What Is Vulvar Cancer?

Vulvar cancer happens when malignant (cancerous) cells form in the vulva. It’s rare.

What’s the Vulva?

It’s the outer part of the female genital organs. It includes:

  • The opening of the vagina. This is the tubelike channel that leads from the uterus, where a baby travels when being born.
  • 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 your pubic bones that becomes covered with hair in puberty.
  • The perineum. It’s the patch of skin between the vulva and the anus.

Types of Vulvar Cancer

There are five main forms of this disease.

Squamous cell carcinoma is the most common. It starts in the skin cells. Some types of it are linked to HPV -- human papilloma virus. That’s an infection you get from having sex with someone who has it. Younger women are more likely to get vulvar cancer that’s linked to HPV.

Older women more often get forms that aren’t related to it.

An extremely rare type of squamous cell carcinoma looks like a wart. It grows slowly. Your doctor will do a biopsy to see if it’s cancerous.

Adenocarcinoma usually starts in cells located in the glands just inside the opening of the vagina. It can look like a cyst, so you might not pay attention to it at first.

This type also can form in sweat glands in the skin of the vulva.

Melanoma forms in cells that make pigment, or skin color. You’re more likely to get it on skin that’s exposed to sun, but it can show up in other areas too, like the vulva. It makes up about 6 out of every 100 vulvar cancers.

Sarcoma starts in bone, muscle, or connective tissue cells. It differs from other vulvar cancers because it can happen at any age, including childhood.

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

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Who Might Get Vulvar Cancer?

Certain things can increase your chances of getting vulvar cancer. Most women who fall into the following groups won’t get it, while others who don’t might:

  • Age. Your risk of getting vulvar cancer goes up as you grow older. More than half of all cases happen in women over age 70.
  • Having a history of abnormal Pap tests
  • HIV
  • HPV infection
  • Having a precancerous condition. These are changes in the cells or tissue in the vulva that can happen sometimes years before you’re diagnosed with cancer.
  • Smoking. If you have a history of HPV and you smoke, you’re at much greater risk for vulvar cancer.

What Are the Symptoms of Vulvar Cancer?

Often there aren’t any symptoms early on. But over time, you might notice a change in the color of your vulva, unusual growths, itching that doesn’t go away, or abnormal vaginal bleeding or tenderness.

If you have these symptoms, it doesn’t mean you have vulvar cancer. But see your doctor to be sure.

Diagnosis and Treatment

Your doctor will first want to judge your overall health, including current habits and past illnesses and treatments you’ve had. She’ll examine your vulva for lumps or anything unusual.

She might take tissue samples at the same time. A specialist will study them under a microscope. This is called a biopsy.

If cancer is detected, your doctor may recommend one of the four main treatments for the disease:

  • Surgery is the most common. Your surgeon might use a laser to cut into or remove affected tissue. Ultrasound sometimes is used to break up tumors and growths. A vulvectomy might be necessary. This means removing the skin where the cancer is found, or removing parts of the vulva affected by the cancer, such as the lymph nodes. Sometimes, organs near the vulva need to be removed, too.
  • Radiation therapy uses high-powered X-rays or other forms of radiation to kill the cancer. This might be done with a machine that beams the rays into your body, or your doctor might place a radioactive substance inside your body, on or near the cancer.
  • Chemotherapy (“chemo”) kills or stops the growth of cancer cells using medications. You can take them by mouth (orally) or through an IV.  Sometimes they’re available in lotion or cream that you apply directly to your skin.
  • Biologic therapy, or immunotherapy, uses substances in the immune system or made in a lab to boost your body’s defenses against cancer.

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What About Sex?

Sexual problems and psychological issues are very common after treatment for vulvar cancer. A vulvectomy, for instance, can involve extreme changes to the anatomy of a woman’s genitals. These can lead to painful sex and body image issues. You might also have a hard time reaching orgasm or even peeing.

But if you prepare in advance, and have tools to help you afterward, it can help a great deal. Options can include counseling and reconstructive surgery.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on November 15, 2016

Sources

SOURCES:

American Cancer Society: “What Is Vulvar Cancer?”

National Cancer Institute: “Vulvar Cancer Treatment.”

Cleveland Clinic: “Vulvar Cancer.”

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

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