Treatment for vaginal cancer depends on the type, stage, and test results, as well as your overall health and fertility goals. The main goal may be to cure the cancer, control its growth, or relieve symptoms. Treatment typically begins with radiation and chemotherapy, but surgery may be an option for small tumors. A gynecologic oncologist, a doctor who specializes in female reproductive cancers, will coordinate your care.
Cancer treatments such as chemotherapy, radiation, and surgery can affect fertility. If preserving fertility is important, discuss options like egg or embryo freezing with your healthcare provider before starting treatment. The Adult Fertility Preservation Program at Dana-Farber Brigham Cancer Center offers specialized care for patients who want to have children now or in the future.
Radiation Therapy: This treatment uses energy beams, such as X-rays or protons, to kill cancer cells and may be delivered in two ways:
Radiation is often combined with low-dose chemotherapy to enhance its effectiveness. Radiation may also be used after surgery to eliminate any remaining cancer cells.
Chemotherapy: Chemotherapy uses strong drugs to destroy cancer cells, shrink tumors, and prevent the spread of cancer. These drugs target rapidly growing cells, which includes both cancer cells and some normal cells, leading to potential side effects. Chemotherapy can be given orally, intravenously, or through injection. Regional chemotherapy delivers drugs directly to a specific area, such as the spinal column or an organ. Sometimes, chemotherapy is combined with immunotherapy for enhanced results.
Hormone Therapy: Hormone therapy works by blocking the hormones that cancer cells need to grow. Certain hormones, like estrogen, progesterone, and testosterone, can encourage the growth of some cancers. Hormone therapy either blocks the production or action of these hormones to slow or stop cancer growth. This treatment may involve medications or surgery to remove the ovaries and stop hormone production.
Immunotherapy: This treatment helps the body’s immune system fight cancer. Immune checkpoint inhibitors are drugs that block cancer cells from avoiding immune attacks.
Radiosensitizers: These drugs make tumor cells more sensitive to radiation, increasing the effectiveness of treatment.
Clinical Trials: Clinical trials test new treatments. While they offer access to advanced therapies, there’s no guarantee of success. Talk to your healthcare provider about potential clinical trial options.
Palliative Care: Palliative care focuses on improving quality of life for patients with serious illnesses like cancer. It helps relieve pain and symptoms, offering emotional, physical, and spiritual support. Palliative care can be used alongside cancer treatments and helps improve well-being, whether the goal is curative or to manage symptoms when curative treatment is no longer an option.
Precancerous Growth Removal: If precancerous cells are found, they can be removed using laser ablation or treated with topical therapy, such as medicated creams applied directly to the affected area.
Vaginectomy (Partial or Radical): This surgery removes part or all of the vagina, depending on the tumor’s size and location. If the cancer has spread, lymph nodes may also be removed (lymph node dissection), along with the uterus and cervix (hysterectomy).
Hysterectomy: A hysterectomy removes the uterus and, in some cases, surrounding tissue or organs. There are different types:
Pelvic Exenteration: This extensive surgery is rarely needed but may be an option if cancer has spread beyond the vagina but remains in the pelvic area. It involves removing multiple organs, including the bladder, rectum, uterus, cervix, vagina, ovaries, and nearby lymph nodes. Afterward, the surgeon creates openings (stomas) in the abdomen for urine and stool to exit into external collection bags. This procedure may be considered if the cancer returns after previous treatments.
Reconstructive Surgery: If the vagina is removed, reconstructive surgery can create a new one (neovagina) using tissue from other parts of the body, such as the abdomen, buttocks, or inner thighs. While this restores vaginal structure and function, the neovagina may feel different due to changes in nerves and may require artificial lubrication. Reconstruction can be done at the same time as tumor removal or later.
Learn more about vaginal cancer surgery.
Planning ahead is key. Arrange for someone to drive you to and from the hospital and help with daily tasks like cooking and cleaning after surgery. Focus on a healthy diet, exercise regularly, limit alcohol, and stop smoking if possible. Your care team will give you specific instructions to prepare for your procedure.
Before surgery, you’ll have a preoperative evaluation at the Roberta and Stephen R. Weiner Center for Preoperative Evaluation or a phone assessment, based on your doctor’s instructions. A nurse practitioner will review your medical history, current medications, and possibly conduct lab tests or an electrocardiogram (EKG) to check your heart health. This ensures you’re medically ready for surgery. Patients are encouraged to ask questions and understand what to expect.
If needed, a social worker can assist with post-surgery care arrangements.
On the day of surgery, our team will welcome you and ensure you’re comfortable. Our skilled gynecologic oncologists will carefully remove cancerous tissue while preserving as much healthy tissue as possible. Surgery typically lasts a few hours, and our team will monitor your safety and comfort throughout the procedure.
After surgery, you’ll be taken to a recovery area, where nurses will track your vital signs as you wake up from anesthesia. Hospital stay length depends on the type of surgery. Some patients go home the same day if the procedure is minimally invasive, while others may need to stay for a few days. Typically:
Our nurses and pain management specialists will ensure you remain as comfortable as possible. Before discharge, you’ll receive detailed instructions on medications, incision care, and recovery guidelines to help you heal smoothly.
Learn more about a typical hospital stay and returning home.
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