Vaginal cancer: Most vaginal cancers (75%) are caused by HPV. Learn about symptoms of, and treatment for, vaginal cancer, a rare type of cancer.
Vulvar cancer: Most vulvar cancers (70%) are caused by HPV. Learn about new cases and death rates from vulvar cancer, a rare type of cancer.
In the United States, high-risk HPVs cause 3% of all cancers in women and 2% of all cancers in men. Each year, there are about 45,000 new cases of cancer in parts of the body where HPV is often found, and HPV is estimated to cause about 36,000 of these, according to the Centers for Disease Control (CDC).
Worldwide, the burden of HPV-related cancers is much greater. High-risk HPVs cause about 5% of all cancers worldwide, with an estimated 570,000 women and 60,000 men getting an HPV-related cancer each year. Cervical cancer is among the most common cancers and a leading cause of cancer-related deaths in low- and middle-income countries, where screening tests and treatment of early cervical cell changes are not readily available.
HPV infection passes easily between sexual partners. It can be transmitted through any intimate skin-to-skin contact, including vaginal–penile sex, penile–anal sex, penile–oral sex, vaginal–oral sex, and use of sex toys or other objects. Condoms and dental dams can lower the chance of HPV transmission but do not prevent it completely.
Infection with high-risk HPV does not usually cause symptoms. The precancerous cell changes caused by a persistent HPV infection at the cervix rarely cause symptoms, which is why regular cervical cancer screening is important. Precancerous lesions at other sites in the body may cause symptoms like itching or bleeding. And if an HPV infection develops into cancer, the cancer may cause symptoms like bleeding, pain, or swollen glands. Learn more about signs and symptoms of cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers.
The HPV vaccine Gardasil 9® protects against infection from nine HPV types: the two low-risk HPV types that cause most genital warts, plus the seven high-risk HPV types that cause most HPV-related cancers.
HPV vaccination is recommended by the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunizations Practices (ACIP) to prevent new HPV infections and HPV-associated cancers and other diseases.
HPV vaccination provides strong protection against new HPV infections. Vaccination is prevention and does not cure an infection once you have it. The HPV vaccine is not used to treat HPV infections or diseases caused by HPV. HPV vaccination offers the most protection when given at ages 9-12. HPV vaccination is estimated to prevent up to 90% of HPV-related cancers.
Vaginal Yeast InfectionThe HPV vaccine series is recommended for girls and boys, at the age of 11 or 12, and the series can be started at age 9. It is important for males as well as females to get vaccinated, because both men and women can develop cancers of the mouth and throat, anal cancers, and genital warts. Women are also at risk for cervical cancer, and men for penile cancer. Vaccination can also reduce the spread of HPV that causes cancer to other people.
Children who start the vaccine series before age 15 need two doses to be protected. For young people who weren’t vaccinated within the age recommendations, HPV vaccination is recommended up to age 26. Those who receive their first dose at age 15 or older need three doses to be protected.
Yes, the vaccine can be given to adults between the ages of 27 and 45 who didn’t receive all vaccine doses earlier. Adults in this age group benefit less from the vaccine because they are more likely to have been exposed to HPV already. Therefore vaccination is not routinely recommended for people in this age group. If you are concerned that you are at risk for a new HPV infection, talk with your health care provider about whether HPV vaccination may be right for you.
Screening tests are used to check for disease when there are no symptoms. The goal of screening for cervical cancer is to find precancerous cell changes at an early stage, before they become cancer and when treatment can prevent cancer from developing.
Currently, cervical cancer is the only HPV-caused cancer for which FDA-approved screening tests are available. Screening for cervical cancer is an important part of routine health care for people who have a cervix. This includes women and transgender men who still have a cervix. Cervical cancer screening tests include the HPV test that checks cervical cells for high-risk HPV, the Pap test that checks for cervical cell changes that can be caused by high-risk HPV, and the HPV/Pap cotest that checks for both high-risk HPV and cervical cell changes.
Learn more about Cervical Cancer Screening—including HPV and Pap testing—and find out about next steps after an abnormal Pap test or positive HPV test.
Sometimes an HPV infection can become active again after many years. Learn more about what it means if a woman has a positive HPV test after many years of negative tests.
