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Because vaginal cancer is relatively uncommon, much of the chemo decision-making for treatment of vaginal cancer is based on cervical cancer studies. To treat vaginal cancer, chemo can be given:
Chemotherapy (chemo) drugs may be given intravenously (into a vein), taken by mouth, or applied to the skin in an ointment. Drugs taken by mouth or injected into a vein are called systemic chemotherapy. They enter the bloodstream to reach throughout the body, making this treatment useful for vaginal cancer that has spread to other parts of the body.
Because vaginal cancer is rare, there haven’t been many studies to see which chemo drug is best. So, at this time, there's no standard or "best" chemo treatment plan. Treatment choices are made based on each person's needs. Most often, doctors use the same types of drugs that are used for cervical cancer. Drugs that have been used include:
Chemo drugs work by attacking cells that are rapidly dividing. This is helpful in killing cancer cells, but these drugs can also affect normal cells, leading to some side effects.
Side effects of chemo depend on the type of drugs, the amount taken, and the length of time you are treated. Common side effects include:
Chemo can also affect the blood-forming cells of the bone marrow, leading to low blood counts. This can cause:
Other side effects can occur depending on which drug is used. For example, cisplatin can cause nerve damage (called neuropathy). This can lead to numbness, tingling, or even pain in the hands and feet.
Most side effects are temporary and stop when the treatment is over, but chemo drugs can have some long-lasting or even permanent effects.
Long-term side effects of chemotherapy can include:
Menstrual changes: If you are younger and have not had your uterus removed as a part of treatment, changes in menstrual periods are a common side effect of chemo. But even if your periods stop while you are on chemo, you might still be able to get pregnant. Getting pregnant while receiving chemo is not safe, as it could lead to birth defects and interfere with treatment. This is why it’s important to discuss your options for birth control with your doctor if you are pre-menopausal before treatment and are sexually active. Patients who have finished treatment (like chemo) can often go on to have children, but it's important to talk to your doctor about when it is safe to do so.
Premature menopause (not having any more menstrual periods) and infertility (not being able to become pregnant) may occur and may be permanent. Some chemo drugs are more likely to cause this than others. The older you are when you get chemo, the more likely it is that you will become infertile or go through menopause as a result. If this happens, there is an increased risk of bone loss and osteoporosis. The are medicines that can treat or help prevent bone loss.
Neuropathy: Some drugs used to treat vaginal cancer, including paclitaxel and cisplatin, can damage nerves outside of the brain and spinal cord. The injury can sometimes lead to symptoms like numbness, pain, burning or tingling sensations, sensitivity to cold or heat, or weakness, mainly in the hands and feet. This is called peripheral neuropathy. In most cases, it gets better or even goes away once treatment stops, but it might last a long time in some people.
Nephrotoxicity: Cisplatin, the main chemo drug used to treat vaginal cancer, can damage the kidneys (called nephrotoxicity). Many times the damage is preventable and reversible, but sometimes the damage may be long-lasting. Often, there are no symptoms, but the damage can be seen on bloodwork done routinely while chemo is given. If the kidneys show damage, the cisplatin is usually stopped and carboplatin may be used instead.
Other side effects are also possible. Ask your cancer care team about the chemo drugs you will receive and what side effects you can expect.
For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Adams TS, Rogers LJ, Cuello MA. Cancer of the vagina: 2021 update. Int J Gynaecol Obstet. 2021 Oct;155 Suppl 1(Suppl 1):19-27. doi: 10.1002/ijgo.13867. PMID: 34669198; PMCID: PMC9298013.
National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines?), Vaginal Cancer, Version 1.2025 -- March 26, 2024. Accessed at https://www.nccn.org on May 28, 2024.
Jhingran A. Updates in the treatment of vaginal cancer. Int J Gynecol Cancer. 2022 Mar;32(3):344-351. doi: 10.1136/ijgc-2021-002517. PMID: 35256422; PMCID: PMC8921584.
Kulkarni A, Dogra N, Zigras T. Innovations in the Management of Vaginal Cancer. Curr Oncol. 2022 Apr 27;29(5):3082-3092. doi: 10.3390/curroncol29050250. PMID: 35621640; PMCID: PMC9139564.
Last Revised: September 23, 2024
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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