Cervical and vaginal cancers are diseases in which malignant (cancer) cells form in the tissues of the cervix or the vagina.

Childhood cervical and vaginal cancers are very rare types of cancer. Cervical cancer forms in the cells of the cervix, and vaginal cancer forms in the cells of the vagina. The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal). The vagina is the canal leading from the cervix to the outside of the body. At birth, a baby passes out of the body through the vagina.

The most common symptom of cervical cancer and vaginal cancer in children is bleeding from the vagina. Other conditions may also cause vaginal bleeding. If your child has vaginal bleeding, it is important that you tell their doctor. The doctor will ask you when it started and how often it occurs as a first step in making a diagnosis.

If your child has symptoms that suggest vaginal or cervical cancer, their doctor will need to find out if they are due to cancer or another problem. They may ask about your child’s personal and family medical history and do a physical exam.

Depending on your child’s symptoms and medical history and the results of their physical exam, the doctor may recommend more tests to find out if your child has vaginal or cervical cancer, and if so, its extent (stage). The results of tests and procedures done to diagnose vaginal and cervical cancers are used to help make decisions about treatment.

The following tests and procedures may be used to diagnose and stage childhood cervical or vaginal cancers:

Pap test

The Pap test (also called a Pap smear or cervical cytology) collects cervical cells from the surface of the cervix and vagina using a soft, narrow brush or tiny spatula. The cells are viewed under a microscope to find out if they are abnormal.

Biopsy

Transvaginal needle biopsy is the removal of tissue using a needle that is guided by ultrasound. A pathologist views the tissue under a microscope to check for signs of cancer.

Serum tumor marker test

Serum tumor markers are substances found in the blood that are either made by vaginal or cervical cancer cells or that the body makes in response to vaginal or cervical cancer. For this test, a sample of blood is checked in the lab to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body.

Ultrasound exam

An ultrasound exam uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs, such as the pelvis, and make echoes. The echoes form a picture of body tissues called a sonogram.

Magnetic resonance imaging (MRI)

MRI uses a magnet and radio waves to make a series of detailed pictures of areas inside the body, such as the pelvis. The pictures are made by a computer. This procedure is also called nuclear magnetic resonance imaging.

CT scan (CAT scan)

A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, such as the pelvis. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

Getting a second opinion

You may want to get a second opinion to confirm your child’s cervical or vaginal cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child’s cancer.

Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of the cervical or vaginal cancer to plan the best treatment.

There are several staging systems for cancer that describe the extent of the cancer. The International Federation of Gynecology and Obstetrics (FIGO) staging system is used for cervical and vaginal cancers. You may see your child’s cancer described by this staging system in the pathology report. Based on the FIGO results, a stage is assigned to the cancer, ranging from stage I, stage II, stage III, or stage IV (may also be written as stage 1, stage 2, stage 3, or stage 4). When talking with you, your child’s doctor may describe it as one of these stages.

Learn about Cervical Cancer Stages and Vaginal Cancer Stages.

Recurrent cervical cancer or vaginal cancer

Recurrent cancer is cancer that has come back after it has been treated. Cervical or vaginal cancer may come back in the cervix or vagina or as metastatic tumors in other parts of the body. Tests will be done to help determine where the cancer has returned in the body, if it has spread, and how far. The type of treatment that your child will have for recurrent cancer will depend on how far it has spread.

There are different types of treatment for children and adolescents with cervical cancer or vaginal cancer. You and your child’s cancer care team will work together to decide treatment. Many factors will be considered, such as your child’s overall health and whether the cancer is newly diagnosed or has come back.

A pediatric oncologist, a doctor who specializes in treating children with cancer, will oversee treatment for childhood cervical and vaginal cancers. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:

• pediatrician
• pediatric surgeon
• gynecologist
• pediatric nurse specialist
• rehabilitation specialist
• social worker
• psychologist
• fertility specialist

Your child’s treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child’s cancer care team before treatment begins about what to expect.

A cervical cancer diagnosis can raise concerns about whether treatment will affect your child’s fertility. Talk with your child’s cancer care team before treatment begins about what to expect.

Types of treatment your child might have include:

Surgery

Surgery is used to remove as much cancer as possible from the cervix or vagina. If cancer cells remain after surgery or cancer has spread to the lymph nodes, more treatment may be needed.

Radiation therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Cervical cancer and vaginal cancer are sometimes treated with external beam radiation therapy. This type of radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. Radiation therapy may be given alone or with other types of treatment, such as chemotherapy.

Chemotherapy

Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells. Chemotherapy either kills the cells or stops them from dividing. Chemotherapy for vaginal cancer or cervical cancer is injected into a vein. When given this way, the drugs enter the bloodstream to reach cancer cells throughout the body.

It is not known if chemotherapy is an effective treatment for childhood cervical cancer or vaginal cancer, although drugs commonly used to treat these cancers in adults, such as carboplatin and paclitaxel, may be used.

Clinical trials

For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.

You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child's age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Treatment of newly diagnosed childhood cervical cancer and vaginal cancer

Treatment of newly diagnosed cervical cancer and vaginal cancer in children may include:

• Surgery will be done to remove as much of the cancer as possible, followed by radiation therapy, if cancer cells remain after surgery or cancer has spread to the lymph nodes.
• Chemotherapy may also be used, but it is not yet known how well this treatment works.

Sometimes childhood cervical cancer and vaginal cancer can recur (come back) after treatment. If your child is diagnosed with a recurrent cervical cancer or vaginal cancer, your child's doctor will work with you to plan treatment.

Side effects and late effects of treatment

Cancer treatment can cause side effects. Which side effects your child might have depends on the type of treatment they receive, the dose, and how their body reacts. Talk with your child's treatment team about which side effects to look for and ways to manage them.

Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Physical problems, such as problems with fertility, may be a late effect of treatment.

Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments.

Follow-up care

Some of the tests that were done to diagnose the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Coping with your child's cancer

When a child has cancer, every member of the family needs support. Taking care of yourself during this difficult time is also important. Reach out to your child’s treatment team and to people in your family and community for support.