Vulvar Cancer

Overview

Vulvar cancer is cancer that begins on the vulva, the outer surface area of the female genitals. The vulva is the area of skin that surrounds the urethra (tube through which urine exits the body) and the vagina (tube that leads to the uterus, where fetal development occurs).

Vulvar cancer causes

Vulvar cancer occurs when the cells of the vulva develop mutations (changes) to their DNA, and then the abnormal cells multiply out of control.

Vulvar cancer risk factors

Factors that may increase your risk for developing vulvar cancer are:

• Being a smoker
• Being exposed to human papillomavirus (HPV)
• Being immunocompromised
• Being over age 65
• Having a precancerous condition of the vulva, such as vulvar intraepithelial neoplasia
• Having human immunodeficiency virus (HIV)
• Having lichen sclerosis, a skin condition that affects the vulva

Vulvar cancer symptoms

Signs and symptoms of vulvar cancer can include:

• Itchiness that won’t go away
• Pain and tenderness
• Bleeding between menstrual periods or after you’ve gone through menopause
• Skin changes to the vulva, such as changes in color or thickening
• A lump, wart-like bump or ulcer (open sore) on the vagina

Vulvar cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam, including asking questions about your health history, your symptoms and related risk factors. During this time, your doctor will also perform a vulva exam to check for irregularities.
• Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer.
• Colposcopy – during this exam, your doctor uses a lighted magnifying instrument (colposcope) to closely examine your vulva of any irregularities.
• Imaging tests – your doctor may use imaging tests – such as X-ray, computerized tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) scan – to check to see if the cancer has spread and to stage the cancer.

Vulvar cancer treatments

Depending on your personal health history, the extent of the cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible. Depending on the extent of your vulvar cancer, your doctor may recommend a partial or radical (complete) vulvectomy or removal of the vulva. If the cancer has spread to nearby lymph nodes, your doctor will also surgically remove the lymph nodes.
• Chemotherapy – you may need to also undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Immunotherapy – this treatment works with your body’s immune system to fight the cancer.
• Radiation therapy – during this treatment, powerful energy beams – such as X-ray or protons – destroy cancer cells. Depending on what your doctor determines is best for you and your situation, the radiation therapy may be delivered outside the body or inside the body.
• Targeted therapy – this treatment involves taking medications that target specific weaknesses of the cancerous cells, working to destroy them.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. Your doctor may suggest seeing an oncologist for more specialized treatment.