Topical Therapy for Vaginal Pre-Cancer

Topical therapy puts the drug right onto the affected area. This may be done to treat vaginal pre-cancer (vaginal intraepithelial neoplasia or VAIN), but it's not used to treat invasive vaginal cancer.

Two drugs are used most often for topical therapy:

  • Fluorouracil (5-FU) is a chemotherapy drug that can be applied directly to the lining of the vagina. This is repeated weekly for about 10 weeks or given nightly for 1 to 2 weeks. However, this treatment can cause severe vaginal and vulvar irritation. Also, it may not work as well as using a laser or simply removing the area of abnormal cells with surgery.
  • Imiquimod is a cream that can be applied to the area of VAIN. Imiquimod is not a chemotherapy drug. Instead, it acts by boosting the body’s immune response to the area of abnormal tissue. It may be used once a week for 3 to 8 weeks. This treatment has led to improvement of VAIN (the lesions changed from VAIN 2 or 3 to VAIN 1). In about half of women with VAIN 1 or 2, it has caused VAIN to go away.

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Gurumurthy M, Cruickshank ME. Management of vaginal intraepithelial neoplasia. J Low Genit Tract Dis. 2012;16(3):306-312.

Kim MK, Lee IH, Lee KH. Clinical outcomes and risk of recurrence among patients with vaginal intraepithelial neoplasia: a comprehensive analysis of 576 cases. J Gynecol Oncol. 2018;29(1): e6.

Last Medical Review: March 19, 2018 Last Revised: March 19, 2018

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