Treatment for vaginal cancer
On this page: Radiotherapy ι Linda's story ι Surgery ι Chemotherapy ι Palliative treatment ι Information reviewed by
Treatment for cancer of the vagina depends on a number of factors including your general health and the stage, grade and type of cancer you have. Treatment may involve radiotherapy, surgery and chemotherapy. You may have one of these treatments or a combination.
Radiotherapy
Radiotherapy is the treatment of cancer using high-energy x-rays to kill or destroy cancer cells. It is a common treatment for women with cancer of the vagina. In some women, radiotherapy is combined with chemotherapy. It can also be used to control symptoms of advanced cancer.
Radiotherapy can be given in two ways: externally or internally (brachytherapy). Most women with vaginal cancer have both types of radiotherapy.
External radiotherapy
External radiotherapy means that radiotherapy beams are directed at the cancer from outside the body. You will lie on a treatment table and under the machine that delivers radiation.
External radiotherapy will not make you radioactive. It is safe for you to be with other people, including children, after your treatment sessions are over and when you are at home.
External radiotherapy is normally given as a series of 10-15 minute daily treatments, Monday to Friday, over about 4-6 weeks. The exact number of sessions you have will depend on the type and size of the cancer.
Radiotherapy to the vagina is a painless treatment, but it can cause side effects. The side effects you experience depend on your radiotherapy dose and the length of your treatment.
Internal radiotherapy
Internal radiotherapy (brachytherapy) is a way of delivering radiotherapy directly to the tumour from the inside of your body. You will be given a general anaesthetic and a thin radioactive applicator, shaped like a tampon, will be put into your vagina. Some women also have small radioactive needles or wires inserted on or near the cancer. You will have to lie still while the needles or wires are in place.
Treatment will make you slightly radioactive, so you will be cared for in a single room in hospital for a few days until the wires or needles are removed. Although it will be safe for your family and friends to visit you for short periods, children and pregnant women won't be allowed to visit to avoid the chance of them being exposed to radiation.
The safety measures and visiting restrictions may make you feel isolated, frightened and depressed. Talking to your medical team, seeing a counsellor or writing in a journal may help you.
While the needles are in place, the tissue around them will become swollen. This usually settles by the time the needles are removed.
The treated area will feel sore after the needles or wires have been taken out. The pain should ease over a couple weeks. Your doctor can prescribe pain-killers to help relieve the discomfort.
Brachytherapy can cause short- and long-term side effects. The side effects you experience depend on your radiotherapy dose and the length of your treatment.
Linda's story
"My journey with vaginal cancer began a year ago. I had only been married a few weeks when I found a nodule on the left side of my vagina near the Bartholin's gland that was a squamous cell carcinoma.
"My gynaecological oncologist said the tumour was close to my anus, so surgery would not be the best option. Instead, I had external and internal radiotherapy and chemotherapy.
"I found that the radiation burned me badly and it was difficult to sit down. I was on bed rest for two weeks. However, after five weeks of external radiotherapy, my tumour was completely gone and there was no evidence of cancer in any other part of my body.
"I went into the hospital for three days of internal radiation to make sure the cancer was gone. After that, my treatment was finished. I'm thankful I didn't have surgery, as for me, it would have meant removal of my anus."
Side effects of radiotherapy
External and internal radiotherapy can cause side effects. This happens because treatment can damage healthy cells as well as cancer cells. The most common effects occur during or soon after treatment:
- Narrowing of the vagina - Radiotherapy can cause your vagina to shorten and narrow, which may make sex uncomfortable or difficult.
- Bleeding and discharge - You may have slight bleeding or discharge from the vagina once the radiotherapy has ended. If this continues or becomes heavy, let your doctor or nurse know.
- Hair loss - You may permanently lose your pubic hair.
- Bowel and bladder problems - Radiotherapy can temporarily cause inflammation to the lining of the bladder (cystitis) and loose stools (diarrhoea). A longer-term side effect may be blood in your urine or stools.
- Lymphoedema - Radiation to the groin can increase the risk of swelling in the legs.
- Menopause - Radiotherapy affects the uterus and ovaries. If you have not been through menopause, your periods will stop and you may have side effects such as hot flushes.
