Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing vaginal cancer. During an evaluation for vaginal cancer, your doctor will ask for your medical history and perform a pelvic exam. A Pap test and human papillomavirus (HPV) test may also be performed at this time.
If vaginal cancer is suspected, your doctor may perform a colposcopy, which uses an instrument to light up and magnify the area, or a biopsy, in which a small piece of the suspected cancer is removed to be tested by a pathologist.
Imaging tests, including X-rays, computed tomography (CT) or Magnetic Resonance Imaging (MRI) scans, may also be done to see if cancer has spread to other parts of the body.
Vaginal cancer prognosis
If vaginal cancer is diagnosed, prognosis (the predicted course of the cancer) will depend on the following factors:
- The stage of the cancer (whether it is in the vagina only or has spread to other areas).
- The size of the tumor
- The grade of tumor cells (how different they look from normal cells under a microscope)
- Where the cancer is within the vagina
- Whether there are signs or symptoms at diagnosis
- Age and general health
- Whether the cancer has just been diagnosed or has recurred (come back)
Vaginal cancer diagnostic tools and tests
If a gynecologic concern is suspected, your physician will begin with performing a pelvic exam. In addition to the pelvic exam, a Pap test, in which the outside of the cervix and vagina are scraped and samples are submitted for microscopic analysis, as well as HPV testing should also be performed.
Even if the suspected diagnosis is vaginal cancer, the Pap test is especially important to rule out cervical cancer, which is much more common than vaginal cancer. Up to 20 percent of vaginal cancers are found incidentally by a Pap test during cervical cancer screening.
Other tests to diagnose vaginal tumors include:
- Biopsy
- Colposcopy
Other tests that may be done include:
- Chest X-ray
- CT scan of the abdomen and pelvis
- MRI scan
Staging vaginal cancer
Staging systems provide doctors with a common language for describing tumors. After vaginal cancer is diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started.
Staging is a way of recording the size, aggressiveness and growth of a cancer, and determining the plan for treatment. By understanding the stage of your cancer, you can make informed decisions about your treatment.
Staging vaginal cancer attempts to discover the following:
- The size of the tumor
- Whether the cancer has spread to nearby lymph nodes and tissues
- Whether the cancer has spread to other parts of the body
Staging vaginal cancer helps Penn Medicine gynecologic oncologists compare an individual situation to other patients with vaginal cancer. They can also review clinical studies on groups of patients in similar cancer stages to determine how the cancer may behave, and how different treatments may work.
Stages of vaginal cancer
Both the American Joint Committee on Cancer (TNM model) and the Federation Internationale de Gynecologie et d’Obstetrique (FIGO) can be used to stage vaginal cancer.
Most gynecologists prefer the five stage FIGO system that begins at stage 0, the earliest, through stage 4, the most advanced.
Staging vaginal cancer is as follows:
- Stage 0. The very earliest stage of vaginal cancer, also known as carcinoma in-situ (CIS), vaginal intraepithelial neoplasia (VAIN), or pre-cancer, because the cancer cells are trapped in the vaginal skin and have not yet grown into the deeper tissues or spread away from the vagina.
- Stage I. Cancer has started to grow into the deeper tissues, but has not spread beyond the vagina.
- Stage II. Cancer has started to spread outside the vagina into the surrounding tissues but has not reached the walls of the pelvis.
- Stage III. Cancer has spread outside the vagina and reached nearby lymph nodes or pelvic side walls.
- Stage IV. Advanced vaginal cancer, with spread to other organs outside the vagina.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.