Vaginal Cancer: Stages 

What does the stage of a cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has spread to nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

The systems of staging vaginal cancer

Healthcare providers sometimes use different rating systems to stage cancer. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand. 

 There are two systems used most often to stage vaginal cancer:

• FIGO staging system

• TNM staging system

The two systems are much the same. They both use the TNM system. Here's what the letters stand for:

• T stands for tumor and tells about the tumor itself, such as if and how far it has spread.

• N stands for lymph nodes and tells if they have cancer in them. Lymph nodes are small organs around the body that help the body fight infections. 

• M stands for metastasis and tells if the cancer has spread to lymph nodes, organs, or bones in other parts of the body.

Numbers or letters after T, N, and M provide more details about each of these factors. There are also two other values that can be assigned:

• X means the provider does not have enough information to tell the extent of the main tumor (TX), or if the lymph nodes have cancer cells in them (NX).

• 0 means no sign of cancer, such as no sign of the primary (main) tumor (T0).

What are the stage groupings of vaginal cancer? 

Stage groupings are determined by combining the T, N, and M values from the TNM system. These groupings give an overall description of your cancer.

A stage grouping is listed as a Roman numeral and can have a value of I through IV (1 through 4). The higher the number, the more advanced your cancer is. Letters and numbers can be used after the Roman numeral to give more details.

These are the stage groupings of vaginal cancer and what they mean. Please note, vaginal melanoma, is staged with a different system and is not covered here.

• FIGO stage I. AJCC stage IA.  The cancer is only in the vagina and is no more than 2 centimeters (cm) across. It has not spread outside the vagina to nearby lymph nodes or to organs in other parts of the body.

• FIGO stage I. AJCC stage IB. The cancer is only in the vagina and is more than 2 cm across. It has not spread outside the vagina to nearby lymph nodes or to organs in other parts of the body.

• FIGO stage II. AJCC stage IIA.  The cancer has spread through the outside of the vaginal wall, but not into the pelvic wall and is no more than 2 cm across. It has not spread to nearby lymph nodes or to organs in other parts of the body.

• FIGO stage II. AJCC stage IIB. The cancer has spread through the outside of the vaginal wall, but not into the pelvic wall. It is more than 2 cm across and has not spread to nearby lymph nodes or to organs in other parts of the body.

• FIGO stage III. AJCC stage III. Either of these is true:

  • The cancer is any size and has spread outside the vagina. It may or may not be growing into the walls of the pelvis, and/or the lower third of the vagina, and/or it's blocking urine flow and making the kidneys not work the way they should. It also may have spread to nearby lymph nodes. The cancer has not spread to organs in other parts of the body.

  • The cancer is growing into the wall of the pelvis, and/or the lower third of the vagina, and/or it's blocking urine flow and making the kidneys not work the way they should. It has not spread to nearby lymph nodes or organs in other parts of the body.

• FIGO stage IVA. AJCC stage IVA. The cancer is growing into the bladder or the rectum, or it may be growing out of the pelvis. It may or may not have spread to lymph nodes in the pelvis or groin. The cancer has not spread to organs in other parts of the body.

• FIGO stage IVB. AJCC stage IVB. The cancer has spread to distant organs like the lungs or bones. It can be any size, and may or may not have spread to lymph nodes or other tissues or organs in the pelvis.

Talking with your healthcare provider

Once your cancer is staged, talk with your healthcare provider about what the stage means for you. Make sure to ask questions and talk about your concerns.