Management depends on staging.
Factors to be considered in planning therapy for vaginal cancer include:
- stage and size of the lesion
- proximity to radiosensitive organs or organs that preclude radical resection without unacceptable functional deficits (e.g., bladder, rectum, urethra)
- ability to retain a functional vagina
- presence or absence of the uterus
- whether there has been previous pelvic radiation therapy
- proximity of the vagina to the bladder or rectum limits surgical treatment options and increases short- and long-term surgical complications and functional deficits involving these organs
Stage I or II vaginal cancer
- radiation or surgery or a combination of these treatments are standard treatment
Stages III and IVA vaginal cancer
- radiation therapy is standard and includes external-beam radiation, alone or with brachytherapy. Regional lymph nodes are included in the radiation portal
Stage IVB or recurrent disease that cannot be managed with local treatments
- current therapy is inadequate
- no established anticancer drugs can be considered of proven clinical benefit, although patients are often treated with regimens used to treat cervical cancer