Vulvar Cancer
This section will take you through the basics of what you need to know about vulvar cancer. It will introduce you to the people who may be part of your treatment team. Also, it will identify the different types of treatments for vulvar cancer. Hopefully, this information will help prepare you to talk with your treatment team and to feel more confident about your treatment plan.
Download a printable version of the information (in booklet form) below.
Vulvar Cancer: Your Guide (English)
Cáncer de Vulva: Su Guía (Español)*
Vulvar Cancer: Your Guide (Chinese)
Vulvar cancer overview
Cancer of the vulva is a rare tumor with the most recent cancer statistics reporting that approximately 5,000 women in the U.S. are afflicted annually. The vulva includes the inner and outer lips of the vagina, the clitoris, the opening of the vagina and its glands.
Vulvar cancer is highly curable if detected at an early stage; however, treatment can have significant adverse effects on body image, sexual function, as well as bladder and rectal function. Lower extremity lymphedema, a form of chronic swelling which results from the disruption of lymphatic drainage in the groin, is a long-term complication and is, for the most part, irreversible.
Protection from infection with the Human Papillomavirus (HPV), including HPV vaccination, reduces the risk of vulvar cancer. Examination of the vulva for changes by a woman at home or by her gynecologist during her annual pelvic examination can lead to the detection of preinvasive disease or early vulvar cancer. Suspicious or unexplained changes on the vulva should be biopsied.
Vulvar cancer symptoms
Symptoms or signs of pre-cancer and cancer include:
- Itching that will not go away
- Skin that appears lighter or darker than usual; it can be red or pink
- A bump or lump, which could be red, pink or white, and could have a wart-like or raw surface
- Pain or burning
- Bleeding or discharge not related to the normal menstrual period
- Open sore (especially if it lasts for a month or more)
- Cauliflower-like growths similar to genital warts
- Ulcer in the genital area
Medical evaluation and diagnosis
If vulvar cancer is suspected or diagnosed, it is important to seek care first from a gynecologic oncologist—medical doctors with specialized training in treating gynecologic cancers who can manage your care from diagnosis to completion of treatment to surveillance. Use our Seek a Specialist tool to find a gynecologic oncologist in your area.
During your treatment, you will come in contact with many health care professionals—these people make up your treatment team. They will work with each other and you to provide the special care you need. Learn more about your treatment team.
Surgical staging
In general, cancers are divided into categories or stages. For vulvar cancer, the final stage depends on the pathologic review of the surgical specimens from the vulva and regional lymph nodes. Assignment of a stage helps guide therapy or surveillance.
Stage I: The cancer is confined to the vulva or perineum—the area between the anus and the vulva.
Stage II: The cancer has spread to the urethra, anus or vagina.
Stage III: The cancer has spread to the lymph nodes—the presence and extent of lymph node involvement is an important factor in the determining the risk of recurrence.
Stage IV: In addition to spreading to nearby lymph nodes, the cancer has spread to distant body parts.
Vulvar cancer treatment and side effects
Surgical resection (removal) is often indicated for patients with vulvar cancer—with additional therapy such as radiation or chemotherapy administered based on the stage.
There are several surgical operations to treat vulvar cancer:
- Removal of the cancer and a margin of healthy tissue (excision): cutting out the cancer and at least 3/4 inch (2 centimeters) of the normal tissue all the way around it.
- Removal of a portion of the vulva (partial vulvectomy): removal of a portion of the vulva, along with its underlying tissues.
- Removal of the entire vulva (radical vulvectomy): removal of the entire vulva, including the clitoris and underlying tissues.
Depending on the extent of your surgery, reconstructive surgery may be recommended. This is something to discuss with your treatment team if you have undergone a partial or radical vulvectomy.
A relatively new procedure called sentinel lymph node biopsy (SLNB) can reduce the need to remove so many lymph nodes, reducing the occurrence or severity of lymphedema. This procedure involves identifying the lymph node where the cancer is most likely to spread first. That lymph node for testing and if cancer cells are not found in that lymph node, then it is unlikely that cancer cells have spread to other lymph nodes.
Side effects of surgery
Some discomfort is common after surgery. It often can be controlled with medicine. Tell your treatment team if you are experiencing pain. Other possible side effects are:
- Wound fails to heal and re-opens
- Hematoma or blood clots
- Bleeding
- Infection
- Swelling in lower extremities (hip, thigh, knee, leg, ankle and foot)
- Difficulty or paid during urination
- Decreased sensation
Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects you experience. They can help you find ways to manage them.
Radiation therapy (also called radiotherapy) uses high-energy x-rays, or other types of radiation, to kill cancer cells or stop them from growing. Radiation therapy for vulvar cancer is usually administered by a machine that directs radiation to a precise target.
Side effects of radiation
The side effects of radiation therapy depend on the dose used and the part of the body being treated. Common side effects include:
- Dry, reddened skin in the treated area
- Fatigue
- Diarrhea
- Discomfort when urinating
- Narrowing of the vagina
- Anemia
Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects you experience. They can help you find ways to manage them.
Chemotherapy are drugs used to kill cancer cells. Chemotherapy usually injected into a vein, but sometimes can be given as a pill. Chemotherapy may be recommended for some women with advanced vulvar cancer.
Side effects of chemotherapy
Each person responds to chemotherapy differently. Some people may have very few side effects while others experience several. Most side effects are temporary. They include:
- Nausea
- Loss of appetite
- Mouth sores
- Increased chance of infection
- Bleeding or bruising easily
- Vomiting
- Hair loss
- Fatigue
Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects you experience. They can help you find ways to manage them.
Importance of participation in clinical trials
There are many ongoing clinical trials studying new and better ways to treat gynecologic cancers. Many treatment options are available today because women diagnosed with gynecologic cancers were willing to participate in prior clinical trials.
Clinical trials are designed to test some of the newest and most promising treatments for gynecologic cancers. The Foundation for Women’s Cancer partners with NRG Oncology (formerly Gynecologic Oncology Group), part of the National Cancer Institute cooperative group working only on gynecologic cancer clinical trials, and others to make information about current clinical trials available. For more information about clinical trials available for enrollment, visit ClinicalTrials.gov.
