Vaginal Cancer: Stages 

The stage of a cancer is how much cancer there is and how far it has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and exactly where it is. The tests are also used to see if the cancer has spread into nearby areas, or if it has spread to other parts of your body. The stage of a cancer is 1 of the most important things to know when deciding how to treat the cancer.

Healthcare providers sometimes use different rating systems to stage cancer. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

There are 2 systems used most often to stage vaginal cancer:

• FIGO staging system

• TNM staging system

The 2 systems are much the same. They both use the TNM system. Here's what the letters stand for:

• T stands for tumor. It tells about the tumor size and if and how far it has spread.

• N stands for lymph nodes. It tells if there's cancer in them. Lymph nodes are small organs around the body that help fight infections.

• M stands for metastasis. It tells if the cancer has spread to tissues or organs in other parts of the body.

Numbers or letters after T, N, and M provide more details about each of these factors. There are also 2 other values that can be assigned:

• X means the healthcare provider does not have enough information to tell the extent of the main tumor (TX), or if the lymph nodes have cancer cells in them (NX).

• 0 means no sign of cancer, such as no sign of the primary (main) tumor (T0).

Stage groupings are done by combining the T, N, and M values from the TNM system. These groupings give an overall description of the cancer.

A stage grouping is listed as a Roman numeral and can have a value of I through IV (1 through 4). The higher the number, the bigger the cancer is or the more it has spread from where it first started. Letters and numbers can be used after the Roman numeral to give more details.

These are the stage groupings of vaginal cancer and what they mean. Please note, vaginal melanoma is staged with a different system and is not covered here.

• Stage I. The cancer has grown through the lining into the muscle wall of the vagina but is only in the innermost layers of vaginal tissue (vaginal mucosa). The cancer has not spread outside the vagina.

• Stage II.  The cancer has spread through the outside wall of the vagina and into nearby tissues. It has not spread to lymph nodes, the pelvic wall, or any other organs.

• Stage III. The cancer has spread outside the vagina and is growing into the walls of the pelvis and/or is in nearby lymph nodes, and/or has blocked urine flow and is causing kidney problems. The cancer has not spread to distant organs.

• Stage IVA.  The cancer has spread to organs near the vagina, like the uterus, ovaries, bladder, or rectum. It may also have spread to lymph nodes in the groin or pelvis. The cancer has not spread to distant organs.

• Stage IVB. The cancer has spread to distant organs in other parts of the body. These may include the lungs, liver, or bones. 

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.