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RGCIRC, Niti Bagh
Vaginal Cancer Treatment in Delhi, India
Vaginal cancer is an uncommon gynaecological cancer that requires timely diagnosis and specialised treatment. Because its symptoms can resemble those of other gynaecological conditions, accurate evaluation by an experienced gynaecologic oncology team is essential for early detection and effective treatment planning.
At RGCIRC (Rajiv Gandhi Cancer Institute and Research Centre), every patient benefits from a multidisciplinary approach to care. Our Gynae-Oncologists work closely with radiation oncologists, medical oncologists, radiologists, pathologists, and rehabilitation specialists to develop an individualised treatment plan based on the type and stage of cancer. The team also has published research on the role of radical surgery in early-stage vaginal cancer, reflecting RGCIRC’s long-standing expertise in the management of rare gynaecological cancers.
Understanding Vaginal Cancer
Vaginal cancer is a rare type of gynaecological cancer that develops in the tissues lining the vagina. Most cases begin in the thin layer of squamous cells that line the vaginal wall, although some cancers arise from glandular cells. If left untreated, the cancer can grow into nearby tissues and spread to lymph nodes or other parts of the body.
Primary vs Secondary Vaginal Cancer
Vaginal cancer may be classified as primary or secondary.
Primary vaginal cancer starts in the vagina itself and is relatively uncommon.
Secondary vaginal cancer occurs when cancer from another organ, most commonly the cervix, uterus, vulva, or rectum, spreads to the vagina. This is more common than primary vaginal cancer. Distinguishing between the two is important because it affects the stage of the cancer, treatment planning, and expected outcomes. By definition, primary vaginal cancer is diagnosed only when the cervix and vulva are not involved.
How Vaginal Cancer Develops
Many vaginal cancers develop gradually from precancerous changes in the vaginal lining known as vaginal intraepithelial neoplasia (VAIN). These abnormal changes can often be detected and treated before they become cancerous. Without treatment, VAIN may progress to invasive vaginal cancer, which can spread through the vaginal wall to nearby organs, such as the bladder and rectum, as well as the pelvic lymph nodes.
Types of Vaginal Cancer
Vaginal cancer is classified based on the type of cells where it first develops. Identifying the type of cancer is an important part of diagnosis, as it helps doctors determine the most appropriate treatment plan and better understand how the disease is likely to behave.
Squamous Cell Carcinoma
Squamous cell carcinoma is the most common type of vaginal cancer, accounting for about 85 to 90% of cases. It develops in the thin, flat cells lining the vagina and is strongly associated with persistent infection by high-risk types of the human papillomavirus (HPV), particularly HPV 16 and HPV 18.
Vaginal Adenocarcinoma
Adenocarcinoma develops in the glandular cells of the vagina and accounts for about 5 to 10% of cases. A rare subtype, called clear cell adenocarcinoma, has been linked to prenatal exposure to diethylstilboestrol (DES), a medication that was used in some countries several decades ago during pregnancy.
Vaginal Melanoma
Vaginal melanoma is a rare but aggressive cancer that develops from pigment-producing cells called melanocytes. Unlike squamous cell carcinoma, it is not linked to HPV infection and often requires a different treatment approach.
Vaginal Sarcoma
Vaginal sarcoma is an uncommon cancer that develops from the connective tissues, such as muscle or blood vessels, within the vaginal wall. Different types of sarcoma can occur in children and adults, and treatment is planned according to the specific subtype and stage of the disease.
Signs and Symptoms of Vaginal Cancer
Early-stage vaginal cancer may not cause any symptoms, which is why some cases are detected during routine gynaecological examinations or follow-up after treatment for another gynaecological cancer. When symptoms do occur, they are often mistaken for more common conditions. If any of the following symptoms persist or occur without an obvious cause, they should be evaluated by a gynae oncologist:
Abnormal Vaginal Bleeding: Abnormal vaginal bleeding is the most common symptom of vaginal cancer. This may include bleeding after sexual intercourse, between menstrual periods, or after menopause. Any unexplained postmenopausal bleeding should be assessed without delay.
Unusual Vaginal Discharge: Persistent vaginal discharge that is watery, blood-stained, foul-smelling, or different from usual may be a sign of vaginal cancer, particularly when there is no evidence of infection.
Pelvic Pain or Pain During Intercourse: As the tumour grows, it may cause persistent pelvic pain, a feeling of pressure, or pain during sexual intercourse.
