Vulvar Cancer: The Basics
The vulva is the outside part of a woman’s sex organs. The vulva is made up of the labia, clitoris, mons pubis, the opening of the vagina (vestibule), and the perineum. Vulvar cancer is cancer that starts in the vulva. It is caused by vulvar cells growing out of control. As the number of cells grows, they form a tumor.
Vulvar cancer that has spread from the vulva to another part of the body is called metastatic cancer.
Some risks are:
- Having gone through menopause.
- Infection with HPV.
- Having had another gynecologic cancer or melanoma in the past.
Signs of Vulvar Cancer
The signs can be:
- Pain with sex.
- Bleeding and/or discharge from your vagina.
- Lesions or new skin growths.
Diagnosis of Vulvar Cancer
When your healthcare providers think you may have vulvar cancer, they will order tests. Some of the tests are:
- Colposcopy and vulvoscopy.
- Pap test.
These tests need to done, but a biopsy is the only way to know for sure if you have cancer. A biopsy:
- Looks at a piece of the vulva for cancer cells.
- Is used to find out the cancer type, how normal it is [grade], and if it has spread.
- May look at samples from lymph nodes to check for cancer.
A pathology report goes over these results and is sent to your healthcare provider, often 5-10 days after the colposcopy or vulvoscopy. This report plays a big part in planning your treatment. You can ask for a copy of your report for your records.
Staging Vulvar Cancer
To guide treatment, vulvar cancer is "staged." This stage is based on:
- Size and where the tumor is.
- If there are cancer cells in the lymph nodes.
- If there are cancer cells in other parts of the body.
Stages go from stage I (one, smallest and most confined tumors) to stage IV (four, tumors that have spread to other parts of the body, also called metastatic cancer). The stage and type of vulvar cancer will guide your treatment plan.
Often, these treatments are used:
- Surgery to remove as much of the cancer as possible.
- Radiation, which is the use of high energy x-rays to kill cancer cells.
- Chemotherapy, which is the use of medications to kill cancer cells.
This article is a basic guide to vulvar cancer. You can learn more about your type of vulvar cancer and treatment by using the links below.
Vulvar Cancer: Staging and Treatment
American Cancer Society, Vulvar Cancer, www.cancer.org/cancer/vulvar/detailedguide
AJCC (June, 2018.) Cancer Staging For Supplement to AJCC Cancer Staging Manual, 8thEdition, retrieved from https://cancerstaging.org/references-tools/deskreferences/Documents/AJCC%20Cancer%20Staging%20Form%20Supplement.pdf
National Comprehensive Cancer Network (NCCN) Guidelines: Vulvar Cancer (2016). (log in required) https://www.nccn.org/professionals/physician_gls/f_guidelines.asp
Alkatout I, Schubert M, Garbrecht N, Weigel MT, Jonat W, Mundhenke C, Günther V. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health. 2015 Mar 20;7:305-13.
Aragona AM, Cuneo NA, Soderini AH, Alcoba EB. An analysis of reported independent prognostic factors for survival in squamous cell carcinoma of the vulva: is tumor size significance being underrated? Gynecologic Oncology. Mar 2014; 132(3):643-648.
Barlow EL, Hacker NF, Hussain R, Parmenter G. Sexuality and body image following treatment for early‐stage vulvar cancer: a qualitative study. Journal of Advanced Nursing. 2014 Aug 1; 70(8):1856-66.
Board, P. A. T. E. (2018). Vulvar Cancer Treatment (PDQ®). In PDQ Cancer Information Summaries [Internet]. National Cancer Institute (US).
Graham K, Burton K. "Unresectable" vulval cancers: is neoadjuvant chemotherapy the way forward? Current oncology reports.Dec 2013; 15(6):573-580.
Han K, Louie AV, Marchand E, Leung EW, Milosevic M, Fyles A. What Is the Optimal Treatment for Patients With Sentinel Node–Positive Vulvar Cancer? International Journal of Radiation Oncology- Biology-Physics. 2014 Sep 1; 90(1):S503.
Kidd, E et al. ACR Appropriateness Criteria management of locoregionally advanced squamous cell carcinoma of the vulva. American Journal of Clinical Oncology. 36(4):415-22, 2013 Aug.
Koh, W. J., Greer, B. E., Abu-Rustum, N. R., Campos, S. M., Cho, K. R., Chon, H. S., ... & Dorigo, O. (2017). Vulvar cancer, version 1.2017, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 15(1), 92-120.
Oonk, M. H. M., & van der Zee, A. G. J. (2017). New Therapies in Vulvar Cancer. In Translational Advances in Gynecologic Cancers (pp. 303-312).
Reade CJ, Eiriksson LR, Mackay H. Systemic therapy in squamous cell carcinoma of the vulva: current status and future directions. Gynecologic Oncology. Mar 2014; 132(3):780-789.
Regauer S, Reich O. Etiology of vulvar cancer will impact on treatment options and therapy outcome: Two major pathways of vulvar cancer. Gynecologic Oncology. Oct 2013; 131(1):246-247.
Viswanathan C, Kirschner K, Truong M, Balachandran A, Devine C, Bhosale P. Multimodality imaging of vulvar cancer: staging, therapeutic response, and complications. AJR. American Journal of Roentgenology. Jun 2013; 200(6):1387-1400.
Wills A, Obermair A. A review of complications associated with the surgical treatment of vulvar cancer. Gynecologic Oncology.Nov 2013;131(2):467-479.