Vaginal Cancer Treatment in Delhi, India

Vaginal cancer is a rare type of cancer that originates in the vagina, the muscular tube that connects the uterus to the external genitalia. It usually begins in the cells lining the vaginal wall and can affect women of any age, although it is more commonly diagnosed in women above 50 years.

In its early stages, vaginal cancer may not produce noticeable symptoms. However, if left undetected, it can grow and spread to nearby tissues or organs.

The type of vaginal cancer depends on the specific cells where the cancer begins. The main types include:

• Squamous Cell Carcinoma: This is the most common type of vaginal cancer, accounting for approximately 85–90% of cases. It develops in the thin, flat cells lining the surface of the vagina and usually progresses slowly.
• Adenocarcinom: Adenocarcinoma develops in the glandular cells of the vaginal lining that produce mucus. It is less common but may spread more quickly than squamous cell carcinoma and is more often seen in women over 50.
• Melanoma: Vaginal melanoma is rare and arises from pigment-producing cells called melanocytes. It often appears as a dark-coloured lesion and may behave more aggressively than other vaginal cancers.
• Sarcoma: Sarcomas originate in connective tissues, muscles, or blood vessels within the vaginal wall. These are very rare and may occur at any age. Examples include leiomyosarcoma and rhabdomyosarcoma.

Vaginal cancer develops when cells in the vagina undergo abnormal changes and begin to grow uncontrollably. Although the exact cause is not always clear, several factors can increase a woman’s risk Key risk factors include:

• Human Papillomavirus (HPV) Infection: Persistent infection with high-risk HPV types is strongly associated with vaginal cancer, particularly squamous cell carcinoma.
• Age: Most cases are diagnosed in women over the age of 60.
• History of Cervical Cancer orCervical Precancer: Women with a history of cervical cancer or cervical dysplasia have a higher risk due to shared risk factors such as HPV infection.
• Smoking: Tobacco use weakens the immune system and increases the risk of several cancers, including vaginal cancer
• Weakened Immune System: Conditions such as HIV infection or medications that suppress immunity can increase susceptibility to HPV and abnormal cell growth.
• Prior Pelvic Radiation Therapy: Women who have previously received radiation therapy to the pelvic region may have an increased long-term risk.
• Vaginal Intraepithelial Neoplasia (VAIN): VAIN is a precancerous condition involving abnormal cells on the vaginal lining. High-grade VAIN may progress to invasive cancer if not monitored and treated.
• Exposureto DES (Diethylstilbestrol): Women whose mothers were prescribed DES during pregnancy between 1940 and 1971 have an increased risk of developing clear cell adenocarcinoma of the vagina.

Having one or more of these risk factors does not mean that cancer will definitely develop, but it highlights the importance of regular medical evaluation.

Early-stage vaginal cancer may not cause symptoms. As the disease progresses, the following signs may appear:

• Abnormal vaginal bleeding, especially after intercourse, between periods, or after menopause
• Unusual vaginal discharge, which may be watery, blood-tinged, or foul-smelling
• Pain during intercourse (dyspareunia)
• Persistent pelvic pain or pressure
• A lump or mass in the vagina
• Painful urination (dysuria)
• Constipation or difficulty passing stool
• Swelling in one or both legs in advanced stages 

These symptoms can also occur in non-cancerous conditions. However, persistent or unexplained symptoms should always be evaluated by a doctor.

Diagnosing vaginal cancer involves a structured evaluation to confirm the condition and determine how far it has progressed

Pelvic Examination

A specialist examines the vagina, cervix, and surrounding tissues to identify abnormalities such as growths, ulcerations, or thickened areas.

Pap Test (Pap Smear)

Although primarily used for cervical screening, a Pap test may occasionally detect abnormal vaginal cells

Colposcopy

A colposcope is used to closely examine the vaginal and cervical tissues under magnification to identify suspicious areas.

Biopsy

A biopsy is the definitive test for diagnosing vaginal cancer. A small tissue sample is removed and examined under a microscope.

Imaging Tests

Imaging helps determine whether the cancer has spread. These may include:

• CT scan: evaluates nearby organs and lymph nodes
• MRI: assesses tumour size and depth within soft tissues
• PET scan: identifies areas of increased metabolic activity
• Chest X-ray: checks for lung involvement

Cystoscopy and Proctoscopy

If the tumour is close to the bladder or rectum, these procedures may be performed to assess possible spread.

Blood Tests

Blood tests evaluate overall health and organ function but cannot directly diagnose vaginal cancer.

Treatment depends on the stage, location of the tumour, and the patient’s overall health.

Surgery

Surgery may be recommended for early-stage disease when the tumour is confined to the vagina. Procedures range from removing a small section of tissue to more extensive operations when necessary. 

Radiation Therapy

Radiation therapy is commonly used in vaginal cancer treatment.

• External Beam Radiation Therapy (EBRT) delivers radiation from outside the body.
• Brachytherapy places a radiation source inside the vagina to target the tumour directly

Chemotherapy

Chemotherapy may be used alongside radiation therapy or in advanced disease. It helps destroy cancer cells or enhance the effectiveness of radiation.

Combined Treatments

Many patients receive chemoradiation, where chemotherapy and radiation are given together to improve treatment effectiveness.

Treatment for Advanced or Recurrent Cancer

If cancer spreads or returns after treatment, options may include systemic therapies, palliative radiation, or additional surgery aimed at controlling symptoms and improving quality of life.

Supportive Care

Supportive care includes management of treatment side effects, vaginal rehabilitation, emotional support, and long-term follow-up to monitor recovery and detect recurrence early.

If untreated or advanced, vaginal cancer may lead to complications such as:

• Spread to nearby organs like the bladder or rectum
• Persistent bleeding or discharge
• Pelvic pain or pressure
• Urinary or bowel difficulties
• Fistula formation between the vagina and bladder or rectum
• Spread to lymph nodes or distant organs
• Side effects of treatment such as vaginal dryness, narrowing, or scarring

Early detection and timely treatment significantly reduce the risk of these complications.

Although vaginal cancer cannot always be prevented, certain measures can help reduce risk:

• Regular gynaecological check-ups and cervical screening
• HPV vaccination where appropriate
• Safe sexual practices to reduce HPV exposure
• Avoiding tobacco use
• Monitoring and treating precancerous conditions such as VAIN
• Prompt medical evaluation of abnormal vaginal bleeding or discharge

Early identification and intervention remain key to improving outcomes.

Reviewed by Dr. Kanika Batra Modi, Director & Clinical Lead- Gynae Onco, Surgical Oncology, Cancer Care / Oncology, Gynecologic Oncology, Robotic Surgery, on 29 April 2026.