Changes in Urination: Cancer involving the bladder or urethra may cause pain while passing urine, frequent urination, difficulty urinating, or blood in the urine. These symptoms can resemble a urinary tract infection and should be evaluated if they persist.
Changes in Bowel Habits: Advanced vaginal cancer may affect the rectum, causing constipation, pain during bowel movements, or other persistent changes in bowel habits.
A Lump or Growth in the Vagina: Some women may notice a lump, growth, or area of thickening inside the vagina. Any new vaginal lump should be examined by a specialist.
Women at higher risk, including those with a history of cervical cancer or precancer, previous pelvic radiation therapy, or persistent HPV infection, should be especially vigilant about these symptoms. Vaginal cancer can also develop in the vaginal cuff after a hysterectomy, making regular follow-up important for women at increased risk.
Causes and Risk Factors of Vaginal Cancer
The exact cause of vaginal cancer is not always known. However, several factors can increase the risk of developing the disease. Some of these, such as HPV infection and smoking, are preventable or modifiable, while others are related to age, previous medical history, or past treatments. Common causes and risk factors include:
Human Papillomavirus (HPV) Infection
Persistent infection with high-risk HPV, particularly HPV types 16 and 18, is the most important risk factor for squamous cell carcinoma of the vagina. Although most HPV infections clear on their own, persistent infection can lead to precancerous changes over time. HPV vaccination is an effective way to reduce the risk of HPV-related vaginal cancer.
Age
The risk of vaginal cancer increases with age, and most cases of squamous cell carcinoma occur in women over 60 years. Some less common types, such as clear cell adenocarcinoma, may occur at a younger age.
Previous Gynaecological Cancers or Precancerous Conditions
Women with a history of cervical cancer, vulvar cancer, or precancerous conditions such as vaginal intraepithelial neoplasia (VAIN) have a higher risk of developing vaginal cancer. Regular follow-up is important for early detection and timely treatment.
Previous Pelvic Radiation Therapy
Women who have received radiation therapy for a previous pelvic or gynaecological cancer have a slightly higher risk of developing vaginal cancer later in life. Regular long-term follow-up helps monitor for any late complications.
DES Exposure Before Birth
Women whose mothers took diethylstilboestrol (DES) during pregnancy have a higher risk of developing a rare type of vaginal cancer called clear cell adenocarcinoma. Although DES is no longer used, this risk remains relevant for women who were exposed before birth.
Smoking and Weakened Immunity
Smoking increases the risk of vaginal cancer by reducing the body’s ability to clear HPV infection and by promoting cancer-causing changes in the vaginal lining. A weakened immune system, including due to HIV infection, organ transplantation, or certain medications, also increases the risk of persistent HPV infection and HPV-related cancers.
How is Vaginal Cancer Diagnosed?
Accurate diagnosis and staging are essential for planning the most appropriate treatment for vaginal cancer. At RGCIRC, the diagnostic work-up is led by the Gynaecologic Oncology team and combines clinical examination, tissue diagnosis, and advanced imaging to determine the type, extent, and stage of the disease. The following investigations are commonly used to confirm the diagnosis, determine the stage of the disease, and guide treatment planning.
Physical and Pelvic Examination
The evaluation begins with a detailed pelvic examination, including a speculum examination to inspect the vaginal lining and a bimanual examination to assess the size, location, and extent of any abnormality.
Pap Smear and HPV Testing
A Pap smear may detect abnormal cells in the vagina or cervix, including precancerous changes such as vaginal intraepithelial neoplasia (VAIN). When indicated, high-risk HPV testing, including HPV mRNA E6/E7 testing available at RGCIRC, provides additional information to support clinical assessment.
Colposcopy and Biopsy
Suspicious areas identified during examination or screening are evaluated using colposcopy, which allows magnified visualisation of the vaginal lining. A biopsy is then performed to obtain tissue for microscopic examination. Histopathological analysis of the biopsy specimen is the definitive method for confirming vaginal cancer.
Imaging for Staging
Once the diagnosis is confirmed, imaging is performed to determine the extent of disease and guide treatment planning. MRI of the pelvis is used to assess the local extent of the tumour and its relationship to adjacent organs. CT scans of the chest, abdomen, and pelvis help evaluate the spread of disease beyond the pelvis, while Digital PET-CT may be recommended in selected patients with advanced or recurrent disease. When bladder or rectal involvement is suspected, cystoscopy or sigmoidoscopy may also be performed.
