Usually you begin by seeing your doctor, who will do a vaginal examination.
If there is a chance you have vaginal cancer, you should be referred to a gynaecologic oncologist, who diagnoses and treats women with cancer of the reproductive organs.
Your doctor may also arrange for you to have a blood test and chest X-ray to check your general health.
The following tests are commonly used to help diagnose vaginal cancer.
Internal vaginal examination
At the hospital, the gynaecologic oncologist will do a full pelvic examination.
This will include examining the inside of your vagina to check for any lumps or swellings.
The doctor will also feel your groin and pelvic area to check for any swollen glands, and may also check your rectum.
You will have a Pap smear to check for cell changes in the vagina or cervix.
Your doctor or nurse will use an instrument called a speculum to open the vagina and see your cervix. Your doctor or nurse will then collect some cells from the cervix using a small brush or spatula. This may feel slightly uncomfortable, but in most cases it only takes a few minutes.
The cells are then sent to a laboratory where they are examined under a microscope for abnormalities. The results are usually available within 2 weeks.
If the cells taken in the smear test are abnormal, your doctor may ask you to have a colposcopy.
This is a closer examination of the vagina using a colposcope, which is a small low-powered microscope that allows the doctor or specialist nurse to see the vagina in more detail.
A colposcope looks like a pair of binoculars sitting on a large stand. It does not enter the body – the doctor inserts an instrument called a speculum into your vagina and then views a magnified picture of the vagina, cervix and vulva through the colposcope.
Some colposcopes are fitted with a camera that is connected to a TV screen. This may allow you to watch what the doctor is doing. You should feel free to ask the doctor or nurse to explain what is happening.
A small sample of tissue will be taken from any abnormal areas and examined under a microscope.
Early cell changes (VAIN)
If the above tests show that you have a vaginal cancer, further tests may be necessary to find out whether any cancer cells have spread (metastasised) to other parts of the body.
This is called staging. The results will help you and your doctor decide on the best treatment for you.
You may have one or more of the following tests.
Cystoscopy is a test that allows the doctor to look at the interior lining of the bladder and the urethra, to see if the cancer has spread to this region. The cystoscope is a slender tube with a lens and a light that is inserted into the urethra and moved into the bladder.
Chest X-ray and blood tests
These are necessary to assess your general health and to check whether there is a possibility of the cancer having spread to the lungs.
A CT (computerised tomography) scan is a series of X-rays that build up a 3-dimensional picture of the inside of the body. The scan is painless and takes between 10 and 30 minutes.
Before the scan, you will be asked to drink a special liquid that shows up on X-ray. You may also need to have an injection of a contrast medium into a vein in your arm.
You will lie flat on a table while the CT scanner, which is large and round like a doughnut, rotates around you and takes a series of pictures.
People who are allergic to iodine may also be allergic to the dye used in a CT or magnetic resonance imaging (MRI) scan. If you think you may have such an allergy, tell your doctor before the scan.
MRI is similar to a CT scan, but uses a magnetic field to build up cross-sectional pictures of inside the body.
Some people are given an injection of dye into a vein in the arm to improve the image.
During the test, you will be asked to lie very still on a couch inside a long chamber for up to an hour.
An MRI scan is painless, but some people find that lying in the cylinder can be noisy and claustrophobic. If you feel uncomfortable, you can communicate with the technologist who is carrying out the scan through a microphone and speaker inside the scanner. You will also be able to see the technologist through a window.
Ureteroscopy is a procedure to look inside the ureters to check for abnormal areas. A ureteroscope is inserted through the bladder and into the ureters. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Ureteroscopy and cystoscopy may be done during the same procedure.
Proctoscopy is a procedure to look inside the rectum to check for abnormal areas. A proctoscope is inserted through the rectum. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.
Lymphangiogram is a procedure used to X-ray the lymph system. A dye is injected into the lymph vessels in the feet. The dye travels upwards through the lymph nodes and lymph vessels, and X-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes.