Stage 0: A vaginectomy, in which all or part of the vagina is removed, may be performed. Skin grafting to repair damage may follow. However, the surgery usually involves the inner part of the vagina and cosmetically does not show on the outside of the vagina. Other treatment options include laser surgery, internal radiation therapy and chemotherapy.
Stage I: Squamous cell cancer: Radiation therapy, wide local excision alone or followed by radiation; or vaginectomy with or without the removal of lymph nodes.
Adenocarcinoma: Vaginectomy and hysterectomy. The lymph nodes in the pelvis are also removed and radiation therapy may follow surgery. Other treatment options include internal radiation therapy and, in selected patients, wide local excision and the removal of some lymph nodes in the pelvis followed by internal radiation.
Stages II, III, IVA: Combined internal and external radiation therapy and surgery, which may be followed by radiation therapy.
Stage IVB: Chemotherapy or with radiation to relieve symptoms such as pain, nausea, vomiting or abnormal bowel function. A patient may also participate in a clinical trial.
Recurrent: May require the removal of the cervix, uterus, lower colon, rectum or `bladder, depending on where the cancer has spread. Radiation and/or chemotherapy may follow surgery, and a patient may participate in a clinical trial of chemotherapy or radiation therapy.
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