The type of cancer you have depends on the specific type of cell that the cancer developed from. To find this out, your doctor takes a tissue sample (biopsy). They send this to the laboratory, where a pathologist looks at the cells under a microscope.
There are a number of different types of vaginal cancer.
Squamous cell carcinoma
Squamous cell is the most common type of vaginal cancer. About 9 out of 10 vaginal cancers (about 90%) are of this type.
Squamous cells are flat, skin-like cells that cover the surface of the vagina. The cancer may look like small lumps (nodules) or sores (ulcers).
This type is most likely to develop in the upper third of the vagina, closest to the cervix.
Vaginal intraepithelial neoplasia (VAIN)
Before squamous cell cancer develops, there may be pre cancerous changes to the cells. These cell changes are called vaginal intraepithelial neoplasia or VAIN.
Verrucous carcinoma is a rare type of squamous cell vaginal cancer. It looks like a large wart and is a slow growing tumour that rarely spreads to other parts of the body. It is usually curable with surgery, even if it is very large.
Around 1 in 10 vaginal cancers (around 10%) are adenocarcinomas. This type of cancer can be harder to diagnose than squamous cell cancer. The cancer is more likely to be hidden inside the vaginal canal.
It’s sometimes difficult for doctors to tell whether this type of cancer started in the vagina, or in a nearby organ and then spread into the vagina.
Adenocarcinomas of the vagina start in the gland cells in the lining of the vagina. These are called adenomatous cells. They can occur in young women.
There are 4 main types of adenocarcinoma of the vagina.
Clear cell adenocarcinoma
This is a rare type of vaginal cancer. It usually occurs in young women whose mothers took the diethylstilbestrol (DES) drug when they were pregnant.
Up until 1970, DES was sometimes given to women to stop them from having a miscarriage.
Clear cell cancers of the vagina usually develop in women in their teens or twenties. But there are reports of women diagnosed in their early forties. As it’s now more than 40 years since the use of DES in pregnancy, these cancers are becoming even rarer.
Papillary cancers can grow throughout the connective tissues that surround the vagina and hold it in place. They are less likely than other types of vaginal cancer to spread into nearby lymph nodes.
Mucinous adenocarcinomas get their name from the pools of mucus that are seen around the cancer cells. Doctors can see this when they look at the cells under a microscope.
Adenosquamous cancers of the vagina are made up of a combination of squamous cells and gland cells. They are also called mixed epithelial tumours. They are very rare. They are often quickly growing tumours.
Sarcomas are cancers that start in the body’s connective tissues. These tissues form the structure of the body, such as bone, muscle, fat and cartilage. Sarcomas of the vagina are rare and account for only about 3 out of every 100 vaginal cancers (about 3%). These cancers tend to grow quickly.
Different types of sarcoma can start in the vagina, including leiomyosarcoma and rhabdomyosarcoma. These are both muscle tumours. About two thirds of vaginal sarcomas are leiomyosarcomas. It's possible to have other types of sarcoma, such as mixed Mullerian sarcoma, but these are extremely rare.
Embryonal rhabdomyosarcoma is also called sarcoma botryoides. It is a very rare type of vaginal sarcoma. It only develops in girls up to the age of 6 years. It is usually recognised by vaginal bleeding and soft nodules that fill the vagina and sometimes show outside the vagina.
This is a very quickly growing cancer. Treatment is usually a combination of surgery, chemotherapy and radiotherapy.
Vaginal melanoma is rare. It develops from the cells in the skin that produce pigment, which gives the skin its colour. Only about 3 out of every 100 vaginal cancers (about 3%) are melanomas. They are most likely to develop in the lower third of the vagina.
They are more common in people in their 50’s. But doctors have recorded cases in people as young as 22 and as old as 83.
Small cell cancer of the vagina
Small cell cancer is also called oat cell carcinoma because the cancer cells are a distinctive oat shape. Small cell vaginal cancers are extremely rare. Doctors have reported fewer than 30 cases. Treatment includes radiotherapy with chemotherapy and surgery.
Lymphoma is cancer that starts in the lymph glands or other parts of the lymphatic system.
Vaginal lymphomas are very rare. Doctors have reported cases in people from the age of 26 to 66 years. Symptoms include a lump in the vagina, vaginal bleeding, and vaginal discharge. Treatment is usually chemotherapy.