Understanding Your Stage of Vaginal Cancer

After a diagnosis of vaginal cancer, your doctor will need to know the stage of the vaginal cancer. The stage is based on the size and extent of the tumor, whether lymph nodes are involved, and how far the cancer has spread. Your doctor can tell the stage of the cancer from biopsies, exams, and tests. A cancer’s stage is one of the most important factors in deciding what treatment to use to fight the cancer.

How Vaginal Cancer Spreads

Vaginal cancer can spread in two ways. It may grow larger and invade other parts of the body, or it may spread through lymph nodes in the pelvis. A third type of spread, through the bloodstream, is uncommon. When vaginal cancer spreads to another part of the body, it’s not considered a new cancer. For example, if it spreads to the lungs, it’s not called lung cancer. It’s called metastatic vaginal cancer.

Stage Groupings for Vaginal Cancer

Doctors use one of two systems to stage vaginal cancer. One is the International Federation of Gynecology and Obstetrics (FIGO) system. The other is from the American Joint Committee on Cancer (AJCC); it is called the TNM system. Here’s what the numbers stand for.

  • T refers to the size of the tumor in the vagina.
  • N refers to whether the lymph nodes in the area of the vagina have become cancerous.
  • M refers to whether the cancer has spread (metastasized) to other, distant organs in the body, such as the lungs.
    • Stage 0 — Cancer cells are limited to the epithelium. They have not spread to other parts of the body. This stage is also called carcinoma in situ or vaginal intraepithelial neoplasia 3 (VAIN 3).
    • Stage I — The cancer has gone beneath the lining of the vagina. But it is limited to the vaginal mucosa. The mucosa has 2 layers: the lamina propria and the subepithelial stroma. If the tumor is less than 2 centimeters and has spread less than one millimeter into the wall of the vagina, it is labeled IA. If it is wider than 2 centimeters and has spread more than one millimeter, it is labeled IB.
    • Stage II — The cancer has spread to the tissues next to the vagina, called connective tissues, but not to the pelvis or other organs. The pelvis is the internal cavity that encloses the female reproductive organs, bladder, and the lower part of the digestive system.
    • Stage III — The cancer has spread to the wall of the pelvis or to nearby lymph nodes, or to both.
    • Stage IVA — The cancer has spread to organs near the vagina, such as the bladder or the rectum. In this stage, the cancer may have also spread beyond the pelvis and to lymph nodes near the pelvis.
    • Stage IVB — The cancer has spread to distant organs, such as the lungs.

    • The FIGO system defines cancers by Roman numbers 0 through IV. The lower the number, the less the cancer has spread. The higher the number, the more the cancer has spread. Be sure to ask your doctor to explain your cancer’s stage to you. Here is a summary of the stage groupings for vaginal cancer.