Revised December 2011
This information should not be used to self-diagnose, or be used in place of a qualified physician’s care.
- Patients with vulva cancers are treated by members of the BC Cancer Agency’s Gynecology Tumour Group.
- For healthcare professional information on treating this cancer, please see our Cancer Management Guidelines.
- For newly diagnosed patients, we offer Taking it Step by Step: a guide for women diagnosed with gynecological cancer. This BC guide was created by survivors and health care professionals of the BC Cancer Agency. It covers all aspects of the patient journey.
- Vulva cancer may also be called vulvar cancer. Paget’s disease of the vulva is a form of vulvar cancer.
- The vulva is located in the female groin area or perineum, and is the outer part of the female genitals.
- The vulva is made up of skin and fatty tissue and includes the opening of the vagina, the outer lips (labia majora), inner lips (labia minora) and the clitoris.
- The inner and outer labia protect the vaginal opening; the clitoris is highly sensitive and gets swollen with blood during sexual stimulation.
What causes it and who gets it?
Listed below are some of the known risk factors for this cancer. Not all of the risk factors below may cause this cancer, but they may be contributing factors.
- Vulva cancer is a very rare type of cancer.
- Vulva cancer mainly affects women in their sixties and seventies.
- Infection with the sexually transmitted human papillomavirus (HPV or genital warts) is the primary risk factor for this cancer.
- Women who get vulva cancer commonly have a history of chronic vulvar pruritus (itching) and may also have a history of abnormal pap smears.
- Some older women with lichen sclerosus (a condition that makes that vulvar skin thin and itchy) may develop vulva cancer.
- Statistics - Vulvar cancers are very rare and statistics are not published separately for this cancer. Instead, numbers are included with a group of related cancers under "Genital Cancers".
Can I help to prevent it?
- Protect yourself against HPV infections by:
- limiting the number of sexual partners you have.
- the use of condoms may decrease the risk but does not eliminate the risk of developing an HPV infection.
- getting the HPV vaccination.
- To find out more about HPV, talk to your family physician, visit the BC HealthGuide at www.bchealthguide.org or call the BC Nurseline at 811 in B.C.
- There is also information available through Health Canada.
- Avoid smoking.
Screening for this cancer
- Women should have a yearly gynecologic examination. The doctor will examine the area and check for lesions or changes in the skin.
Signs and Symptoms
- In the early stages of vulva cancer there may be no symptoms.
- Symptoms of vulvar cancer may include:
- Burning
- Itching
- Bleeding that is not related to menstruation (your period)
- Pain
- Discharge
- A lump or ulcer
- Leukoplakia (white patches)
Diagnosis
This is a list of some or all of the tests used to diagnose this type of cancer.
- Gynecologic / Pelvic examination – the doctor will examine the perineal area.
- Biopsy – removal of a small amount of tissue for examination.
- For more information on all cancer diagnostic tests, see our Recommended Websites, Diagnosis section.
Types and Stages
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary);
N describes involvement of lymph nodes;
M relates to whether the cancer has spread (presence or absence of distant metastases).
Stages
| |
Stage 0 |
abnormal (precancerous) cells are found on the vulva skin; Carcinoma in situ. |
|
Stage I |
the tumour is confined to the vulva and/or perineum and is 2cm or less; lymph nodes cannot be felt. |
|
Stage II |
the tumour is confined to the vulva and/or perineum and is more than 2 cm; lymph nodes cannot be felt. |
|
Stage III |
a tumour of any size has spread to at least one of these nearby sites: the vagina, lower urethra, anus, and/or has metastasized to one side of the groin lymph nodes. |
|
Stage IVA |
a tumour of any size has spread to any of the: upper urethra, lining of the bladder, lining of the rectum, pelvic bones, and/or has metastasized to both sides of the groin lymph nodes. |
|
Stage IVB |
Any distant metastasis including the pelvic lymph nodes. |
Types
- Squamous cell carcinomas are the most common type of vulvar cancers
Other less frequent types of cancers that occur in the vulva are:
- Melanomas
- Adenocarcinomas of the Bartholin Gland
- Sarcomas
- Basal cell carcinomas (has an excellent rate of cure)
- Paget’s disease of the vulva (has an excellent rate of cure)
Treatment
Cancer therapies can be highly individualized – your treatment may differ from what is described below.
- Note: Creams and ointments should only be used under a doctor’s direction after a thorough examination of the area.
Surgery
- Surgery is the primary treatment for vulva cancer.
- Laser surgery is used to treat pre-invasive (in situ) cancers. It uses a focused beam of light to vapourize the cancer off of the skin.
- Basal cell carcinoma, Paget’s disease and some in situ cancers are treated with a wide local excision (removal of the tumour and some healthy surrounding tissue) or by a simple vulvectomy (removal of the skin of the vulva).
- Early vulvar cancers may be treated with a radical local excision removing the cancer and a margin of normal tissue. In addition, a sentinel lymph node procedure (lymph nodes from the groin area are removed and checked for cancer) may be recommended for cancers smaller than 3 centimeters in size.
- Advanced invasive forms of vulva cancer are treated by radical vulvectomy (removal of the entire vulva including clitoris and surrounding tissues and frequently the nearby lymph nodes).
- Other surgical procedures may be used if the cancer has spread outside of the vulva.
- Reconstructive surgery is an option in cases where surgery has been extensive.
- It is still possible for younger patients to become pregnant after surgery.
Radiation Therapy
- Radiation therapy may be used as a primary treatment in the following cases:
- inoperable cases
- in cases where the cancer is located close to the anus to avoid a colostomy
- recurrent disease following surgery
- in patients who are medically unfit for radical surgery
Chemotherapy
- Chemotherapy may be used in combination with radiation.
Follow-up after Treatment
- Guidelines for follow-up after treatment has ended have been developed by the BC Cancer Agency and are listed on our website.
- You will be returned to the care of your family doctor or your specialist for regular follow-up.
- Follow-up testing is based on your type of cancer and your individual circumstances.
- The BCCA Survivorship Research Centre focusses on the issues that cancer survivors can face.
Coping with Cancer
The Coping with Cancer section of our website is a joint project among different BC Cancer Agency departments and programs. This website section provides information and links that can help cancer patients with the physical, emotional, psychological and practical aspects of care. Each cancer experience is different, but in one way or another, many cancer patients share the same needs.
The effects of cancer and its treatment can present unique challenges: from practical concerns like money and housing, to emotional concerns like anxiety and grief. If you need support with the practical and emotional impacts of cancer, or in managing symptoms and side effects you can use the information in Coping with Cancer to connect to these resources.
Search our library catalogue
- The BC Cancer Agency Library has many resources about cancer, coping, talking to children, etc. Please visit the Library in your Centre, call a librarian, or visit the Library online to see the many resources available.
- Automatically get a bibliography of books, videos and other items available through our library.
Recommended websites
The BC Cancer Agency has selected and evaluated these useful websites for your further information.
Vulva cancer
Sexuality and fertility websites
Websites for cancer survivors, and how to stay healthy after treatment.
Videos
View videos on cancer-related topics that the BC Cancer Agency produces.
How can I help with research at BCCA?
BC Cancer Agency patients are very helpful when it comes to the fight against cancer. Here are a few ways that you can help:
This information has been reviewed and approved by a member of the Gynecology Tumour Group.