There are no Food and Drug Administration (FDA) approved tests to detect HPV infections or HPV-caused cell changes in anal, vulvar, vaginal, penile, or oropharyngeal tissues. Research studies are ongoing to identify tests that can detect precancers in these areas or find cancer in an earlier, more treatable stage.
Anal cancer screening: Among populations that are at higher risk for anal HPV infection, such as men who have sex with men or people who are HIV positive, research has found that an anal Pap test (also called an anal Pap smear) may help to detect early cell changes or precancerous cells. A clinical trial found that treating precancerous anal lesions (called HSIL) in people living with HIV cut their risk of developing anal cancer by more than half.
Oral cancer screening: Currently, there are no standard screening tests for oral cancer. The United States Preventive Services Task Force (USPSTF)Exit Disclaimer has found that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults. However, dentists usually check for signs of oral and oropharyngeal cancer as part of a routine dental check-up.
Learn more about Oral Cavity, Pharyngeal, and Laryngeal Cancer Screening (PDQ®) and about symptoms in Oropharyngeal Cancer Treatment (Adult) (PDQ®). Treatment for Cell Changes Caused by HPV Infection Although HPV infection itself cannot be treated, there are treatments for the precancerous cell changes caused by infection with high-risk HPV. Precancerous cervical cell changes: Most women who have precancerous cervical cell changes are treated with the loop electrosurgical excision procedure (LEEP), which is a method to remove the abnormal tissue. Learn more about treatments for abnormal cervical cell changes.
Surgery Surgery is used to remove all cancer that can be seen from the vagina. Depending on the severity of the condition, patients may undergo surgeries that remove only the affected tissues or have their uterus, ovaries, and vagina removed entirely. Radiation Therapy During radiation therapy, high energy x-rays are used to kill cancerous cells or prevent them from growing. If needed, the gynecologic oncologist will usually recommend a combination of external beam radiation and brachytherapy.
External radiation therapy: A machine is used outside the body to send radiation to the intended area.
Internal radiation therapy involves placing hollow tubes in the vagina next to the tumor so that a precise dose of radiation can be inserted into the tubes and directly applied to the cancer. The radioactive substance is left in place in the vagina for several minutes, and patients must stay in bed during this time. These are most often done as outpatient procedures.
In chemotherapy, drugs are used to stop the growth of cancer. Chemo is often given to vaginal cancer patients, along with radiation after surgery is complete. Depending on the type and stage of cancer, either systemic or regional chemotherapy, will be administered. Regional chemotherapy affects only the infected areas. Systemic chemotherapy is often injected into the muscle or taken orally. This way, the drug enters the bloodstream and works its effect on cancer cells throughout the body.
Vaginal cancer can come back to the vagina or other parts of the body after it has been treated; therefore, it's important to carry out regular follow-up tests after cancer treatments conclude.
Vaginal cancer is the rarest of gynecologic cancers. It begins in the vagina, the muscular tube that connects the outer genitalia to the uterus (also called the “birth canal”).
Vaginal cancer patients find comfort in our personalized, holistic, and warm approach to care at Weill Cornell Medicine. In addition to access to experts at a leading academic medical center, our patients also benefit from greater access to their attending physician, video visits, e-message, flexible scheduling, and collaborative care with a wide range of specialists.
Vaginal Cancer Prevention and Screening Vaginal Cancer Risk Factors Women who are over 50 years old, took diethylstilbestrol (DES), use tobacco, or have the human papillomavirus (HPV) have a greater risk of developing vaginal cancer. Prevention Strategies The HPV vaccine protects against the HPV virus that can cause vaginal cancer. Typically, the HPV vaccine is given to preteens. In addition, quitting tobacco use and using condoms can help prevent vaginal cancer. Vaginal Cancer Screening There is no recommended screen for vaginal cancer. Precancerous cells of the vagina can at times be detected by Pap smears performed for cervical cancer screening.
Vaginal Cancer Symptoms The most common signs for vaginal cancer include: Abnormal vaginal bleeding Watery vaginal discharge Lump or mass in vagina Painful or frequent urination Changes in bowel movements Pelvic pain How We Diagnose Vaginal Cancer Diagnostic Tests Your physician will first conduct a physical and pelvic exam. A biopsy is the best way to confirm the diagnosis, so a small sample of cells is removed from the vaginal wall and examined under a microscope.
