Cancer starts when cells in the body change (mutate) and grow out of control. To help you understand what happens with cancer, let's look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them and die when they're damaged or your body doesn't need them any longer.

Cancer is made up of abnormal cells that grow even though your body doesn't need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).

Vaginal cancer starts in the cells of your vagina. The vagina is also known as the birth canal. It's the hollow, tube-like passageway between the bottom part of your uterus (cervix) and the outside of your body. It's the passageway through which fluid passes out of the body during menstrual periods.

Most vaginal cancers start in the lining of your vagina, which is called the epithelium. These are called vaginal squamous cell carcinomas. This type of vaginal cancer develops over many years. It starts as precancerous changes, called vaginal intraepithelial neoplasia (VAIN).

These are other, very rare types of vaginal cancer:

• Adenocarcinomas. These develop in the gland tissue in your vagina.

• Malignant melanomas. These are a form of skin cancer. On rare occasion, malignant melanomas can affect the lower or outer part of your vagina.

• Sarcomas. These develop deep in the muscular wall of your vagina.

If you have questions about vaginal cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel, how your body will work after treatment, and how treatment might affect your sex life.

Your healthcare provider is the best person to answer your questions. They can tell you what your treatment options are, how well each one is expected to work, and what the risks and side effects are. Your provider may advise a certain treatment. Or you may be offered more than 1 and asked which you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision for you.

Treatment may help control or cure vaginal cancer. It can also improve your quality of life by helping to control symptoms the cancer is causing. The goal of vaginal cancer treatment is to do 1 or more of these:

• Remove the main tumor in the vagina

• Kill vaginal cancer cells

• Stop the growth or spread of vaginal cancer cells

• Prevent or delay the cancer from coming back

• Ease symptoms caused by the cancer, such as pain or pressure on organs

There are 2 main kinds of treatment for vaginal cancer:

• Local treatments. These remove, destroy, or control cancer cells in 1 part of your body. Surgery and radiation are local treatments.

• Systemic treatments. These destroy or control cancer cells throughout your whole body. Chemotherapy is a systemic treatment.

You may have just 1 treatment or a combination of these treatments:

• Surgery. Surgery is used to remove the cancer in your vagina. The type of surgery used depends on the stage of the cancer. During surgery, a biopsy may be done on nearby lymph nodes in the groin and the pelvis. Vaginal cancer often spreads (metastasizes) to these nodes. The biopsy results will help your healthcare provider know if the cancer has spread. If it has spread, other organs or tissue may need to be removed during surgery. Or you may need more treatment after surgery.

• Radiation therapy. This treatment kills cancer cells with high-energy radiation. The radiation may come from a large machine that sends it into your body. Or radioactive implants may be put inside your vagina for a certain amount of time. Radiation might be the only treatment needed for smaller cancers. Many times, both types of radiation are used. Low-dose chemotherapy is sometimes given along with radiation therapy to help treatment work better.

• Chemotherapy. This is the use of strong medicines to kill cancer cells throughout your body. Chemo can be used to shrink the cancer. It can reduce the chance that the cancer will spread to other parts of your body. Chemotherapy can be given alone. Or you might get it along with radiation to help treatment work better.

Sometimes the only way to get newer types of treatment is through a research study. This is called a clinical trial. Talk with your healthcare provider about what clinical trials may be an option for you.

Deciding on the best treatment plan may take some time. Talk with your provider about how much time you can take to check your options. You may want to get a second opinion before deciding on your treatment plan. This can help you feel sure about the treatment plan that's best for you. You also may want to include your family and friends in this process.

There are often no symptoms in the early stages of vaginal cancer, when the cancer is small and before it has spread. Most cases diagnosed in the early stages are found during routine pelvic exams or on a Pap test. Vaginal cancer in later stages may cause symptoms such as:

• Bleeding that's not related to menstrual periods

• Abnormal vaginal discharge

• A lump or growth you can feel

• Vaginal bleeding after sex

• Pain during sex

• Pain when urinating

• Constipation

• Constant pain in the pelvis

• Back pain

• Swelling in the legs

Most of the time, these symptoms are caused by other health problems. But it's important to see your healthcare provider if you have any of these symptoms. Only a healthcare provider can tell if you have cancer.