The vagina is a canal of around 7 cm to 10 cm (3 to 4 inches) in length that forms a passage between the lower part of the cervix and the vulva. Since a baby passes through the vagina during delivery, it is also called the birth canal.
The inside of the vagina is lined with squamous epithelial cells, beneath which are connective tissues, muscles, lymphatic channels, blood vessels and nerves. The vagina is usually collapsed, with its walls touching each other. However, the elastic and creased nature of the walls means they can open and stretch during sexual intercourse or childbirth. Glands are present near the vaginal opening that secrete mucus to keep the lining moist.
Vaginal cancer is a rare form of cancer, with around 260 cases diagnosed each year in the UK. The most common symptom of this cancer is vaginal bleeding and a woman should visit her doctor if any of the following apply:
- Abnormal bleeding such as between periods or after sexual intercourse
- Bleeding after menopause
- Irregular periods or periods heavier than usual
- Pain on urination
The cause of vaginal cancer is not yet clear but risk factors include:
- Age over 60 years
- Human papilloma virus (HPV) infection
Diagnosis is made by internal and colposcopy examination of the vagina. A small sample of tissue (biopsy) may then be removed and sent for analysis to check for the presence of cancer cells. If the biopsy results suggest cancer is present, further imaging studies such as an X-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be performed to see how widespread the cancer is.
Treatment includes a combination of surgery, radiation therapy and chemotherapy. The chance of recovery is determined by the stage of disease and the patient’s response to therapy.
Vaginal cancer is divided into four stages, where stage 1 is the least advanced and stage 4 indicates spread beyond the pelvis. About 90% of those with stage 1 cancer live beyond five years after diagnosis, compared with around 20% of those with stage 4 cancer.
Reviewed by Sally Robertson, BSc