What is Vulvar Cancer?
Vulvar cancer is cancer that develops in the outer surface of the vagina. The vulva is the area of skin around the urethra and vaginal opening, including the labia, clitoris, and perineum. Vulvar cancer usually presents as an itchy lump or sore in the vulva area.
Stages of Vulvar Cancer
Vulvar cancer is classified into stages (I-IV), depending on the size of the tumor and where the cancer has spread throughout the body.
Vulvar cancer staging is determined as follows:
- Stage I: Cancer has formed on the vulva or perineum, the area between the vagina and the anus. There are subsets within Stage I based on the size of the tumor.
- Stage IA: The tumor is smaller than or equal to 2 cm. It has not spread beyond 1 mm into the tissue of the vulva.
- Stage IB: The tumor is larger than 2 cm and has spread beyond 1 mm into the vulva’s tissue
- Stage II: The tumor has increased in size and spread to the lower part of the vagina or urethra, or to the anus. The cancer hasn’t reached the lymph nodes.
- Stage III: The cancer has reached the lower part of the vagina or urethra and to one or more lymph nodes in the area. Subsets are based on the lymph node progression:
- Stage IIIA: The cancer has spread to one or two lymph nodes and is smaller than 5 mm, or larger than 5 mm in only lymph node
- Stage IIIB: The cancer is 5 mm and has reached two or more lymph nodes, or reaches three or more but is still smaller than 5 mm
- Stage IIIC: The cancer has progressed to the outside surface of the lymph nodes
- Stage IV: The cancer has spread to the upper vagina, upper urethra, and other parts of the body
- Stage IVA: The cancer has reached the lining of the upper vagina, upper urethra, rectum, or bladder. It may be embedded in the pelvic bone or overtaken nearby lymph nodes.
- Stage IVB: The cancer has spread to the pelvis, lymph nodes, and other areas of the body
Types of Vulvar Cancer
There are two common types of vulvar cancers:
- Vulvar squamous cell carcinoma: The most common type of vulvar cancer, which begins in the flat, thin cells that line the vulva’s surface
- Vulvar melanoma: This type of cancer starts in the pigment-producing skin cells of the vulva
Signs & Symptoms of Vulvar Cancer
People may experience all or none of these vulvar cancer symptoms:
- Chronic itching or burning in the vulvar area
- Lumps or growths—similar to ulcers or warts—in the vulvar area
- A rash around the vulva
- Skin discoloration or skin thickening in the vulvar area
- Tenderness around the vulva
- Bleeding around the vulva (not related to menstrual periods)
- Pain during urination
- Pelvic pain during sex
What Causes Vulvar Cancer?
While there is no known cause of vulvar cancer, about half of the vulva squamous cell cancer causes can be linked to the human papillomavirus (HPV). Other vulvar cancer causes are related to lichen sclerosus, a rare and chronic skin condition.
Risk Factors for Vulvar Cancer
There are some risk factors that can increase a person’s chances of getting vulvar cancer, including:
- Human papillomavirus (HPV) infection: This sexually transmitted infection can increase the risk of vulvar, cervical, and other cancers
- Age: The average age of people diagnosed with vulvar cancer is 65
- Weakened immune system: This leaves your body less able to fight off disease on its own
- Precancerous skin condition: Having a condition such as vulvar intraepithelial neoplasia (VIN) can increase your risk of vulvar cancer
- Lichen sclerosus: A vulvar condition where the skin becomes thin and itchy
- History of genital warts
- Smoking tobacco
- Unprotected sex: Having sex without a condom raises the risk of contracting HPV, which can cause vulvar cancer
While any woman can develop vulvar cancer, there are certain preventive steps you can take to decrease your risk:
- HPV vaccine: Getting the vaccine for the human papillomavirus before the age of 26 can reduce your risk of developing vulvar cancer
- Condoms: Use a condom when you have sex to prevent contracting HPV, a known risk factor for vulvar cancer
- Pelvic exams: While there’s no screening test for vulvar cancer, a regular pelvic exam can help your doctor spot any abnormalities around the vulva
- Be aware of the symptoms: Knowing the signs of vulvar cancer can help you catch it at an early stage, increasing your chances for effective treatment
Trust NewYork-Presbyterian for Vulvar Cancer Care
Our doctors at NewYork-Presbyterian are experts in treating a range of gynecological cancers, including vulvar, cervical, ovarian, uterine, and vaginal. We offer one-on-one and group support programs to help guide patients from cancer diagnosis to cancer recovery.
Early detection of cancer can be key to a successful treatment outcome. If you are experiencing symptoms of vulvar cancer, don’t hesitate to contact us for an appointment.