For more information see our radiotherapy section or call Cancer Council Helpline 13 11 20.
Surgery
The cancer may need to be removed with an operation. The type of surgery you have depends on the size and position of the cancer.
- Partial vaginectomy - The affected part of the vagina is removed.
- Radical vaginectomy - The entire vagina is removed. In some cases, a plastic (reconstructive) surgeon can make a new vagina using skin and muscle from other parts of your body. This is called vaginoplasty or vaginal reconstruction, and it may be done to improve the appearance of your genitals.
The doctor will try to remove all of the cancer along with some surrounding healthy tissue, called a margin. This helps ensure that the cancer doesn't come back. The surgeon may also take out some lymph nodes in the pelvis.
Some women also need to have a radical hysterectomy. This means the uterus, cervix, ovaries and Fallopian tubes are removed. This will cause menopause.
Recovery after surgery
The length of your hospital stay will depend on the type of surgery you have. Most women are in hospital for a few days to a week.
Pain-killers - You will be given medication to reduce any pain. Tell your doctor or nurses if you are uncomfortable so they can adjust the dose.
Catheter - A tube called a catheter will drain urine and keep your wound clean and dry. This will be removed within a few days.
Exercise and movement - You will be encouraged to start gently moving around as soon as possible after your operation. While you are in hospital, the nurse or a physiotherapist will help you do regular gentle leg exercises to prevent blood clots forming, as well as deep breathing exercises to prevent chest infection.
When you return home, you will need to take it easy. You may not be able to lift anything heavy or drive for 6-8 weeks.
Sexuality - Depending on the amount of tissue removed, the remaining or reconstructed vagina may be stretched so that you may still be able to have sexual intercourse. However, scar tissue in your vagina can cause pain and you may not be able to have an orgasm through penetration.
Surgery to the vagina does not affect the clitoris, so it is still possible to have an orgasm through direct stimulation, oral sex and masturbation. For tips about dealing with changes to your sex life, see our sexuality and cancer section.
The emotional impact of having cancer and surgery is significant. It can affect how you feel about yourself as a woman, and impact your sexuality. For information, see our sexuality and cancer section.
Chemotherapy
Chemotherapy uses anti-cancer drugs to kill or slow the growth of cancer cells. Treatment is usually given if the cancer is advanced or if it returns after treatment.
Drugs are sometimes given as tablets or, more commonly, by injection into a vein (intravenously). You will usually have a treatment session, followed by a break. Treatment can often be given to you during visits to a hospital or clinic as an outpatient, but sometimes you may spend a few days in hospital.
Side effects
Most people have some side effects from chemotherapy. However, these can usually be controlled with medication.
Common problems include feeling sick (nausea), tiredness and a reduced resistance to infections. Chemotherapy for vaginal cancer may also increase any skin soreness caused by radiotherapy.
There are many different types of chemotherapy drugs and the side effects vary. Some people find that they are able to lead a fairly normal life during their treatment, while others become very tired and need to take things more slowly. Do as much as you feel like and try not to overdo it.
For more information, see our Chemotherapy pages or call the Helpline for a free booklet about chemotherapy and its side effects.
Palliative treatment
Palliative treatment helps to improve people's quality of life by reducing symptoms of cancer without trying to cure the disease. It is particularly important for people with advanced cancer. However, it is not just for end-of-life care and it can be used at different stages of cancer.
Often treatment is concerned with pain relief and stopping the spread of cancer, but it also involves the management of other physical and emotional symptoms.
Treatment may include radiotherapy, chemotherapy or other medication.
For more information, call Cancer Council Helpline 13 11 20 for free information about palliative care and advanced cancer.
Reviewed by: Dr Greg Robertson, Gynaecological Oncologist, Royal Hospital for Women and St George Hospital; Jonathan Carter, Prof of Gynaecological Oncology, The University of Sydney and Head of Sydney Gynaecological Oncology Group, Sydney Cancer Centre; Belinda Fern, Consumer; Alicia Hiron, Consumer; Jayne Maidens, Clinical Nurse Consultant, Gynaecological Oncology Department, Royal North Shore Hospital; Anne Mellon, Clinical Nurse Consultant, Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital; Fiona Pearce, Cancer Council NSW Helpline; Ann Tocker, Cancer Voices.
