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Tests and diagnosis
By Mayo Clinic staff
While there is no general screening test for vaginal cancer, it's sometimes found during a routine pelvic exam before signs and symptoms become evident. During a pelvic exam, your doctor carefully inspects the outer exposed part of your vagina, and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries. He or she also inserts a device called a speculum into your vagina. The speculum widens your vagina so that your doctor can check your vagina and cervix for abnormalities.
Your doctor usually also conducts a Pap test to screen for cervical cancer, but sometimes vaginal cancer cells can be detected on a Pap test. Pap tests and pelvic exams are generally recommended every two to three years. How often you undergo these screenings depends on your risk factors for cancer and whether you've had abnormal Pap tests in the past. Talk to your doctor about how often you should have this health screening.
If you have any signs and symptoms, your doctor may conduct a pelvic exam and Pap test to check for abnormalities that may indicate vaginal cancer. Additionally, your doctor may conduct other procedures to determine whether you have vaginal cancer, such as:
- Colposcopy. Colposcopy is an examination of your vagina with a special lighted microscope called a colposcope. Colposcopy allows your doctor to magnify the surface of your vagina to see any areas of abnormal cells.
- Biopsy. Biopsy is a procedure to remove a sample of suspicious tissue to test for cancer cells. Your doctor may take a biopsy of tissue during a colposcopy exam. Your doctor sends the tissue sample to a laboratory for testing.
Staging
Once your doctor diagnoses vaginal cancer, he or she takes steps to determine the extent of the cancer — a process called staging. The stage of your cancer helps your doctor decide what treatments are appropriate for you. In order to determine the stage of your cancer, your doctor may use:
- Biopsy. Tissue samples from your cervix or vulva may show whether cancer has spread to those areas.
- Imaging tests. Your doctor may order imaging tests to determine whether cancer has spread. Imaging tests may include X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI).
- Tiny cameras to see inside your body. Procedures that use tiny cameras to see inside your body may help your doctor determine if cancer has spread to certain areas. Cameras help your doctor see inside your bladder (cystoscopy) and your rectum (proctoscopy).
- Positron emission tomography (PET) scan. This test uses sugar (glucose) combined with a radioactive atom to detect areas where cancer has spread. Cancer cells use more glucose because they're more active than normal cells, and the PET scan highlights areas where it isn't always easy to noninvasively detect cancer, such as your lymph nodes.
Once your doctor determines the extent of your cancer, he or she assigns your cancer a stage. The stages of vaginal cancer are:
- Stage 0. Cancer hasn't spread past the first layer (epithelium) of the vaginal wall. Five-year survival rates at this stage are as high as 96 percent.
- Stage I. Cancer is limited to the vaginal wall.
- Stage II. Cancer has spread to tissue next to your vagina.
- Stage III. Cancer has spread to nearby lymph nodes, or to the pelvic wall or both.
- Stage IVA. Cancer has spread to nearby lymph nodes, and has also spread to your bladder, rectum or pelvis.
- Stage IVB. Cancer has spread to areas away from your vagina, such as your lungs.
- Detailed guide: Vaginal cancer. American Cancer Society. http://documents.cancer.org/5016.00/5016.00.pdf. Accessed Aug. 25, 2008.
- Elkas JC, et al. Vaginal cancer. http://www.uptodate.com/home/index.html. Accessed Aug. 25, 2008.
- Holschneider CH, et al. Vaginal intraepithelial neoplasia. http://www.uptodate.com/home/index.html. Accessed Aug. 25, 2008.
- Benefits of good nutrition. American Cancer Society. http://www.cancer.org/docroot/MBC/content/MBC_6_2X_Benefits_of_nutrition_during_treatment.asp?sitearea=MBC. Accessed Aug. 24, 2008.
- FDA Approves Expanded Uses for Gardasil to Include Preventing Certain Vulvar and Vaginal Cancers. U.S. Food and Drug Administration. http://www.fda.gov/bbs/topics/NEWS/2008/NEW01885.html. Accessed Oct. 15, 2008.
- USPPI Patient Information about GARDASIL. U.S. Food and Drug Administration. www.fda.gov/cber/label/gardasilppi.pdf. Accessed Oct. 15, 2008.
