Vulval cancer

What is vulval cancer?

Vulval cancer affects any part of the external female genitals (vulva). It’s more common in people who have gone through menopause, but it can also develop in younger people.

There are different types of vulval cancer:

• Squamous cell carcinoma (SCC) – this is the most common vulval cancer and accounts for 90% of cases. It starts in the thin, flat (squamous) cells that cover the vulva.
• Adenocarcinoma – this cancer starts in the mucus-producing (glandular) cells of the vulva.
• Vulval (mucosal) melanoma – this is a rare form of vulval cancer that starts in the cells that give skin its colour (melanocytes). This cancer is not related to UV radiation from the sun.
• Sarcoma – this cancer is also rare. It starts in the muscle, fat and other tissue of the vulva.
• Basal cell carcinoma (BCC) – this is the most common form of skin cancer but a very rare type of vulval cancer. It begins in the basal cells in the lower layer of skin.

Symptoms of vulval cancer

See your doctor if you notice any unusual symptoms. They may be due to other conditions, but it’s important to check.

Many women don’t have any symptoms in the early stages of vulval cancer. But you may notice:

• itching, burning or pain
• tenderness
• a lump or swelling
• an ulcer or a growth that is wart-like
• thickened, raised patches of vulval skin that may be red, white or dark brown.

You may also notice:

• a mole that changes shape or colour
• bleeding that’s not related to your period
• blood, pus or discharge from a lesion or sore
• hard or swollen lymph glands in the groin.

What causes vulval cancer?

We don’t know the exact cause of vulval cancer, but it may be associated with:

• human papillomavirus (HPV)
• having a precancerous condition called ‘vulvar intraepithelial neoplasia’ (VIN), where abnormal cells develop in the lining of the vagina
• skin conditions such as lichen planus and lichen sclerosus
• having had cervical cancer or vaginal cancer in the past
• smoking
• having a weakened immune system.

How is vulval cancer diagnosed?

Your doctor will ask about your symptoms, medical history and family health history. They will also do a pelvic examination to check your vulva, vagina and cervix.

They may take a tissue sample (biopsy) of the abnormal area of your vulva and send it to a pathology lab for testing.

If your examination and test results suggest you may have vulval cancer, your doctor will refer you to an oncologist who specialises in this type of cancer straight away.

You may need the following tests:

• A colposcopy – a magnifying instrument (colposcope) is used to look closely at your vulva, vagina and cervix.
• A cystoscopy – a procedure to check your bladder and urethra.
• A proctoscopy – a procedure to check inside your rectum.
• A chest X-ray.
• Blood tests.
• Imaging tests such as CT and MRI scans.

Treatments for vulval cancer

Treatment for vulvar cancer depends on the extent of the cancer. It may include:

• surgery
• radiotherapy
• chemotherapy
• palliative treatment.

Medical treatment, such as chemotherapy and radiotherapy, can cause menopause. Learn more about medically induced menopause.

Reducing the risk of vulval cancer

While there isn’t a screening test for vulval cancer, you can lower your risk by:

• not smoking
• having regular cervical screening tests
• getting immunised against HPV.

You can also do regular self-checks and see your doctor if you notice any changes.

When to see your doctor

It’s important to see your doctor if you notice any unusual symptoms. In most cases, early detection and diagnosis lead to good outcomes.

Related resources

More information about vaginal cancer can be found on the Cancer Australia website and the Cancer Council website.

If you would like to speak to a nurse for general information and support, call Cancer Council on 13 11 20 (9 am to 5 pm, Monday to Friday).

On this Jean Hailes podcast, gynaecological cancer survivor Kath Mazzella OAM speaks to host Shelley Ware about fighting the shame that surrounds vulval cancer and women’s bodies.

*Please be advised, this episode contains strong language*