Vaginal Cancer TypesImaging and Staging If vaginal cancer is confirmed, it is critical to determine where the cancer is and the extent of disease. Our team of expert gynecologic oncologists carefully evaluate each patient to determine the stage of vaginal cancer and develop a personalized treatment plan. Imaging tests may include a CT, MRI, or PET scan. Stage I: Cancerous cells are found in the vaginal wall. Stage II: The cancer has spread to the tissue next to the vagina. Stage III: The cancer has spread to the nearby lymph nodes or elsewhere in the pelvis. Stage IV: The cancer has spread beyond the pelvis to other parts of the body. Illustration explaining the staging of vaginal cancer
Vaginal Cancer Treatment Options at Weill Cornell Medicine Our team of gynecologic oncologists personalize treatment depending on many factors, including the extent of disease. Individual treatment plans may include a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and other treatment options. Our physicians work closely with patients to minimize side effects and promote greater comfort throughout treatment. Precancerous Growth Removal If precancerous cells are detected, our gynecologic oncologists can surgically remove them with laser ablation. Precancerous cells can also be treated with topical therapy (a cream or ointment that is put directly on the cancer).
Surgical Approaches There are several surgical options to treat vaginal cancer, all of which include removing cancerous tissue (excision). A gynecologic oncologist will evaluate your specific condition and present the most appropriate options. Your physician may recommend: Partial vaginectomy (removal of part of the vagina) Radical vaginectomy (removal of the entire vagina) Hysterectomy (removal of uterus and ovaries) Pelvic exenteration (removal of the majority of the pelvic organs) Sentinel lymph node biopsy is a procedure in which the sentinel lymph node is removed and biopsied for cancer cells. Cancer typically spreads to these nodes first. This procedure helps physicians determine the extent of disease, as well as prevent the need for a full pelvic lymph node dissection.
Since several important organs are located in close proximity to the vagina, it is important to seek a highly trained surgeon who specializes in gynecologic cancers. Radiation Therapy Our gynecologic oncologists work closely with expert radiation oncologists at Weill Cornell Medicine to treat appropriate vaginal cancer patients with radiation therapy. Chemotherapy Chemotherapy is the use of drugs to kill cancerous cells. To limit side effects and damage to healthy cells, vaginal cancer patients are usually given chemotherapy in cycles with several rest periods.
Most women receive intravenous chemotherapy in combination with radiation to increase the effectiveness of radiation. Our expert gynecologic oncologists determine the most effective combination of therapies for each patient depending on a variety of factors. Our patients benefit from Weill Cornell Medicine's state-of-the-art chemotherapy treatment center, which provides unique support and resources. Immunotherapy Immunotherapy is the use of medications to stimulate your immune system to recognize and destroy cancer cells more effectively. Your physician determines the best immunotherapy medications and timing for taking them. With care from a highly trained gynecologic oncologist, immunotherapy can be an integral part of your vaginal cancer treatment.
The majority of vaginal cancers are caused by high-risk strains of the human papillomavirus (HPV). Having cervical precancer or cervical cancer also raises the risk of developing vaginal cancer.
If you have been diagnosed with HPV, cervical precancer or cervical cancer, talk to your gynecologist about your vaginal cancer risk.
Other risk factors for vaginal cancer include: Being 60 or older Smoking A history of abnormal cells or cancer in the cervix or uterus A hysterectomy for health problems that affect the uterus Exposure to the drug diethylstilbestrol (DES) while in the womb — this is linked to clear cell adenocarcinoma Vaginal cancer prevention There are no screening tests for vaginal cancer, but you can reduce your chance of developing vaginal cancer and treat precancerous conditions in several ways:
Get an annual pelvic exam. This is the best way to check your overall reproductive health. During this visit, you may get an HPV test to check for high-risk (cancer-causing) strains of HPV and a Pap test to check for abnormal or precancerous cells on the cervix. Pap tests are not needed if you have had a hysterectomy.
Get the HPV vaccine. This will help prevent infection with high-risk strains of HPV. HPV can cause multiple gynecologic cancers, as well as anal cancer and head and neck cancer. The HPV vaccine is available for certain adults. Ask your doctor if it is right for you.
Practice safe sex. Because HPV is a sexually transmitted virus, practicing safe sex can help prevent exposure. While condoms will not fully protect you against contracting HPV, because the virus can affect areas not covered by a condom, they do help in HPV prevention.
