Women's Health Unit at Epworth

Our Women's Health Unit team are highly skilled in the treatment and care of women with gynaecological cancers. The Medical Specialists, Gynaecological Clinical Nurse Consultant, Allied Health and Ward staff work closely with patients and families providing expertise, education, and support at this challenging and stressful time.

Vaginal cancer and vulvar cancer are rare in Australia.

  • What is vulvar cancer?

    Vulvar cancer occurs in any external area of the female genitals, including the labia majora, labia minora, perineum, clitoris, mons pubis, Bartholin gland or anus. Vulvar cancer accounts for less than one per cent of all cancers in Australian women. 

  • What is vaginal cancer?

    Vaginal cancer arises in the tissues of the vagina. There are two main types of vaginal cancer: primary vaginal cancer and secondary vaginal cancer.

    Secondary vaginal cancer is more common than primary and means that the cancer has spread to the vagina from another location, such as the cervix, uterus, vulva, bladder, bowel or nearby organs. 

  • What are the risk factors for vaginal and vulvar cancer?

    Below are a few factors that could increase your risk of developing vulvar or vaginal cancers. If you want to learn more about how your personal medical history could impact your risk, we encourage you to speak with your doctor. 

    • Vulvar intraepithelial neoplasia (VIN)
      This is a precancerous condition which causes changes in vulval skin. The vulva may itch, burn or feel painful. VIN can resolve with no treatment, but most women need some treatment as there is a risk of VIN developing into cancer.
    • HPV
      The human papillomavirus (HPV) is a common sexually transmitted virus that infects the squamous cells that line certain organs. Most sexually active people have HPV at some point in their life, but persistent infection can cause cervical, vaginal, and vulvar cancer. Fortunately, the HPV vaccine can reduce the risk of infection.  
    • Abnormal cervical screening test 
      Any abnormal cell changes that are detected on a cervical screen increase the risk of development of vulvar cancer.
    • Other skin conditions
      Vulvar lichen planus and vulvar lichen sclerosus are skin conditions that can cause itching and pain.
    • Smoking and passive smoking
      Smoking can make the immune system less effective. 

    • Radiation therapy to the pelvis can slightly increase the risk of vaginal cancer.


Signs and symptoms

It is natural and common for changes to occur to your body as you age and remember all changes aren't due to cancer. However, we encourage you to recognise what is normal for your body and if changes are persistent consult your GP for peace of mind.

Symptoms of vaginal and vulvar cancer:

  • Itching, burning, tenderness or pain around the vulva
  • A lump, sore, swelling or growth on the vulva
  • Thickened or raised red, white or dark brown skin patches
  • A vulvar mole that changes colour or shape
  • Blood, pus or discharge from an area of skin or sore spot in the vulva, with an offensive or unusual smell or colour, unrelated to your period
  • Swollen lymph nodes in the groin
The vulva and vagina are difficult to see without a mirror and, if you are experiencing symptoms, but are uncomfortable examining your genitals, visit your GP for a check-up.


Epworth fact sheet | Vaginal and vulvar cancers

Overview of common tests, treatments and your care team at Epworth. Open to read online, or print for later.
Vaginal and vulvar cancers

Colposcopy Clinic at Epworth Freemasons

When you’ve had an abnormal Pap smear result, you shouldn’t have to wait to find out what comes next. Learn about our dedicated clinic.


Epworth uses a range of diagnostic tests to thoroughly investigate signs and symptoms of underlying health concerns.

Below is an overview of common tests used to diagnose vaginal and vulvar cancers:  

Physical examination

Your GP or specialist may perform a general physical examination to understand your current health. This may include an examination of your vagina, groin and pelvic area and may include an internal pelvic floor examination. 


Tissue samples are taken and looked at under a microscope to determine if cancer cells are present. Biopsies may be performed on the cervix via colposcopy, or taken from the vagina or vulvar lining via hysteroscopy, or lesions in the pelvis or abdomen via laparoscopy or at an open procedure (laparotomy).

A colposcope and hysteroscope are magnifying instruments used to look closely at the vagina, cervix, vulva and uterus.

Blood test

Your doctor may order several blood tests to check your overall health and to detect proteins produced by cancer cells. These proteins are called tumour markers. 


An ultrasound may be one of the first tests you encounter following a blood test and physical exam. Your doctor may recommend an abdominal and/or a transvaginal ultrasound. 

  • Abdominal ultrasound
    The sonographer moves a small device (transducer) over your abdominal area.
  • Transvaginal ultrasound
    A small transducer wand is inserted into the vagina to provide a clearer picture of both ovaries, uterus, bladder and bowel. 

