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Vulvar cancer (also known as vulval or vulva cancer, or cancer of the vulva) is a type of cancer that occurs anywhere on the external female genitals (vulva). It mostly affects women who have gone through menopause but it can occur in younger women.

Vulvar cancer has no obvious symptoms in its early stages, but they can include itching and burning, lumps and lesions, bleeding not related to your period, or thickened, raised patches of skin. As there is no known way to prevent or screen for vulvar cancer, it’s important to see your doctor if you notice any symptoms.

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What is vulvar cancer?

Vulvar cancer is cancer that occurs anywhere on the vulva (the external female genitals). The most common area for this type of cancer to develop is the labia minora (inner lips), labia majora (outer lips) and the perineum (the area between the vagina and the anus).

Vulva diagram1 RGB

There are several types of vulvar cancer:

  • Squamous cell carcinoma (SCC) – This is the most common form of vulvar cancer and accounts for 90% of cases. It starts in the thin, flat (squamous) cells that cover the vulva
  • Vulvar (mucosal) melanoma – Vulvar cancer that begins in the cells that give skin its colour (melanocytes) which are found in the lining of the vulva. These cancers make up between 2% and 4% of vulvar cancers. These cancers are not related to UV radiation from the sun
  • Sarcoma – A rare type of vulvar cancer that occurs in the muscle, fat and other tissue under the skin
  • Adenocarcinoma – This type begins in the mucus-producing (glandular) cells of the vulvar glands
  • Basal cell carcinoma (BCC) – This is the most common form of skin cancer but a very rare type of vulvar cancer that begins in the basal cells of the lower layer of the skin.

Vulvar cancer mostly occurs in women who have gone through menopause, however younger women may also experience it.

It’s estimated that around 447 women are diagnosed with vulvar cancer each year, which represents 0.7% of all female cancers.

What increases your risk of vulvar cancer?

The exact cause of vulvar cancer isn’t known, but known risk factors include:

Just because you have risk factors, doesn’t mean you will get vulvar cancer. However, some women who develop this type of cancer don’t have any risk factors at all. If you’re concerned about your risk, speak to your doctor.

What are the signs and symptoms of vulvar cancer?

There are usually no symptoms in the early stages of vulvar cancer. However, some symptoms may include:

  • itching, burning or pain in the vulva
  • tenderness in the vulval area
  • a lump or swelling, an ulcer or a growth that is wart-like on the vulva
  • thickened, raised patches of vulval skin (can be red, white or dark brown)
  • a mole on the vulva that changes shape or colour
  • bleeding that is not related to your period
  • blood, pus or discharge from a lesion or sore in the vulva area
  • hard or swollen lymph glands in the groin.

These symptoms may be due to other conditions and not related to vulvar cancer. However, if you notice any of them, visit your doctor.

How is vulvar cancer diagnosed?

Your doctor will ask questions about your symptoms, health history and family health history. A physical examination will then be conducted, including a pelvic examination where they will examine your vulva, vagina and cervix.

Other tests used to diagnose vulvar cancer include:

  • A sample of tissue (vulvar biopsy from the edge of the abnormal area) may be taken and sent away to pathology for testing
  • If your GP is unable to do a biopsy you may be referred to a vulval clinic, a vulvar specialist or gynaecologist for further assessment. This may include a vulvar biopsy and/or a colposcopy/vulvoscopy. This is a magnifying instrument called a colposcope which will magnify the tissues of your vulva. It is also used to observe abnormalities in the vagina and on the cervix.
  • Sometimes the cancer is visible and your doctor will refer directly to the gynaecological oncologist for further tests and management.

Referral to a gynaecological oncologist

If your assessment and investigations suggest vulvar cancer is a possibility, ask your doctor for an immediate referral to a gynaecological oncologist. Gynaecological oncologists are specialist gynaecologists who treat cancers such as vulvar cancer.

If the above tests show that you have vulvar cancer, further tests may be used to check if the cancer has spread (metastasised) to other parts of the body. These may include:

  • cystoscopy, (to examine the bladder and urethra) and proctoscopy (to check inside the rectum)
  • chest X-ray and blood tests
  • other imaging tests such as computerised tomography (CT) and magnetic resonance imaging (MRI) scans.

Treatment for vulvar cancer

Treatment for vulvar cancer depends on the extent of the cancer. It may include any of, or a combination of, the following:

  • surgery
  • radiotherapy
  • chemotherapy.

Prevention of vulvar cancer

There are no proven ways to prevent vulvar cancer, and there is no national screening program in Australia. However, not smoking, having regular cervical screening tests and being immunised against HPV may reduce your risk.

Any vulvar conditions such as lichen sclerosus and lichen planus need to be diagnosed and managed to stop itching and scratching, which are damaging to tissues as well.

In most cases, early detection and diagnosis lead to good outcomes, which is why it’s important to see your doctor if you feel something isn’t quite right.

When to see your doctor

It’s important to see your doctor if you notice any of the symptoms listed above, or anything else that is unusual.

Further information about vulvar cancer can be found at:

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at July 2021.

Last updated: 12 October 2021 | Last reviewed: 16 July 2021

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