Vaginal cancer originates in the cells lining the vagina, a muscular female reproductive organ that connects the cervix to the vulva. The majority of cases are caused by high-risk strains of the human papillomavirus (HPV). Other risk factors include cervical dysplasia, a precancerous condition of the cervix, and cervical cancer.

Early-stage vaginal cancer is often asymptomatic, which can delay the diagnosis. As the tumor progresses, it may begin to cause noticeable symptoms, such as vaginal bleeding between menstrual periods or after menopause, unusual vaginal discharge and pain during sexual intercourse.

Vaginal cancer is relatively uncommon, accounting for less than 1% of gynecologic cancers. In many cases, the primary treatment is surgery, which may be combined with radiation therapy.

Surgical treatment options for vaginal cancer can include:

Laser surgery for vaginal intraepithelial neoplasia (VAIN)

Laser surgery may be a treatment option for VAIN, a precancerous condition of the vagina. This minimally invasive procedure involves the use of a highly focused beam of intense light to precisely destroy abnormal cells in the vaginal lining with minimal impact on the surrounding healthy tissues. The goal is to prevent vaginal intraepithelial neoplasia from progressing into vaginal cancer.

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How to prepare for laser surgery for VAIN

Before laser surgery, the patient should closely follow her physician’s preoperative instructions, which may include:

Stopping certain medications, such as blood thinners
Abstaining from sexual activity for a short time before the procedure
Fasting if anesthesia is planned
Arranging for transportation home afterward if necessary (some types of anesthesia may require post-surgical assistance)

The patient should also discuss any concerns or questions with her healthcare team before the surgery.

What to expect after laser surgery for VAIN

After laser surgery, the patient can expect mild discomfort along with some spotting or watery vaginal discharge for a few days. Any pain is typically manageable with over-the-counter pain relievers. The patient may be instructed to avoid sexual intercourse, tampon use and strenuous physical activities for a few weeks to allow the treated area to heal properly. Follow-up appointments will be scheduled to monitor the patient’s healing and ensure that the abnormal cells were effectively treated.

What are the risks and potential complications of laser surgery for VAIN?

The risks and potential complications of laser surgery include:

Infection – Though rare, the surgical site could become infected, requiring further treatment.
Excessive bleeding – While minor bleeding and spotting are common after laser surgery for VAIN, significant bleeding is a cause for concern.
Scarring – The laser procedure may cause scarring, which could lead to vaginal narrowing and discomfort.
Pain – Some patients experience prolonged discomfort during the healing process.
Recurrence – The abnormal cells may return, necessitating further treatment.

With regular follow-up care, these risks can usually be effectively managed.

Wide local excision for vaginal cancer

A common treatment option for early-stage, localized vaginal cancer, a wide local excision involves surgical removal of the cancerous tumor and a slim margin of surrounding healthy tissue. The margin will be microscopically examined by a pathologist to help ensure that all cancerous cells were removed. The goal is to eliminate the tumor while preserving as much healthy tissue as possible.

How to prepare for a wide local excision for vaginal cancer

Before a wide local excision, the patient should follow their surgeon’s preoperative instructions, which may include stopping blood thinners and other medications if applicable, fasting if anesthesia will be used and arranging transportation for the day of the procedure. The patient should also discuss any concerns, recovery expectations and post-operative care with their healthcare team to ensure full preparation and a clear understanding of the process.

What to expect after a wide local excision for vaginal cancer

After a wide local excision, the patient can expect some mild pain and swelling at the surgical site, which can usually be managed with prescription or over-the-counter pain relievers. There may be some vaginal bleeding or discharge for a few days. Depending on the extent of the surgery, the patient may need to avoid strenuous activities, sexual intercourse and tampon use for several weeks to allow for proper healing. Follow-up appointments will be scheduled to monitor the patient’s recovery, check for complications and ensure that all cancerous tissue has been removed.

What are the risks and potential complications of a wide local excision for vaginal cancer?

The risks and potential complications of a wide local excision include:

Infection – The surgical site may become infected, requiring antibiotic treatment.
Excessive bleeding – During or after surgery, bleeding may occur, possibly requiring further intervention.
Scarring – Scar tissue may form in or around the vagina, potentially affecting vaginal function or causing discomfort.
Pain – Some patients may experience prolonged discomfort or sensitivity in the treated area.
Narrowing of the vagina – Scarring or tissue removal can lead to vaginal stenosis (narrowing), which can potentially affect sexual function and comfort.
Recurrence – There is a chance that the cancer could return, necessitating additional treatment.

