Primary carcinoma of the vagina is an uncommon condition, accounting for 1%-2% of all gynecologic malignancies. 1 It usually affects elderly women and symptoms include vaginal bleeding, dysuria, and pelvic pain. The concurrence of vaginal cancer with irreducible uterine prolapse is even more rare (Figure 1). Treatment is always challenging, and options involve radiotherapy, surgery, or palliative treatment.External beam radiotherapy field-in the presence of associated advanced prolapse-may be associated with higher exposure of bladder and bowel to radiation, thus increasing the associated complications, such as vesicovaginal or enterovaginal fistulae. 2 Brachytherapy is