The short answer: most women with vaginal cancer are treated with radiotherapy (sikai), often given together with chemotherapy, rather than with an operation. Surgery is an option only in selected situations: some small, early cancers in the upper part of the vagina, precancerous changes of the vaginal skin (VAIN), and some cancers that come back after radiotherapy. The right plan depends on the stage, the exact position of the tumour, any previous hysterectomy or pelvic radiotherapy, and your general health, so it is decided by a gynaecological oncologist together with the radiotherapy team. For symptoms, tests and staging, see our page on vaginal cancer care.
In Hindi this is often searched as yoni cancer ka ilaj (योनि कैंसर का इलाज).
On this page
- Why Vaginal Cancer Treatment Is Complex
- Radiation Therapy: External Beam and Brachytherapy
- Surgery for Vaginal Cancer
- Survivorship and Quality of Life
Why Vaginal Cancer Treatment Is Complex
The vagina lies between the bladder (urine bag) and the back passage (rectum), so removing a vaginal cancer with a safe margin can affect urine or bowel function. For this reason, radiotherapy — either alone or as chemoradiation (radiotherapy given together with chemotherapy) — is the usual treatment for most invasive vaginal cancers.
Radiation Therapy: External Beam and Brachytherapy
- External beam radiation therapy (EBRT) — radiation beams from a machine treat the vagina, the tissue beside it (parametrium) and the pelvic lymph nodes. It is usually given as daily sessions over about 5–6 weeks (often around 25 sessions). Modern techniques (IMRT or VMAT) shape the beam to reduce the dose to the nearby bowel and bladder, which lowers side effects.
- Brachytherapy (internal radiation) — a radiation source is placed inside the vagina, or sometimes directly into the tumour, for a short time to give a high dose to the cancer itself. This extra “boost” helps control the cancer where it started. The number of sessions depends on the plan.
For more advanced cancers that are still within the pelvis (stages II–IVA), chemotherapy, usually cisplatin, is often given during radiotherapy to make the cancer more sensitive to radiation. This approach is borrowed from cervical cancer, because vaginal cancer is rare and has few trials of its own. Whether it suits you depends on your kidney function, general health and the stage.
Surgery for Vaginal Cancer
Surgery is used much less often than radiotherapy, because the vagina lies so close to the bladder and bowel. It may be considered in these situations:
- Small stage I tumours of the upper vagina — in selected women, an operation to remove the upper vagina and the tissue around it (radical vaginectomy), usually together with the womb if it is still present and the nearby pelvic lymph nodes, may give results similar to radiotherapy. In younger women it can help keep the ovaries working and avoid radiotherapy to the vagina. It is not suitable for most vaginal cancers.
- Precancerous changes (vaginal intraepithelial neoplasia, VAIN) — this is not yet cancer. Depending on how much of the vagina is affected, treatment may be removal of the affected skin (local excision), laser treatment, or a cream used inside the vagina, such as 5-fluorouracil.
- Cancer that comes back after radiotherapy — for a small number of carefully selected women whose cancer has come back only in the centre of the pelvis, a major operation to remove the affected pelvic organs (pelvic exenteration) may be considered. It is a big decision, often involving a stoma bag, and needs a detailed discussion of recovery and life afterwards.
Like any operation, vaginal cancer surgery carries risks such as bleeding, infection, blood clots and changes to sexual, bladder or bowel function. Your team should explain why surgery or radiotherapy is being recommended for you, what the alternative is, and what recovery is likely to involve.
Survivorship and Quality of Life
Radiotherapy to the vagina and pelvis can cause long-term effects, including narrowing and shortening of the vagina (vaginal stenosis), dryness and pain during sex, bladder and bowel changes, and swelling of the legs (lymphoedema). Your team should explain how to use vaginal dilators after treatment, whether pelvic floor physiotherapy may help, and how often you will need follow-up check-ups.
Survivorship planning — discussing these side effects, their management, and psychosexual support — is an integral part of comprehensive gynaecological oncology care.
Before deciding on treatment, it helps to write down your questions: Why is radiotherapy or surgery recommended for me? Will treatment affect my bladder, bowel or sex life? Can my ovaries be protected? Our guide to preparing for a specialist appointment lists the reports and scans to bring.
Contact Dr. Nishtha Tripathi Patel at +91 76988 00333 for specialist consultation on vaginal cancer treatment in Ahmedabad.