Diagnosis & Staging
Vulvar cancer is very rare.
The vulva is made up of skin and fatty tissue. It 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.
Paget's disease of the vulva is also a form of vulvar cancer.
People with early stage vulvar cancer may not have any symptoms.
Symptoms of vulvar cancer may include:
- Bleeding that is not related to menstruation (your period).
- A lump or ulcer.
- Leukoplakia (white patches).
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose vulvar cancer include:
- Pelvic exam: a doctor or nurse practitioner examines your perineal area (area between your thighs).
- Biopsy: a small amount of tissue is removed. A specialist (pathologist) will examine the tissue to see if it is cancer.
The most common type of vulvar cancer is squamous cell carcinoma (cancer of the cells that are on the surface of the skin and the lining of internal organs).
Less common types include:
- Adenocarcinomas of the Bartholin Gland
- Basal cell carcinomas
- Paget's disease of the vulva
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
Vulvar cancer staging:
- Stage 1: Tumour is only in the vulva.
- Stage 2: Tumour has grown into structures next to the perineum (lower third of the urethra, lower third of the vagina, and/or the anus). No spread to nearby lymph nodes.
- Stage 3: Tumour may or may not have grown into structures next to the perineum but has spread to nearby lymph nodes.
- Stage 4: One or all of the following
- Tumour has grown into the upper urethra, upper vagina, inner lining of the bladder or inner lining of the rectum.
- Cancer has spread to nearby lymph nodes.
- Cancer has spread other parts of the body, such as the lungs. This is called distant metastasis.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing. A pathologist will give the cancer a grade after looking at the cells under a microscope.
Vulvar cancer can be grade 1, 2 or 3. The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.
The grade of the cancer helps your health care team plan your treatment.