Vaginal cancer
Prepared with OnCo (onco.cc/prep/vaginal/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
16 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example HPV DNA / p16 IHC, FIGO stage, PD-L1 CPS, Prior cervical neoplasia or hysterectomy history, DES exposure history), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (vain 2 to 3), which of the standard options do you recommend and why?
- 6.For my situation (stage i, small upper-vaginal lesion), which of the standard options do you recommend and why?
- 7.For my situation (stage i to iva, most patients), which of the standard options do you recommend and why?
- 8.Am I a candidate for Cisplatin, and what side effects should I expect?
- 9.For my situation (recurrent or metastatic), which of the standard options do you recommend and why?
- 10.Am I a candidate for Cisplatin, Paclitaxel / nab-paclitaxel, Pembrolizumab, and what side effects should I expect?
- 11.How do the results of KEYNOTE-826 apply to someone like me?
- 12.Are there clinical trials I could join, for example of Pembrolizumab, KEYNOTE-A18 / ENGOT-cx11 / GOG-3047, HPV & HBV vaccination?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “No dedicated randomised trials; HPV-basket immunotherapy trials and international rare-tumour registries are filling the gap”. How does that affect my plan?
- 16.I read that “Optimal brachytherapy technique and dose for vaginal primaries; MRI-guided adaptive brachytherapy series are maturing”. How does that affect my plan?
The words I may hear
- Cervical precancer (CIN, HSIL/LSIL): Abnormal cervical cells caused by HPV that can turn into cancer over 10-20 years.
- HPV status (HPV-positive / HPV-negative): Whether a cancer is caused by human papillomavirus.
- HPV-positive (p16) head and neck cancer: Throat cancers caused by the human papillomavirus, identified by a p16 stain.
- Chemoradiation (chemoradiotherapy, CRT): Radiotherapy given at the same time as chemotherapy, which sensitises the cancer to radiation.
Tests and results to bring
Biomarker results to ask for: HPV DNA / p16 IHC, FIGO stage (clinical, MRI and PET-CT), PD-L1 CPS (checkpoint inhibitor eligibility, extrapolated from cervical cancer), Prior cervical neoplasia or hysterectomy history, DES exposure history (clear cell adenocarcinoma).
Scans and tests linked to this cancer: Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV DNA testing and self-sampling.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Stage I, small upper-vaginal lesion: Wide excision or brachytherapy alone in selected cases. (Brachytherapy)
- Stage I to IVA, most patients: External beam radiotherapy with concurrent weekly cisplatin followed by image-guided brachytherapy, extrapolated from cervical cancer. (Cisplatin, IMRT / IGRT (modern external beam), Brachytherapy, Chemoradiation (chemoradiotherapy, CRT))
- VAIN 2 to 3: Laser ablation, topical imiquimod or fluorouracil, or excision; surveillance after treatment of CIN 3 or hysterectomy for CIN. (HPV DNA testing and self-sampling, Colposcopy and excisional treatment (LEEP/LLETZ, cone), Thermal ablation and cryotherapy for cervical precancer)
- Recurrent or metastatic: Platinum-based chemotherapy; pembrolizumab for PD-L1-positive disease by extension from cervical cancer; salvage exenterative surgery for isolated central recurrence after radiotherapy. (Cisplatin, Paclitaxel / nab-paclitaxel, Pembrolizumab, KEYNOTE-826)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.