Surgery and such management are dependent on the stage of cancer. Stage one – the cancer is found only in the vaginal wall. Stage two – the tumor is spread to the tissue next to the vagina. Stage three – the cancer has spread to the lymph nodes or in the pelvis. Stage four A – in addition to spreading to the lymph nodes nearby, the cancer has spread to the bladder or rectum or other parts of the pelvis. Stage four B – the cancer has spread beyond the vagina to areas like the lungs. Early stages can be treated with local resection. Sometimes if the uterus and cervix are still in the patient and vaginal cancer is diagnosed near the cervix, then a hysterectomy with upper vaginectomy can be utilized to match the cancer, but most vaginal cancers need chemotherapy and radiation.