Stages of Vaginal Cancer
The stage of vaginal cancer describes how far the disease has spread. Determining the stage is an essential part of treatment planning, as it helps the multidisciplinary team recommend the most appropriate treatment approach. Vaginal cancer is staged using the FIGO (International Federation of Gynaecology and Obstetrics) staging system.
|
Stage |
Description |
|
Stage I |
Cancer is confined to the vaginal wall and has not spread to nearby tissues or lymph nodes. |
|
Stage II |
Cancer has spread to the tissues surrounding the vagina but has not reached the pelvic wall. |
|
Stage III |
Cancer has spread to the pelvic wall, involves the lower third of the vagina, or has caused hydronephrosis or a non-functioning kidney. |
|
Stage IVA |
Cancer has spread to nearby organs, such as the bladder or rectum, or has extended beyond the pelvis. |
|
Stage IVB |
Cancer has spread to distant organs, such as the lungs, liver, or bones. |
How is Vaginal Cancer Treated at RGCIRC?
Treatment for vaginal cancer is individualised and depends on the stage of the disease, the location and type of the tumour, and the patient’s overall health. At RGCIRC, every case is reviewed by the Gynaecologic Oncology Multidisciplinary Tumour Board to develop a personalised treatment plan. Depending on the diagnosis, treatment may involve one or a combination of the following approaches.
Radiation Therapy
Radiation therapy is the primary treatment for most vaginal cancers, particularly squamous cell carcinoma. It may be used alone or in combination with chemotherapy, depending on the stage of the disease.
RGCIRC offers advanced radiation techniques, including:
- External Beam Radiation Therapy (EBRT): Delivers radiation from outside the body to treat the tumour and nearby lymph nodes, usually over several weeks.
- Brachytherapy: Places a radioactive source inside the vagina to deliver a high dose of radiation directly to the tumour while minimising exposure to surrounding organs. It may be used alone in selected early-stage cancers or after EBRT.
- Image-Guided Radiation Therapy (IGRT): Uses advanced imaging during treatment to improve precision and reduce radiation exposure to nearby healthy tissues.
Surgery
Surgery may be recommended for selected patients with early-stage disease, recurrent cancer, or when complete tumour removal is considered achievable. RGCIRC has published research on the role of radical surgery in early-stage vaginal cancer and has extensive experience in managing these complex procedures.
Depending on the extent of the disease, surgery may include:
- Local Excision: Removal of a small, superficial tumour with a margin of healthy tissue.
- Partial Vaginectomy: Removal of the affected portion of the vagina while preserving the remaining healthy tissue.
- Radical Vaginectomy: Removal of the entire vagina. In selected patients, this may be combined with radical hysterectomy, pelvic lymph node dissection, and vaginal reconstruction.
- Pelvic Exenteration: An extensive operation reserved for carefully selected patients with advanced or recurrent disease involving nearby pelvic organs. Robotic-assisted pelvic exenteration is available for suitable candidates at RGCIRC.
- Pelvic Lymph Node Dissection: Removal of nearby lymph nodes when cancer spread is suspected or confirmed.
Chemotherapy
Chemotherapy is most commonly given together with radiation therapy (concurrent chemoradiation) to improve treatment effectiveness. It may also be used as the primary treatment for recurrent or metastatic vaginal cancer when local treatment is not possible.
Targeted Therapy and Immunotherapy
For selected patients with advanced or recurrent vaginal cancer, targeted therapy and immunotherapy may be considered based on the tumour’s molecular profile. At RGCIRC, molecular testing helps identify patients who may benefit from treatments such as immunotherapy or targeted agents.
Treatment by Stage
Treatment recommendations vary according to the stage of the disease:
- Stage I: Surgery or brachytherapy for selected small tumours; larger tumours are usually treated with EBRT followed by brachytherapy.
- Stage II: Concurrent chemoradiation combining EBRT, brachytherapy, and chemotherapy.
- Stage III and Stage IVA: Definitive chemoradiation is the standard treatment. Selected Stage IVA patients may also be candidates for pelvic exenteration.
- Stage IVB: Systemic treatment, including chemotherapy, immunotherapy, or targeted therapy, with radiation therapy used when needed for symptom relief.
Recovery and Follow-Up Care
Recovery after vaginal cancer treatment depends on the type of treatment received and the extent of the disease. At RGCIRC, post-treatment care focuses not only on recovery from treatment but also on managing long-term side effects, restoring quality of life, and monitoring for recurrence.
