Vulvar cancer

Vulvar cancer can develop in any part of a female’s genitals. It most commonly develops in the labia minora (inner lips), the labia majora (outer lips), and the perineum (skin between the vagina and the anus).

Vulvar cancer is a less common type of cancer, with about 424 people being diagnosed each year in Australia. Anyone with a vulva can get vulvar cancer, including women, transgender men, non-binary people and intersex people.

Vulvar cancer is not common. It most commonly affects women who have gone through menopause, however vulvar cancer can also occur in younger women. The average age at diagnosis is 69 years old.

The exact cause of vulvar cancer is unknown, but there are some factors that can increase your risk:

• Vulvar intraepithelial neoplasia (VIN)
• Having human papillomavirus (HPV)
• Abnormal cervical screening test
• Other skin conditions
• Other cancers
• Smoking tobacco (which can make cancer more likely to develop in people with HPV)
• Weakened immune system
• Having other skin conditions including vulvar lichen planus, vulvar lichen sclerosus or extramammary Paget disease
• Having had other cancers including cancer of the cervix or vagina

Vulvar cancer is often diagnosed after a history of vulvar symptoms over several months or years. There are only a few obvious symptoms of early vulvar cancer.

Signs and symptoms of vulvar cancer can include:

• Itching, burning and soreness or pain in the vulva
• A lump, sore, swelling or wart-like growth on the vulva
• Thickened, raised skin patches (may be red, white or dark brown)
• A mole on the vulva that changes shape or colour
• Blood, pus or other discharge coming from an area of skin or sore spot in the vulva, which may have an offensive or unusual smell or colour (not related to your menstrual period)
• An ulcer that won’t heal
• Hard or swollen lymph nodes in the groin area.

While some symptoms of vulvar cancer can be obvious, others need to be touched or seen. Most people don’t look at their vulva regularly, so they don’t know what is normal for them. The vulva can be difficult to see without a mirror, and some people may feel uncomfortable examining their genitals.

If you feel any pain in your genital area or notice any of these symptoms, visit your general practitioner (GP) for a check-up.

The main tests used to diagnose vulvar cancer are a physical examination, a procedure called a colposcopy and inspection of a removed skin tissue sample (biopsy). Because vulvar cancer is sometimes associated with cervical and vaginal cancer, your doctor may also check for abnormal cells in the vagina and cervix.

• Physical examination
• Colposcopy
• Biopsy – removal of a tissue sample
• Cervical Screening Test

Sometimes further tests are needed to assess your general health, determine the size and position of the cancer, and find out whether the cancer has spread. You will probably not need to have all of these tests:

• Blood test
• Chest x-ray
• Cystoscopy
• Proctoscopy
• CT scan
• MRI scan

Waiting for your test results can be a stressful time. It may help to talk to a friend or family member, a healthcare professional, or call our Cancer Council support line on 13 11 20.

Vulvar cancer usually takes many years to develop. But like other types of cancer, it is easier to treat and cure the earlier it is detected.

Vulva cancer can be treated by surgery, radiation therapy and chemotherapy. You may have one of these treatments or a combination, and regular check-ups are also normal to see how the cancer has responded to treatment. Your doctor will recommend the best treatment plan for you depending on the results of your tests, the type and location of the cancer, whether it has spread, your age and your general health.

While everyone’s journey is unique, your doctor can help you understand what to expect and guide you through your experience with vulvar cancer, drawing on their knowledge of similar cases.

The earlier the vulvar cancer is diagnosed usually means the better the chances of successful treatment. In some cases, your doctor will consider your tests results; the type of vulvar cancer you have; the stage and grade of the cancer; whether the cancer has spread to the lymph nodes; and other factors such as your age, fitness and overall health to work out your prognosis. In most cases, the doctor will not have enough information to assess the prognosis until after surgery to remove the cancer.

It can be difficult discussing your prognosis and thinking about the future. It may help to talk with family and friends, but if you need more information, practical advice or emotional support, call our Cancer Council support line on 13 11 20.