Childhood Cervical and Vaginal Cancer Treatment: Treatment - Patient Information [NCI]

Childhood Cervical and Vaginal Cancers

Childhood cervical cancer and vaginal cancer 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. To learn more about how cancer forms, see What Is Cancer?.

Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

Childhood cervical cancer and vaginal cancer symptoms

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.

Tests to diagnose childhood cervical cancer and vaginal cancer

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 condition. 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 cancer are used to help make decisions about treatment.

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

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

An ultrasound uses high-energy sound waves (ultrasound), which bounce off internal tissues or organs in 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 is a procedure that makes a series of detailed pictures of areas inside the body, such as the pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.

Computed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.

Getting a second opinion

Some people may want to get a second opinion to confirm their child's cervical or vaginal cancer diagnosis and treatment plan. If you choose to seek a second opinion, you will need to get important 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 before giving a recommendation. The doctor who gives the second opinion may agree with the first doctor, suggest changes or another approach, or provide more information about your child's cancer.

To learn more about choosing a doctor and getting a second opinion, see Finding Cancer Care. You can contact NCI's Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your appointments, see Questions to Ask Your Doctor about Cancer.

Cervical cancer and vaginal cancer stages

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 tests and procedures used to diagnose and stage cervical and vaginal cancer in children.

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.

Learn more about Recurrent Cancer: When Cancer Comes Back.

Types of treatment for childhood cervical and vaginal cancer

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. The pediatric oncologist works with other pediatric health professionals who are experts in treating children with cancer and who specialize in certain areas of medicine. This may include the following specialists and others:

• 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. For help every step of the way, see our downloadable booklet, Children with Cancer: A Guide for Parents.

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. For more information and support, see Fertility Issues in Girls and Women with Cancer.

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.

Learn more about Surgery to Treat Cancer.

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.

To learn more, see External Beam Radiation Therapy for Cancer and Radiation Therapy Side Effects.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping 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.

To learn more about how chemotherapy works, how it is given, common side effects, and more, see Chemotherapy to Treat Cancer and Chemotherapy and You: Support for People With Cancer.

Clinical trials

A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. For some patients, taking part in a clinical trial may be an option.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

To learn more about clinical trials, see Clinical Trials Information for Patients and Caregivers.

Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.

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 of treatment

For information about side effects that begin during treatment for cancer, see our Side Effects of Cancer Treatment page.

Side effects from cancer treatment that begin 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. For more information, see Late Effects of Treatment for Childhood Cancer.

Follow-up testing

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 and support

When a child has cancer, every member of the family needs support. Honest and calm conversations build trust as you talk with your child and their siblings. 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. To learn more, see Support for Families When a Child Has Cancer and the booklet Children with Cancer: A Guide for Parents.

Last Revised: 2024-03-01

If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.