Managing Treatment Side Effects
Side effects vary depending on the treatment received. Pelvic radiation therapy may cause temporary fatigue, pelvic discomfort, urinary frequency, loose stools, and skin irritation, which usually improve within a few weeks after treatment. Some patients may also experience long-term effects such as vaginal dryness, vaginal narrowing (stenosis), bladder or bowel changes, or lymphoedema. At RGCIRC, these potential side effects are discussed before treatment, and supportive care is provided to help manage them.
Sexual Health and Intimacy
Treatment for vaginal cancer can affect sexual health and vaginal function. Depending on the treatment received, vaginal dilators, lubricants, and, where appropriate, topical oestrogen may be recommended to reduce the risk of vaginal narrowing and improve comfort. Sexual health concerns are addressed as an integral part of post-treatment care at RGCIRC.
Emotional and Psychological Support
A diagnosis of vaginal cancer and its treatment can affect emotional wellbeing, body image, and quality of life. RGCIRC’s psycho-oncology team provides counselling and psychological support to help patients and their families cope throughout treatment and recovery.
Follow-Up Care and Surveillance
Regular follow-up is essential to monitor recovery, detect any recurrence at an early stage, and manage the long-term effects of treatment. Follow-up at RGCIRC includes scheduled pelvic examinations, with Pap smear, HPV testing, and imaging performed when clinically indicated. Patients who have received pelvic radiation are also monitored for potential late effects of treatment as part of their long-term care.
Why Choose RGCIRC for Vaginal Cancer Treatment?
Because vaginal cancer is uncommon, its diagnosis and treatment require specialist expertise and a coordinated multidisciplinary approach. At RGCIRC, patients benefit from experienced gynaecologic oncologists, advanced treatment technologies, and comprehensive care throughout every stage of treatment and recovery. Here’s what makes RGCIRC stand out:
Dedicated Gynaecologic Oncology Expertise
RGCIRC’s Gynaecologic Oncology department is led by Dr Vandana Jain, Senior Consultant and Head of Department, who has nearly 17 years of experience, including more than 13 years dedicated to gynaecologic oncology. Dr Jain has also completed an international observership at Memorial Sloan Kettering Cancer Center (MSKCC), New York. The department has published peer-reviewed research on the role of radical surgery in early-stage vaginal cancer, reflecting its expertise in managing this rare disease.
Comprehensive Treatment Under One Roof
RGCIRC offers comprehensive vaginal cancer treatment, including advanced radiation therapy, brachytherapy, surgery, chemotherapy, targeted therapy, and immunotherapy. This integrated approach enables patients to receive diagnosis, treatment, and follow-up care within a single specialist cancer centre.
Advanced Radiation Therapy
Radiation therapy is the cornerstone of treatment for many vaginal cancers. RGCIRC offers advanced radiation techniques, including IMRT, IGRT, and image-guided brachytherapy, enabling precise treatment while minimising radiation exposure to surrounding healthy tissues.
Multidisciplinary Treatment Planning
Every vaginal cancer case is reviewed by the Gynaecologic Oncology Multidisciplinary Tumour Board. Gynaecologic oncologists, radiation oncologists, medical oncologists, radiologists, and pathologists work together to develop an individualised, evidence-based treatment plan for every patient.
Advanced Diagnostic Facilities
RGCIRC offers comprehensive diagnostic services, including Pap smear and HPV testing with high-risk HPV mRNA E6/E7 analysis, colposcopy with biopsy, MRI, Digital PET-CT, and molecular profiling. These facilities support accurate diagnosis, staging, and personalised treatment planning.
Recognised Excellence
RGCIRC holds NABH (5th Edition) and NABL accreditations, along with Green OT and Nursing Excellence certifications. The institute has been recognised among the World’s Best Specialised Hospitals by Newsweek (2024 and 2025), ranked No. 1 in North India among single-specialty hospitals by The Times of India (2025), and awarded Best Oncology Hospital of the Year 2026 by the IHW Council.
Commitment to Accessible Care
As a not-for-profit institution, RGCIRC provides financial assistance and subsidised treatment support through its Philanthropy Department, helping ensure that specialist cancer care remains accessible to eligible patients.
Book a Consultation at RGCIRC
If you are experiencing symptoms that concern you, have been referred for evaluation of a vaginal abnormality, or have received a vaginal cancer diagnosis and wish to discuss your treatment options, our Gynaecologic Oncology team is available for consultation and second opinions.
