Most patients present with abnormal vaginal bleeding. Usually diagnose with punch biopsy; sometimes wide local excision is necessary. [merckmanuals.com]

• Dyspareunia

  Some also present with a watery vaginal discharge or dyspareunia. A few patients are asymptomatic, and the lesion is discovered during routine pelvic examination or evaluation of an abnormal Papanicolaou (Pap) test. [merckmanuals.com]

and nearby lymph nodes and sometimes radiation therapy For most other vaginal cancers, radiation therapy Treatment of vaginal cancer also depends on the stage. [merckmanuals.com]

[…] paravaginal tissues 50–80% III Extending to the pelvic wall and/or the lower third of the vagina and/or causing hydronephrosis or nonfunctioning kidney 30–60% IV Extending beyond the true pelvis and/or involving the bladder or rectal mucosa 15−50% * Prognosis [msdmanuals.com]

One rare type, clear cell adenocarcinoma, occurs almost exclusively in women whose mothers took the drug diethylstilbestrol (DES), prescribed to prevent miscarriage during pregnancy. (In 1971, the drug was banned in the United States.) [merckmanuals.com]