Medical imaging

Depending on the types of cancer being investigated, your doctor may order an MRI (magnetic resonance imaging), CT (computerised tomography), or PET (positive emission tomography) scan to be performed. Upon formal diagnosis, medical imaging will allow your care team to examine and stage cancer. 


Staging - Investigating the extent of the cancer

Staging helps your care team and specialists to create a unique treatment plan. During your initial diagnostic tests, your care team may be able to stage your cancer at the same time during a biopsy or CT, MRI, or PET scans. 

What does my cancer stage mean?

Staging is a term used to describe the size of the cancer and whether it has spread. Staging helps your care team and specialists to create a unique treatment plan.

Vulvar cancer staging

Stage 1

Early cancer where the tumour is relatively small and found only in the vulva or perineum.

Stage 2

Cancer is found in the vulva and has spread to the lower urethra, vagina or anus.

Stage 3

Cancer has spread from the vulva or perineum to the nearby lymph nodes.

Stage 4

Sometimes called advanced cancer, stage 4 means cancer has spread to the upper urethra, upper vagina or to more distant parts of the body.

Grading of vulvar cancer

Grading provides a guide to how quickly the cancer may grow and spread. Low grade cancer cells (grade 1) are slow growing, while high grade (grade 3) look more abnormal and grow and spread rapidly.

Vaginal cancer staging

Stage 1

Early cancer where the tumour is relatively small and found only in the vagina.

Stage 2

Cancer has begun to spread through the wall of the vagina, but not into the pelvic wall.

Stage 3

Cancer has spread to the pelvis and may also be present in lymph nodes close to the vagina.

Stage 4

Sometimes called advanced cancer, stage 4 means cancer has spread to the pelvis, lining of the bladder or bowel or to a distant part of the body.

Grading of vaginal cancer

Grading provides a guide to how quickly the cancer may grow and spread. Low grade cancer cells (grade 1) are slow growing, while high grade (grade 3) look more abnormal and grow and spread rapidly.


Prognosis refers to the expected outcome of the disease related to the stage and grade. Your doctor can provide an idea about the general prognosis for people with the same type and stage of vulvar or vaginal cancer. In most cases, the earlier vulvar and vaginal cancers are detected and diagnosed, the better the success of treatment.

Specialist search

Find your Epworth gynaecological cancer specialist

View our gynaecologists and medical oncologists with a sub-specialty in gynaecological cancers (cervical, ovarian, uterine and vaginal and vulvar cancer).


Why choose Epworth for cancer care?

Epworth HealthCare is Victoria's largest not-for-profit private hospital group. As a not-for-profit, we use our revenue to reinvest in our people, training and facilities. This allows our hospitals to be renowned for excellence in cancer diagnosis, treatment, rehabilitation and care for our patients and their families.

Treatment overview

Depending on the stage and type of cancer, your treatment plan may recommend surgery, chemotherapy prior to or after surgery, or a combination of chemotherapy and radiotherapy. Some cancers are cured with surgery alone and others require a combination of treatments. 

  • Radiotherapy
    People with vaginal cancer are often recommended radiotherapy as their first line of treatment. Radiotherapy is the use of radiation (X-rays) to kill or injure cancer cells. 
    Learn more

  • Chemotherapy
    Chemotherapy is a common form of treatment that involves the use of anti-cancer drugs to kill or slow the growth of cancer cells. Chemotherapy is often used alongside other treatments such as radiotherapy and surgery. 
    Learn more

  • Surgery
    Surgery is often first line treatment for vaginal and vulvar cancer that has not spread beyond the uterus. Our oncologists perform more than 1,000 major gynaecological cancer operations each year and are leading experts in this field.
    Learn more

Multidisciplinary Team (MDT) Assessment and Plan of Treatment

You will have access to an MDT to plan the management of your cancer. All members of the MDT have a special interest in gynaecological cancer, and include:

  • Gynaecological oncologists
  • Medical oncologists
  • Radiation oncologists
  • Gynaecology clinical nurse specialists/oncology liaison nurse
  • Gynaecology histopathologists/cytologists
  • Physiotherapists
  • Radiologists
  • Research staff
  • Genetics counsellors
  • Social workers
  • Psychiatrist/psychologist
  • Pastoral Care
  • Rehabilitation team


Types of vulvar cancer surgery:

Surgery is a common treatment for vulvar cancer, especially in the early stages of the disease. Some common types of surgery for vulvar cancer include:

  • Excisional biopsy
    This procedure involves the removal of the entire tumour along with a small amount of surrounding healthy tissue.
  • Wide local excision
    This procedure involves the removal of the tumour and a wider area of surrounding tissue to ensure that all of the cancer cells are removed.
  • Radical vulvectomy
    This is a more extensive surgery that involves the removal of the entire vulva, including the clitoris, labia majora, and labia minora.
  • Radical hysterectomy
    This is a surgical procedure in which the uterus, cervix, and part of the vagina are removed along with the vulva to treat advanced vulvar cancer.