To book a consultation, call at +91-11-4702 2222 (Rohini) / +91-11-4582 2222 (Niti Bagh, South Delhi) Book online at care.rgcirc.org | Download the RGCI Care app on iOS and Android
OPD Hours: Monday to Saturday, 9:00 AM to 5:00 PM | Emergency Services: 24×7 at both campuses
Frequently Asked Questions (FAQs)
Can vaginal cancer be detected during a routine gynaecological examination?
Yes, in many cases. Vaginal cancer and its precursor, vaginal intraepithelial neoplasia (VAIN) , can be identified during a routine pelvic examination and Pap smear, even before symptoms develop. This is one of the most important reasons why regular gynaecological check-ups are valuable, particularly for women with known risk factors such as a history of HPV infection, previous cervical cancer, or prior pelvic radiation.
What is the difference between vaginal cancer and cervical cancer?
Cervical cancer originates in the cervix, the lower part of the uterus, while vaginal cancer originates in the vaginal wall. They share common risk factors, particularly HPV infection, but are staged and treated differently. For a cancer to be classified as primary vaginal cancer, the cervix must not be involved. When cervical cancer spreads to the vagina, it is still classified as cervical cancer at an advanced stage, not vaginal cancer.
Can abnormal vaginal discharge be a sign of vaginal cancer?
Yes. Unusual vaginal discharge, particularly discharge that is watery, blood-stained, persistent, or foul-smelling without signs of infection, can be a symptom of vaginal cancer. However, abnormal discharge has many more common benign causes, including infections and hormonal changes. The key is persistence: discharge that does not resolve with standard treatment or that occurs alongside other symptoms such as bleeding or pelvic pain should be evaluated by a specialist.
Does a history of cervical cancer increase the risk of vaginal cancer?
Yes, meaningfully so. Women who have had cervical cancer or cervical pre-cancer face an elevated risk of vaginal cancer, both because they share the same underlying HPV-related risk and because the entire lower genital tract may have been exposed to the same carcinogenic processes. Women who have had a hysterectomy for cervical cancer still require vaginal vault surveillance with Pap smear cytology, as cancer can develop at the vaginal cuff.
Can vaginal cancer be prevented through HPV vaccination?
HPV vaccination significantly reduces the risk of infection with the high-risk HPV strains most commonly associated with vaginal squamous cell carcinoma. The vaccine is most effective when given before the onset of sexual activity, but it also provides benefit to women who are already sexually active and have not yet been exposed to the vaccine strains. HPV vaccination is recommended for girls from the age of nine to fourteen years as the primary target group, with catch-up vaccination available up to 26 years and in selected older women.
Can vaginal cancer affect fertility and reproductive health?
Yes. Treatment for vaginal cancer, particularly radiation therapy, can affect fertility and reproductive function. Pelvic radiation damages the ovaries, often causing premature ovarian insufficiency in premenopausal women, and can affect the uterus in ways that compromise future pregnancy. For women who have not completed their family and are diagnosed with early-stage vaginal cancer, fertility-preserving approaches may be discussed where oncologically appropriate. This conversation should take place early in the treatment planning process at RGCIRC.
Is vaginal cancer hereditary?
Most vaginal cancers are not directly inherited. They develop primarily through HPV-driven mucosal changes and other environmental and lifestyle risk factors. However, women with Lynch syndrome, a hereditary DNA mismatch repair deficiency, carry an elevated risk of gynaecological cancers including vaginal cancer. Genetic counselling is available at RGCIRC for patients and families with a relevant family history.
How does vaginal cancer treatment affect sexual health and intimacy?
Vaginal cancer treatment, particularly radiation therapy, can cause vaginal dryness, narrowing (stenosis), and reduced elasticity, which may affect comfort during intercourse. These effects are manageable with vaginal dilators, lubricants, and topical hormone therapy where appropriate. Surgery may alter vaginal anatomy depending on the extent of resection. At RGCIRC, sexual health concerns are addressed openly as part of the post-treatment care pathway, and patients are supported in managing these changes with the help of the gynaecologic oncology and supportive care team.
Which hospital provides specialised vaginal cancer treatment near me?
RGCIRC (Rajiv Gandhi Cancer Institute and Research Centre) offers comprehensive treatment for vaginal cancer through its dedicated Gynaecologic Oncology department. Patients receive multidisciplinary care under one roof, including advanced diagnostics, surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and long-term follow-up. Consultations are available at both the Rohini and Niti Bagh campuses in Delhi.