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Tests and diagnosis

By Mayo Clinic staff

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Illustration of how a pelvic examination is done 
Pelvic examination

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Screening healthy women for vaginal cancer
Vaginal cancer is sometimes found during a routine pelvic exam before signs and symptoms become evident.

During a pelvic exam, your doctor carefully inspects the outer genitals, 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 opens your vaginal canal so that your doctor can check your vagina and cervix for abnormalities.

Your doctor may also do a Pap test. Pap tests are usually used to screen for cervical cancer, but sometimes vaginal cancer cells can be detected on a Pap test.

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 these health screenings.

Tests to diagnose vaginal cancer
Your doctor may conduct a pelvic exam and Pap test to check for abnormalities that may indicate vaginal cancer. Based on those findings, your doctor may conduct other procedures to determine whether you have vaginal cancer, such as:

  • Inspecting the vagina with a magnifying instrument. Colposcopy is an examination of your vagina with a special lighted magnifying instrument called a colposcope. Colposcopy allows your doctor to magnify the surface of your vagina to see any areas of abnormal cells.
  • Removing a sample of vaginal tissue for testing. 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, steps will be taken 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:

  • Imaging tests. Your doctor may order imaging tests to determine whether cancer has spread. Imaging tests may include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) or positron emission tomography (PET).
  • 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).

Once your doctor determines the extent of your cancer, it is assigned a stage. The stages of vaginal cancer are:

  • 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 further into the pelvis.
  • Stage IVA. Cancer has spread to nearby areas, such as your bladder or rectum.
  • Stage IVB. Cancer has spread to areas away from your vagina, such as your liver.
References
  1. Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1709/0.html. Accessed Jan. 28, 2013.
  2. Vaginal cancer treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/vaginal/patient. Accessed Jan. 28, 2013.
  3. Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed Jan. 28, 2013.
  4. Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed Jan. 28, 2013.
  5. Total pelvic exenteration. American Cancer Society. http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinwomen/sexualityforthewoman/sexuality-for-women-with-cancer-tot-pelvic-exenterat. Accessed Jan. 28, 2013.
  6. Taking time: Support for people with cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/takingtime. Accessed Jan. 29, 2013.
DS00812 April 27, 2013

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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