposure before birth. When caught early, while still confined to the vagina, it has the best chance for a cure. Treatment most often starts with radiation and low-dose chemotherapy together, with surgery for some small cancers, and immunotherapy, clinical trials, and palliative care round out the options. If you notice persistent symptoms that worry you, make an appointment with a healthcare professional — an early conversation is your best first step.
Take the Next Step
If you have unusual vaginal bleeding or other persistent symptoms, schedule an appointment with your doctor or gynecologist. If a diagnosis is confirmed, you may be referred to a gynecologic oncologist who coordinates your care. Bring a list of questions and a trusted companion, and ask about every option, from radiation and chemotherapy to surgery, immunotherapy, and palliative support.
Frequently Asked Questions
What is vaginal cancer?
Vaginal cancer is a growth of abnormal cells that begins in the vagina, the muscular tube that connects the uterus with the outer genitals. The cells multiply quickly and can invade and destroy healthy body tissue. It is rare; most cancer found in the vagina starts somewhere else and spreads there.
What are the first signs of vaginal cancer?
Vaginal cancer may cause no symptoms at first. As it grows, it may cause unusual vaginal bleeding (such as after menopause or after sex), vaginal discharge, a lump or mass in the vagina, painful or frequent urination, constipation, or pelvic pain.
What causes vaginal cancer?
It begins when cells in the vagina develop changes in their DNA that tell them to multiply quickly and keep living when healthy cells would die. Most of these DNA changes are thought to be caused by human papillomavirus (HPV), a common virus passed through sexual contact.
Who is most at risk of vaginal cancer?
Risk increases with age, and the disease happens most often in older adults. Other risk factors include HPV exposure, smoking tobacco, and having a mother who took DES (diethylstilbestrol) while pregnant.
Where does vaginal cancer usually spread?
When it spreads, vaginal cancer most often spreads to the lungs, liver, and bones. Spread of cancer is called metastatic cancer.
How is vaginal cancer diagnosed?
Doctors use a pelvic exam, colposcopy (a magnified exam of the vagina), and a biopsy (removing a tissue sample for lab testing). If cancer is found, imaging tests such as X-rays, CT, MRI, and PET, plus camera procedures such as cystoscopy and proctoscopy, determine the stage, which ranges from 1 (only in the vagina) to 4 (involving nearby organs or spread elsewhere).
How is vaginal cancer treated?
Treatment most often starts with radiation therapy and chemotherapy at the same time. For very small cancers, surgery may be the first treatment. Other options include immunotherapy and clinical trials, and palliative care can be used alongside any treatment to relieve pain and improve quality of life.
Can surgery remove the vagina?
Yes. Vaginectomy removes some or all of the vagina and may be an option for small cancers that have not grown beyond it. A more extensive operation, pelvic exenteration, may remove several pelvic organs if cancer returns or does not respond to other treatments. If the vagina is completely removed, surgeons can use skin or muscle from other body areas to build a new vagina.
What happens after treatment regarding intimacy?
A reconstructed vagina allows vaginal intercourse, but sex may feel different. It lacks natural lubrication and may lack feeling due to nerve changes. Take intimacy slowly, build emotional closeness in other ways, and talk to your healthcare team if side effects are affecting your relationship.
Can vaginal cancer be prevented?
There is no sure way to prevent it. You may lower your risk by having regular pelvic exams and Pap tests and by considering the HPV vaccine, which may reduce the risk of vaginal and other HPV-related cancers.
Related Reading
References
Mayo Clinic Staff. Vaginal cancer: Symptoms and causes. Mayo Clinic. Reviewed April 30, 2025. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20352447
Mayo Clinic Staff. Vaginal cancer: Diagnosis and treatment. Mayo Clinic. Reviewed April 30, 2025. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/diagnosis-treatment/drc-20352453
National Cancer Institute. Vaginal cancer treatment (PDQ®) – patient version. National Cancer Institute. Accessed October 14, 2026. https://www.cancer.gov/types/vaginal/patient/vaginal-treatment-pdq
Guo C, Yan Z, Li J, et al. Human papillomavirus infection in patients with VaIN and vaginal cancer: a retrospective cross-sectional study. J Low Genit Tract Dis. 2026;30(4):305-311. PMID: 42407123. https://doi.org/10.1097/LGT.0000000000000969
Zhao X, Wang H, Hong Y, et al. Clinical characteristics, treatment patterns, and prognosis in vulvar cancer and vaginal cancer: a national multicenter retrospective study in China. BMC Public Health. 2026;26(1). PMID: 42032499. https://doi.org/10.1186/s12889-026-27384-3
Chae YK, Czeskleba J, Patel SP, et al. A phase II basket trial of dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors (DART) SWOG S1609: vaginal cancer sub cohort results. J Gynecol Oncol. 2026;37(5):e92. PMID: 41995270. https://doi.org/10.3802/jgo.2026.37.e92
Disclaimer: This guide is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here. If you think you may have a medical emergency, call your doctor or emergency services immediately.
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