The short answer: Vaginal cancer is a rare cancer that starts in the vagina (the birth passage). The most common warning sign is unusual bleeding or a watery, blood-stained discharge, especially after menopause or after sex; a lump or sore inside the vagina is less common. Most women with these symptoms do not have cancer, but they should be checked by a gynaecologist, and any bleeding after menopause should be checked even once. Only a biopsy (a small tissue sample) can confirm vaginal cancer, and when it is found early it is very treatable.
In Hindi it is often searched as yoni cancer (योनि कैंसर) or yoni cancer ke lakshan (symptoms); in Gujarati, યોનિનું કેન્સર.
On this page
- What Is Vaginal Cancer?
- Who Is at Risk?
- What Are the Symptoms?
- Diagnosis: What to Expect
- Is Screening Available?
What Is Vaginal Cancer?
Primary vaginal cancer — cancer that originates in the vagina rather than spreading to it from another site — is one of the rarest gynaecological malignancies, accounting for approximately 1–2% of all gynaecological cancers. Because of its rarity, it is often managed sub-optimally when it falls outside specialist oncology centres.
The most common type is squamous cell carcinoma (SCC), which accounts for around 85–90% of cases and is strongly linked to HPV infection — particularly types 16 and 18. Our main page on vaginal cancer care explains the types, stages and treatment in more detail.
Who Is at Risk?
- Previous cervical cancer or cervical intraepithelial neoplasia (CIN)
- HPV infection (particularly HPV 16)
- Vaginal intraepithelial neoplasia (VAIN) — a precancerous condition
- In utero diethylstilboestrol (DES) exposure
- Immunosuppression (HIV infection, post-transplant)
- History of pelvic radiation for another cancer
What Are the Symptoms?
- Abnormal vaginal bleeding (post-coital, postmenopausal, or irregular)
- Watery or blood-stained vaginal discharge
- A painless lump or ulcer in the vagina
- Pelvic pain or dyspareunia (pain during intercourse) — in more advanced disease
- Urinary symptoms or rectal symptoms if the tumour involves adjacent structures
Diagnosis: What to Expect
Diagnosis requires direct visualisation of the vagina (colposcopy) and tissue biopsy. MRI of the pelvis is the gold standard for assessing tumour extent and is essential for staging and planning radiotherapy fields.
Because vaginal cancer is rare, it is critical that management takes place at a centre with gynaecological oncology expertise. Treatment decisions involve a multidisciplinary team of gynaecological oncologists, radiation oncologists, and medical oncologists.
What happens after diagnosis? Treatment depends on the stage, size and position of the cancer, and is not the same for everyone. Many women are treated with radiotherapy (often called sikai): external radiotherapy is usually about 25 sessions over around 5 weeks, with brachytherapy (internal radiotherapy placed in the vagina) as needed, and chemotherapy is often added for more advanced cancers. Surgery is an option for selected small, early cancers. Our page on vaginal cancer treatment: radiation and surgery explains the options. If you have been referred to a specialist, this guide to preparing for a specialist appointment lists the reports and questions to bring.
Is Screening Available?
There is no population-level screening programme for vaginal cancer. However, women who have been treated for cervical cancer or high-grade CIN should continue with vault smears for life. Women who have had a hysterectomy for a non-cancer reason, with no history of high-grade CIN, are at very low risk and usually do not need vault smears. Any bleeding from the vagina after a hysterectomy should still be checked.
Dr. Nishtha Tripathi Patel is a gynaecological oncologist in Ahmedabad treating all gynaecological cancers. For specialist consultation: +91 76988 00333.