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Treatments for vaginal carcinoma
The following are treatment options for stages 1 to 4 and recurrent carcinoma of the vagina. Vaginal carcinomas include squamous cell carcinomas (SCC) and adenocarcinomas. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
You may be offered surgery or radiation therapy or both for stage 1 vaginal carcinoma. The treatment may vary with squamous cell carcinoma and adenocarcinoma.
Squamous cell carcinoma
Radiation therapy is used for most stage 1 SCCs. Brachytherapy with or without external beam radiation therapy can be given. Radiation therapy may be given as the main treatment or it may be given after surgery when surgical margins are close to the tumour or have cancer cells present. External beam radiation therapy may be given to the lymph nodes in the pelvis.
SCCs may be treated with surgery. The type of surgery depends on the location of the tumour. Types of surgery for SCC include:
- wide local excision if the tumour is small and is located in the lower part of the vagina
- partial vaginectomy or a radical vaginectomy if the tumour is located higher in the vagina
- radical hysterectomy if the tumour is located higher in the vagina
- lymph node dissection of pelvic or groin lymph nodes
- vaginal reconstruction if the vagina has been removed
Radiation therapy, usually both brachytherapy and external beam radiation therapy, is used for adenocarcinomas in the lower part of the vagina. External beam radiation therapy is often given to the lymph nodes in the groin or pelvis or both.
Surgery is the treatment for adenocarcinomas of the upper part of the vagina. The surgery is a radical hysterectomy, partial or radical vaginectomy and removal of the pelvic lymph nodes. Radiation therapy may be given following surgery.
Treatment with wide local excision with removal of lymph nodes and brachytherapy may be an option for a tumour in the lower part of the vagina.
You may be offered radiation therapy or surgery or both for stage 2 vaginal carcinoma.
A combination of brachytherapy and external beam radiation therapy to the tumour is usually the main treatment. Lymph nodes in the groin and pelvis may be treated with external beam radiation therapy.
Surgery with radical vaginectomy or pelvic exenteration followed by vaginal reconstruction may be an option for some women if the cancer is small and in the upper vagina. Surgery is also used to treat women who have had previous radiation therapy to the pelvis.
Radiation therapy with brachytherapy and external beam radiation therapy is the main treatment for stage 3 vaginal carcinoma. Pelvic exenteration followed by vaginal reconstruction may be an option for some women.
Radiation therapy with brachytherapy and external beam radiation therapy is the main treatment for stage 4A vaginal carcinoma. Pelvic exenteration followed by vaginal reconstruction may be an option for some women.
You may be offered radiation therapy to the vagina and pelvis to control symptoms for stage 4B vaginal carcinoma. Chemotherapy is sometimes given.
Chemotherapy drugs that may be used include:
- 5-fluorouracil (5-FU, Adrucil)
- cisplatin (Platinol AQ)
- carboplatin (Paraplatin, Paraplatin AQ)
- paclitaxel (Taxol)
- docetaxel (Taxotere)
Recurrent vaginal carcinoma means that the cancer has come back after it has been treated. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.The following are treatment options for recurrent vaginal carcinoma:
- pelvic exenteration surgery if the cancer has come back after treatment with radiation therapy
- radiation therapy if the cancer was previously treated with surgery
- chemotherapy with drugs as listed for treatment of stage 4B vaginal carcinoma
If you can’t have or don’t want cancer treatment
You may want to consider a type of care to make you feel better without treatingthe cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Some clinical trials in Canada are open to women with vaginal carcinoma. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.