Types of vaginal cancer surgery:

  • Local excision
    Local excision is the removal of a small amount of tissue from the surface of the vagina where the cancer is located.
  • Partial vaginectomy
    This procedure involves the removal of part of the vagina where the cancer is located, while preserving as much of the healthy tissue as possible.
  • Radical vaginectomy
    This is a more extensive surgery that involves the removal of the entire vagina, including the cancerous tissue, and often also involves the removal of nearby lymph nodes.
  • Pelvic exenteration
    This is a major surgical procedure that involves the removal of all organs in the pelvic region, including the vagina, cervix, uterus, ovaries, and bladder, in order to treat advanced vaginal cancer.



Epworth oncologists use radiation to cure, control and reduce gynaecological cancer cells for our patients. 

Radiotherapy at Epworth

Epworth offers patients radiotherapy through our provider, Icon. As Australia’s largest dedicated cancer care provider, Icon has a long history of delivering exceptional cancer care to the Australian community.

Supported by the latest world-class technology and evidence-based techniques, Icon’s highly experienced team of radiation oncologists, radiation therapists, physicists and nurses are committed to providing compassionate, exceptional care for patients and their loved ones.

What are the side effects of radiotherapy?

Side effect types and duration will vary from person to person. Some general side effects may include:

  • Fatigue
  • Skin irritation
  • Feeling weak
  • A stinging sensation when urinating
  • Diarrhoea



Your medical oncologist will oversee your chemotherapy. These specialists work closely with surgeons, radiation oncologists, physicians, nurses, and allied health professionals to ensure that all elements of your care are coordinated.

Your medical oncologist will explain and discuss current treatment recommendations and the opportunity to participate in appropriate clinical trials.

How will I receive my treatment?

The treatment can be given orally, through an intravenous cannula, direct introduction to the affected organ/tissue or as a cream. Chemotherapy is often given in courses or cycles with periods of rest in between, allowing normal cells to recover.

Are there different types of chemotherapy?

Yes, there are many different types of chemotherapy. Your care team will explain which chemotherapy is best for your circumstance.

What are the side effects of chemotherapy?

Our team is here to support you throughout your cancer journey and will help you prevent and manage these potential and often temporary side effects.

Side effects may include:

  • Nausea and vomiting
  • Diarrhoea or constipation
  • Fatigue
  • Hair loss
  • Muscle weakness
  • Skin sensitivity to sunlight
  • Loss of appetite

Epworth Wig salons

Head wear and wigs are offered to all Epworth patients experiencing hair loss at our convenient on-site salons. This service is provided via the generosity of our Epworth Medical Foundation donors so there is no cost to patients.

How do I prepare for chemotherapy?

  • The Gynae Clinical Nurse Consultant and Oncology Liaison Nurse Consultant will provide education and a support pack for your information and explain the chemotherapy process.
  • You may be able to use “cold caps” to prevent hair loss or may like to be fitted for a wig prior to starting chemotherapy in case you need it.
  • Recovering from surgery, eating well, staying well hydrated, sleeping and exercising will all play a part in preparing for chemotherapy.
  • You may choose to have your chemotherapy at one of Epworth’s Day Oncology Units or a unit closer to your home.
  • If you have children or grandchildren from babies to age 18, you may like to read the Cancer Council book: Talking to Kids About Cancer. The ward team can provide a copy.
Treatment locations

Epworth cancer care locations

Epworth offers comprehensive cancer services at all four major hospitals: Epworth Eastern, Epworth Freemasons, Epworth Geelong and Epworth Richmond. This includes specialist wards, day oncology facilities, radiation oncology and palliative care.
Gynaecological cancer

Rehabilitation with Epworth

If you've recently been diagnosed with cancer or are already in your cancer treatment journey, we highly recommend you participate in our holistic rehabilitation programs. Epworth offers patients offers rehabilitation before, during and after treatment. We believe this approach allows our patients to feel best prepared for treatment or feel more like themselves following surgery or other medical interventions.

Vaginal and vulvar cancer rehabilitation 

Rehabilitation doesn't just start after your treatment has ended. You may benefit from our holistic rehabilitation programs at any time throughout your cancer journey. Our programs support you to physically and emotionally prepare for treatment or restore your strength and wellbeing.


