World Gynecologic Oncology Day/September 20th

Vulvar Cancer

Overview

Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia.

Cancer of the vulva is a rare type of cancer that affects women

The vulva, which is the outer part of the female genitals, includes the opening of the vagina, the outer lips, inner lips, and the clitoris.

Most of those affected by vulvar cancer are older women over the age of 65. The condition is rare in women under 50 who have not yet gone through the menopause.

Symptoms

Signs and symptoms of vulvar cancer may include:

  • Itching that doesn’t go away
  • Pain, soreness or tenderness
  • Bleeding that isn’t from menstruation
  • Skin changes, such as color changes or thickening
  • A lump, wart-like growth on the vulva
  • A burning pain when passing urine

Causes

The exact cause of vulvar cancer is unclear, but your risk of developing the condition is increased by the following factors:

  • Older age
  • Vulvar intraepithelial neoplasia (VIN) – where the cells in the vulva are abnormal and at risk of turning cancerous
  • Persistent infection with certain versions of the human papilloma virus (HPV)
  • Skin conditions affecting the vulva, such as lichen sclerosus
  • Smoking

Diagnosis

The doctor will carry out a gynecological evaluation, which includes checking the vulva.

If there is an ulceration, lump, or a mass that looks suspicious, a biopsy is required.

The examination should include the perineal area, including the areas around the clitoris and urethra. The doctor should also palpate the Bartholin’s glands. Anesthesia may be used.

Depending on the results of the biopsy, there may be further tests:

  • Cystoscopy: the bladder is examined to determine whether the cancer has spread to that area.
  • Proctoscopy: the rectum is examined to check whether the cancer has spread to the rectal wall.
  • Imaging scans: these can help the doctor determine whether the cancer has spread, and if so, where to. An MRI or CT scan may be used. X-rays may be used to determine whether the cancer has reached the lungs.

Treatment

The main treatments for vulvar cancer are:

  • Surgery – In most cases, your treatment plan will involve some form of surgery.
  • Chemotherapy – It’s usually used if vulval cancer comes back or to control symptoms when a cure is not possible.
  • Radiotherapy – It can be used to relieve symptoms and improve quality of life.