Careful post-surgical monitoring can help manage these risks and promote optimal healing.

Partial vaginectomy for vaginal cancer

Partial vaginectomy is a surgical procedure used to treat vaginal cancer by removing only the affected portion of the vagina along with a slim margin of surrounding healthy tissue. The procedure aims to eliminate cancerous cells while preserving as much of the vagina as possible. The extent of the removal can vary based on the size and location of the tumor. For heightened treatment effectiveness, partial vaginectomy may be combined with radiation therapy and/or chemotherapy depending on the stage of the cancer.

How to prepare for a partial vaginectomy for vaginal cancer

Before a partial vaginectomy, the patient should follow their surgeon’s specific preoperative instructions. This may include stopping medications like blood thinners, fasting if general anesthesia will be used and arranging for transportation home afterward. The patient should also discuss any questions, concerns and expectations with their healthcare team to gain a thorough understanding of the procedure, projected recovery timeline and possible impact on sexual function.

What to expect after a partial vaginectomy for vaginal cancer

After a partial vaginectomy, the patient can expect some pain and swelling at the surgical site, which can usually be managed with prescription or over-the-counter pain relievers. There may be some vaginal bleeding or discharge for a few days. The patient will need to follow specific wound care instructions and avoid sexual activity, tampon use and strenuous physical activities for several weeks to allow proper healing. Scarring or vaginal stenosis may occur, potentially affecting sexual function and comfort. Follow-up appointments will be necessary to monitor the patient’s recovery and check for signs of cancer recurrence.

What are the risks and potential complications of a partial vaginectomy for vaginal cancer?

The risks and potential complications of a partial vaginectomy include:

Infection – There is a risk of infection at the surgical site, which may require antibiotics.
Bleeding – Some patients may experience excessive bleeding during or after the procedure.
Scarring – Scar tissue may form, which could affect vaginal function or cause discomfort.
Vaginal stenosis – Narrowing of the vagina due to scarring may lead to discomfort during sexual activity.
Pain – Prolonged discomfort in the surgical area may occur, requiring pain management.
Impact on sexual function – The procedure can affect the structure of the vagina, leading to changes in sexual function and/or sensation.
Recurrence – There is a possibility that vaginal cancer could return, necessitating additional treatment.

Careful post-operative care and follow-up appointments can help manage these risks and ensure proper healing.

Total vaginectomy for vaginal cancer

Total vaginectomy is a surgical procedure that involves removing the entire vagina. This extensive surgery is usually reserved for advanced cases where the cancer has spread throughout the vaginal tissues. For heightened treatment effectiveness, total vaginectomy may be combined with other treatments, such as radiation therapy and/or chemotherapy. Depending on the patient’s needs and preferences, the vaginal canal may be reconstructed using tissue from another part of the body.

How to prepare for a total vaginectomy for vaginal cancer

Before a total vaginectomy, the patient should follow the surgeon's specific preoperative instructions, which may include stopping certain medications, such as blood thinners, fasting if general anesthesia will be used and arranging transportation and assistance during the initial recovery period. The patient should be sure to discuss any concerns with her healthcare team, such as the potential impact on her bodily function and reconstruction options, as well as post-operative care and recovery expectations. Emotional support or counseling may also be beneficial given the life-altering nature of the surgery.

What to expect after a total vaginectomy for vaginal cancer

After a total vaginectomy, the patient can expect some pain and swelling at the surgical site, which can usually be managed with prescription pain relievers. There may be some vaginal bleeding or discharge for several days, and the patient will need to follow the surgeon’s specific wound care instructions. Full recovery can take up to several weeks, during which sexual intercourse and strenuous physical activity should be avoided. Depending on the extent of the procedure, the patient may experience changes in her urinary, bowel and/or sexual function. In some cases, vaginal reconstruction may be considered. Follow-up appointments will be scheduled to monitor the patient’s healing and check for signs of cancer recurrence. Emotional and psychological support may also be important to help the patient adjust to any post-surgical changes.

What are the risks and potential complications of a total vaginectomy for vaginal cancer?