Epworth offers patients programs to support their wellbeing before, during and after treatment. We believe this approach allows our patients to feel best prepared for treatment or feel more like themselves following surgery or other medical interventions. 

Who is the program for? 

Our cancer rehabilitation program is designed for anyone diagnosed with gynaecological cancer at any time from diagnosis to treatment and recovery. 

What does the cancer rehabilitation program involve?

Before you start

You will meet a rehabilitation doctor and allied health team for a medical, psychosocial, and physical assessment.

Everyone's cancer care journey is different. The assessments will help the team understand your specific needs to develop the right program for you. You will work with the team to develop goals to work towards throughout the program.

During the program

Depending on your assessment and individual needs, you may complete your program:

  • as part of a group, with other people, who have been diagnosed with varying cancers
  • on your own, one to one with the rehab team members.

A typical program may involve:

Most people will attend as an outpatient, coming to hospital for a few hours once or twice a week, over several weeks. Some people may need to stay overnight in hospital and complete a program over several consecutive days.

Either way, you will receive the same support from our team to address your physical, functional and emotional needs.

Your rehabilitation program may focus on the following:

  • A physical exercise component to help restore movement, strength and fitness.
  • An educational component where you will learn about different areas associated with your cancer diagnosis and treatment and how to manage them, including:
    • fatigue
    • pain
    • emotional wellbeing
    • body image and self-esteem
    • work or family challenges
    • relationships
    • late-onset of side effects.

At the end of your program

Our rehabilitation team will keep in touch with your referring doctor and/or treating team throughout the program and will let them know how you went at the end.

They will also connect you to local services and support networks so you can leave the program with strength and confidence to live life to your fullest potential.

Who will support me during the rehabilitation program?

Depending on your needs, you may see some or all of our multidisciplinary team which includes:

  • Rehabilitation specialist doctor
  • Cancer nurse 
  • Exercise physiologist
  • Physiotherapist
  • Psychologist
  • Social worker
  • Occupational therapist
  • Dietitian.

How can I access a rehabilitation program?


A referral from your specialist or GP is required to participate.

Ask your doctor to complete the referral form at www.epworth.org.au/rehab and return it to us via fax: 03 9982 6696 or email: [email protected]


Group programs are located at Epworth Camberwell and Epworth Hawthorn.

Individual programs can be accessed at Epworth Brighton, Epworth Camberwell, Epworth Geelong, Epworth Hawthorn or Epworth Richmond Rehabilitation.

Contact us

If you have any questions about our cancer rehabilitation programs, call us on: 1300 345 600.

Life after treatment

Following treatment, you may feel excited, anxious or depressed. Life after cancer treatment can pose its own challenges but our Epworth specialists are here to support you. 

Life after cancer treatment can be a mixture of emotions. You may not 'bounce back' as quickly as you expected to, but be kind to yourself.

Remember that:

  • You may still feel fatigued after finishing treatment.
  • You may like to make an advanced care plan with the assistance of our social worker. We encourage you to speak with your care team to learn more.
  • Ask for help. If your body has changed due to treatment, remember help is out there to support you to feel your best and regain your sense of identity and self-esteem.
  • Speak with your care team about options to support your general wellbeing after treatment. The Cancer Council provide a free telephone intimacy counselling service (13 11 20). Your care team can also make referrals to sexual counsellors, menopause, fertility and lymphoedema experts.

Follow-up appointments

Epworth patients in remission for gynaecological cancer will have follow up appointments every three months, alternating between surgical and oncology specialists. This will also involve tumour marker blood tests and imaging, such as PET or CT scans.

Managing your health and wellbeing ongoing

Knowing how to best manage your wellbeing ongoing is an essential step toward recovery. We encourage people who have been living with gynaecological cancer to stay active, eat healthy foods, sleep well and enjoy your post treatment life.

You may like to explore different ways to relax, such as meditation, yoga or massage.

The Memorial Sloan Kettering Cancer Centre (New York) website has many useful online videos about adjusting to life after cancer, with useful dietary and lifestyle advice.

To learn more, please read the Cancer Council resource Living Well After Cancer - menopause, fertility, sadness, emotions, complementary therapies (PDF).

More information

Download the Understanding Vulvar and Vaginal Cancer Guide (PDF) published by Cancer Council. 

Specialist search

Find your Epworth gynaecological cancer specialist

View our gynaecologists and medical oncologists with a sub-specialty in gynaecological cancers (cervical, ovarian, uterine and vaginal and vulvar cancer).