Vulvar Cancer

What Is Vulvar Cancer?

Vulvar cancer is when cancerous cells grow out of control on or in the vulva, the outer part of a woman’s genitals. It’s different from vaginal cancer, which starts inside the vagina.

A woman’s vulva includes:

  • The opening of the vagina. This is the tubelike channel that leads out from her uterus.
  • The labia. These are two sets of skin folds that look like lips. The labia majora are the fleshy set on the outside. The labia minora are thinner and set inside them.
  • The clitoris. This is a sensitive knob of tissue under a hood of skin where the labia minora meet.
  • The mons pubis. This is the soft mound in front of her pubic bones that becomes covered with hair in puberty.
  • The perineum. This is the patch of skin between her vulva and anus.

Types of Vulvar Cancer

There are several main forms of this disease.

Squamous cell carcinoma. This is the most common type. It starts in your skin cells. It might be linked to the human papillomavirus (HPV), especially in younger women. A subtype called verrucous carcinoma grows slowly and can look like a wart.

Adenocarcinoma. This type usually starts in cells in the Bartholin’s glands just inside the opening of your vagina. It can look like a cyst. It also can form in sweat glands in the skin of your vulva or in the top layer of vulvar skin, which is called Paget’s disease.

Melanoma. This type forms in cells that make pigment, or skin color. You’re more likely to get it on skin that’s exposed to the sun, but it sometimes forms on your vulva.

Sarcoma. This starts in bone, muscle, or connective tissue cells. It can happen at any age, including in childhood.

Basal cell carcinoma. This is the most common type of skin cancer. It usually appears on skin that’s exposed to the sun, rarely on the vulva.

Vulvar Cancer Symptoms

You might not notice any symptoms early on. Over time, you might have:

  • A change in the color of your vulva
  • Unusual growths or bumps
  • Itching that doesn’t go away
  • Unusual vaginal bleeding or tenderness
  • Thickened skin on your vulva
  • An open sore

These can also be signs of other conditions, so talk to your doctor if you spot problems.

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Vulvar Cancer Causes and Risk Factors

The exact causes of vulvar cancer aren’t clear. But certain things can raise your chances of getting it. These include:

  • Age. More than half of cases are in women over age 70.
  • A history of unusual Pap tests
  • HIV or AIDS
  • HPV
  • A precancerous condition like vulvar intraepithelial neoplasia (VIN). These are changes in cells or tissue that can happen years before you’re diagnosed with cancer.
  • Lichen sclerosus, a condition that makes vulvar skin thin and itchy
  • Smoking, especially if you’ve also had HPV

Vulvar Cancer Diagnosis

Your doctor will ask about your overall health, including habits and illnesses.

They’ll check your vulva for signs of cancer. A magnifying tool called a colposcope can give a close-up look at any problem areas in your vagina, vulva, and cervix.

Your doctor might take a bit of tissue for a specialist to look at under a microscope. This is called a biopsy.

Imaging tests like X-rays, CT and PET scans, and MRIs make detailed pictures inside your body to tell your doctor if you have cancer or how far it’s spread.

Vulvar Cancer Treatment

Treatment depends on many things, including the type of cancer, how far it’s spread, and your overall health. The four main treatments are:

  • Surgery. This is the most common. Your doctor might use a laser to cut into or remove affected tissue such as your lymph nodes, parts of your vulva, or other organs. Or they might use ultrasound to break up tumors and growths.
  • Radiation therapy. This uses high-powered X-rays or other forms of radiation to kill cancer. Your doctor might use a machine that beams the rays into your body or implant a radioactive needle or seed inside your body, on or near the cancer.
  • Chemotherapy (“chemo”). This uses medicines to kill or stop the growth of cancer cells. You can take these drugs by mouth or through an IV. Some kinds come as a lotion or cream that you put on your skin.
  • Biologic therapy, or immunotherapy. This targets your immune system to boost your body’s defenses against cancer.

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Vulvar Cancer and Sex

It’s common to have some sexual and psychological issues after treatment for vulvar cancer. Your body might look or feel different. You could have pain during sex and a hard time reaching orgasm or even peeing.

Counseling can help, or you might choose to have reconstructive surgery. Talk with your doctor ahead of time and learn more about the condition so you know what to expect and what steps you can take.

Vulvar Cancer Prevention

You can lower your risk of vulvar cancer with a few lifestyle changes:

  • Avoid HPV. Limit your number of sex partners. Practice safe sex, including using condoms. Get the HPV vaccine, which can help prevent genital warts and several kinds of cancer.
  • Don’t smoke.
  • Get regular checkups. Talk to your doctor as soon as possible if you notice a problem between visits.
WebMD Medical Reference Reviewed by Laura J. Martin, MD on February 09, 2020

Sources

SOURCES:

American Cancer Society: “What Is Vulvar Cancer?” “Can Vulvar Cancer Be Prevented?” “Signs and Symptoms of Vulvar Cancers and Pre-Cancers.”

National Cancer Institute: “Vulvar Cancer Treatment,” “Vulvar Cancer Treatment (PDQ) -- Patient Version.”

Cleveland Clinic: “Vulvar Cancer.”

Abramson Cancer Center of the University of Pennsylvania: “Side Effects of Vulvar Cancer & Cancer Treatment.”

UpToDate: “Vaginal cancer.”

American Society of Clinical Oncology: “Vulvar Cancer.”

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