Vulvar Cancer

Vulvar Cancer

Vulva cancer, a rare form of cancer, occurs on the outer surface area of the female genitalia. Vulva is the area of skin surrounding the urethra and vagina, including the clitoris and labia. A lump or a sore on the vulva that often causes itching.

Six percent of cancers diagnosed in the female reproductive organs are vulva cancer and less than 1% of all cancers in women.

What are the symptoms of vulva cancer?

  • Constant itching that refuses to go
  • Change in color of the vulva
  • Unusual red, pink, or white growths or bumps that may feel rough or thick
  • Change in the appearance of a mole
  • Thickened skin on the vulva
  • Pain, soreness, or burning
  • Unusual vaginal bleeding or discharge
  • Pain while peeing

What are the causes and types of vulvar cancer?

The cause of vulvar cancer is not known but it is a change in the genetic makeup of a person. This type of cancer begins with thin, flat cells lining the surface of the vulva are known as squamous cell carcinomas. The other type of cancer beginning with the pigment-producing cells found in the skin of the vulva is known as vulvar melanoma.

What are the risk factors of vulvar cancer?

Although vulvar cancer causes are unknown, but some risk factors increase the chances of cancer:

Increasing age: Risk increases with age with average age of diagnosis being 65.

Exposure to human papillomavirus (HPV): A sexually transmitted infection, HPV increases the risk of several cancers, including vulvar cancer.

Other risk factors include –

  • Smoking,
  • Having a weakened immune system, or medications to suppress the immune system (eg. organ transplant, or human immunodeficiency virus (HIV) treatment),
  • History of precancerous conditions of the vulva (Vulvar intraepithelial neoplasia).
  • The presence of a skin condition involving the vulva such as lichen sclerosus, which causes the vulvar skin to become thin and itchy, increases the risk of vulvar cancer.

How can vulva cancer be prevented?

Post completion of medical history where the doctor asks about the overall health, including habits and illnesses of a person, the doctor may conduct a pelvic exam.

The pelvic exam includes inspecting the vulva for signs of cancer.

Colposcopy: A magnifying tool provides a close look at the vagina, vulva, and cervix.

Biopsy: Tissue testing from the vulva to be sent for lab test.

Imaging tests: X-rays, CT and PET scans, and MRIs are conducted for detailed pictures of the inside of the body to inspect cancer presence and it’s spread.

What are the stages of vulva cancer?
If the tests detect signs of cancer, the doctor will check the size of the tumour and if it has spread (staging).

Stage I: Small tumour that has not spread past the vulva and perineum.

Stage II: Cancer moved to nearby tissues but not the lymph nodes.

Stage III: Cancer spread to nearby tissues and to the lymph nodes in the groin.

Stage IV. Cancer present in the upper part of your vagina, urethra, or anus, or father part of the body.

What are the treatment options for vulvar cancer?

Surgery: Different type of operations include:

  • Cancer removal along with a margin of healthy tissue (excision)
  • Removal of a part or the entire vulva (vulvectomy)
  • Removal of a few nearby lymph nodes (sentinel node biopsy) – To assess if the cancer has spread to the lymph nodes.
  • Removal of multiple lymph nodes – In case of cancer spread to the lymph nodes, multiple lymph node removal is conducted to prevent spread to distant areas of the body.

Radiation therapy

Killing cancer cells by using high-powered energy beams, such as X-rays and protons is known as radiation therapy. A machine beaming rays into the body may be used.


A drug treatment typically using chemicals to kill cancer cells, usually administered vias a vein in your arm or by mouth. Usually an option for those with advanced vulvar cancer that has spread to other areas of the body.

Targeted drug therapy

Focused on specific abnormalities present within cancer cells. Blocking these can cause cancer cells to die. Targeted therapy could be an option for treating advanced vulvar cancer.


Targets the body’s immune system to boost its defenses against cancer.

What are the follow-up tests required after treatment of vulva cancer?

To assess cancer recurrence, after completing vulvar cancer treatment, the doctor may recommend periodic follow-up exams. Vulvar cancer may return even after successful treatment and the doctor determines the follow-up schedule suited for that person. General recommendation is about two to four times each year for the first two years after vulvar cancer treatment.


  1. Nandwani M, Barmon D, Begum D, Liegise H, Kataki AC. An Overview of Vulvar Cancer: A Single-Center Study from Northeast India. J Obstet Gynaecol India. 2019 Dec;69(6):541-545.
  2. Melinda Ratini. Vulvar Cancer. December 2023. WebMD.
  3. Vulvar cancer. Mayo Clinic. December 2023.

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