The risks and potential complications of a total vaginectomy include:

Infection – There is a risk of infection at the surgical site, which may require antibiotics.
Bleeding – Significant bleeding may occur during or after surgery.
Scarring – Extensive scar tissue may form, potentially affecting nearby organs and tissues.
Urinary or bowel complications – Total vaginectomy may impact bladder or bowel function, leading to difficulties such as incontinence.
Pain – Discomfort in the pelvic area may persist.
Sexual dysfunction – Removal of the vagina can lead to a loss of sexual function and/or sensation, potentially impacting intimacy and body image.
Emotional and psychological effects – Given the life-altering nature of total vaginectomy, the patient may experience emotional distress, requiring counseling or psychological support.
Recurrence – Despite the surgery, the risk of cancer recurrence remains.

Careful post-operative care and regular follow-up visits can help manage these risks and promote full recovery.

Radical hysterectomy for vaginal cancer

A radical hysterectomy is a surgical procedure that involves removing the uterus, cervix, part of the vagina and possibly the tissue around the cervix (parametrium), fallopian tubes, ovaries and nearby lymph nodes. This extensive surgery is typically used for treating vaginal cancer that has spread beyond the vagina but remains localized to the pelvic area. The goal is to remove all cancerous tissues while preventing the tumor from spreading further.

How to prepare for a radical hysterectomy for vaginal cancer

Before a radical hysterectomy, the patient should follow the surgeon’s specific preoperative instructions, which may include stopping certain medications, such as blood thinners, and fasting for several hours before the surgery if general anesthesia will be used. The patient should also arrange transportation and support during the recovery period. It will be important for the patient to have a candid discussion with her healthcare team regarding the possible impact of the surgery on her fertility, sexual function and overall health. Additionally, preparing for post-operative care, including wound care and mobility limitations, will be essential to ensure a smooth recovery. Emotional support or counseling may also be helpful due to the potential physical and emotional effects of the surgery.

What to expect after a radical hysterectomy for vaginal cancer

After a radical hysterectomy, the patient can expect pain and swelling at the surgical site, which should be manageable with pain-relieving medications. There may be some vaginal bleeding or discharge for a few weeks, and sexual intercourse, heavy lifting and other strenuous activities will be restricted for several weeks to allow for full and proper healing. The patient may feel tired during the initial recovery period, and her hospital stay could range from a few days to a week. Depending on the extent of the surgery, the patient may experience changes in her bladder or bowel function. Follow-up appointments will be essential to monitor the patient’s healing, check for complications and ensure that no cancer remains. Additionally, emotional support may be important as the patient adjusts to the physical and reproductive changes that follow the surgery.

What are the risks and potential complications of a radical hysterectomy for vaginal cancer?

The risks and potential complications of a radical hysterectomy include:

Infection – There is a risk of infection at the surgical site or internally, requiring antibiotics.
Bleeding – Significant blood loss during or after surgery may occur, potentially requiring a transfusion.
Bladder or bowel dysfunction – The surgery may interfere with nearby organs, leading to issues such as incontinence or difficulty with bowel movements.
Nerve damage – Nerves near the surgical site can be affected, leading to numbness or pain.
Fistula formation – Abnormal connections between the vagina and bladder or rectum may form, requiring further treatment.
Sexual dysfunction – Removal of part of the vagina or surrounding tissues may impact sexual function or sensation.
Blood clots – The risk of deep vein thrombosis (DVT) or pulmonary embolism increases after any major surgery.
Emotional and psychological effects – The impact of post-surgical reproductive changes may lead to emotional distress, requiring counseling or psychological support.
Recurrence – While the goal of a radical hysterectomy for vaginal cancer is to remove all cancerous tissues, there remains a possibility of cancer recurrence.

Close post-operative monitoring and follow-up care help manage these risks and promote recovery.

Benefit from world-class care at Moffitt Cancer Center

At Moffitt, we understand the decision to undergo vaginal cancer surgery is a highly personal one. The multispecialty team in our high-volume gynecological clinic includes experienced and compassionate oncologists who are dedicated to helping each patient select the optimal treatment plan. Our surgeons specialize in performing gynecological procedures and have extensive experience in all types of vaginal cancer surgery. Additionally, through our robust portfolio of clinical trials, our patients have unique opportunities to be among the first to benefit from promising new vaginal cancer surgery techniques and technologies.

If you would like to learn more about vaginal cancer treatment, you can request an appointment with a specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

Treatment

Vaginal Cancer Surgery