Topical Therapy for Vaginal Pre-Cancer

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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 put directly on 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 (Aldara) 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. 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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Developed by the ºÚÁÏÍø±¬³Ô¹Ï medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

Fiascone S, Vitonis AF, Feldman S. Topical 5-Fluorouracil for Women With High-Grade Vaginal Intraepithelial Neoplasia. Obstet Gynecol. 2017 Dec;130(6):1237-1243. doi: 10.1097/AOG.0000000000002311. PMID: 29112645.

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

Rahangdale L, Lippmann QK, Garcia K, Budwit D, Smith JS, van Le L. Topical 5-fluorouracil for treatment of cervical intraepithelial neoplasia 2: a randomized controlled trial. Am J Obstet Gynecol. 2014 Apr;210(4):314.e1-314.e8. doi: 10.1016/j.ajog.2013.12.042. Epub 2013 Dec 31. PMID: 24384495.

Sasagasako N, Kosaka K, Sagae Y, Itoh K, Aratake J, Yamada K,  et al. Recurrent vaginal intraepithelial neoplasia successfully treated with topical imiquimod: A case report. Mol Clin Oncol. 2020 Sep;13(3):19. doi: 10.3892/mco.2020.2089. Epub 2020 Jul 13. PMID: 32754333; PMCID: PMC7391826.

Last Revised: September 23, 2024

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