Vulvar Cancer

Overview

Vulvar cancer is a type of cancer that starts in the vulva, the outer part of the female genital area. The vulva includes the labia, the clitoris, the opening of the vagina, and nearby skin. Vulvar cancer is less common than many other gynecologic cancers, and it usually develops slowly over time.

Many vulvar cancers begin as changes in the skin cells of the vulva before becoming cancer. These early changes may not cause obvious symptoms, which is why persistent vulvar discomfort, skin changes, or sores should be checked by a healthcare professional. With appropriate evaluation and treatment planning, care can be tailored to the stage of the disease, the patient’s overall health, and personal needs.

Symptoms

Symptoms of vulvar cancer can vary. Some people notice changes early, while others may have mild or vague symptoms for a long time. Common symptoms may include:

• Persistent itching, burning, or tenderness in the vulvar area
• A lump, thickened area, wart-like growth, or sore on the vulva
• Skin color changes, such as red, white, dark, or patchy areas
• Pain or discomfort during urination or sexual activity
• Bleeding or discharge not related to menstrual periods
• An open sore or ulcer that does not heal
• Swelling in the groin area, which may suggest enlarged lymph nodes

These symptoms can also be caused by infections, skin conditions, hormonal changes, or non-cancerous growths. However, symptoms that continue, worsen, or return after basic care should be medically assessed.

Causes and Risk Factors

Vulvar cancer develops when cells in the vulvar skin undergo changes that allow them to grow in an uncontrolled way. The exact cause is not always known, but several factors may increase risk.

• Human papillomavirus infection, a common virus that can affect genital skin cells
• Long-term vulvar skin conditions, such as chronic inflammation or certain precancerous skin changes
• Increasing age, although vulvar cancer can occur at younger ages
• A weakened immune system
• Smoking, which may affect the body’s ability to clear certain viral infections
• A history of cervical, vaginal, or vulvar precancerous changes

Having one or more risk factors does not mean a person will develop vulvar cancer. Likewise, some people diagnosed with vulvar cancer may have no clear risk factors. Regular gynecologic care and reporting new vulvar symptoms can support earlier detection of concerning changes.

Diagnosis

Diagnosis begins with a discussion of symptoms, medical history, and risk factors, followed by a careful physical and pelvic examination. The doctor may closely inspect the vulvar skin and nearby areas to identify any abnormal patches, sores, or growths.

If an abnormal area is seen, a small tissue sample may be taken for laboratory examination. This is called a biopsy and is the main way to confirm whether cancer cells are present. The sample is examined by a specialist under a microscope.

If vulvar cancer is confirmed, additional tests may be recommended to understand the size of the tumor, whether nearby lymph nodes are involved, and whether the cancer has spread. These may include imaging tests and examination of the groin lymph nodes. The results help determine the stage of the cancer and guide the treatment plan.

International patients may be asked to bring previous test results, biopsy reports, imaging records, and treatment summaries, if available. This can help the medical team review the case efficiently and avoid unnecessary repeat testing when appropriate.

Treatment Options

Treatment for vulvar cancer depends on several factors, including the type and stage of cancer, the exact location of the tumor, lymph node involvement, overall health, and patient preferences. Care is usually planned by a multidisciplinary team that may include gynecologic oncologists, medical oncologists, radiation oncologists, pathologists, radiologists, and specialist nurses.

Surgery is a common treatment approach. The goal is to remove the cancer while preserving as much healthy tissue and function as possible. Depending on the situation, surgery may involve removing a small area of vulvar tissue, a larger portion of the vulva, or nearby lymph nodes in the groin.

Radiation therapy may be used in certain cases, either after surgery or as part of the main treatment plan. It uses carefully targeted energy to treat cancer cells in a specific area. Some patients may also receive systemic treatments, which travel through the body and are used when cancer is more advanced, has returned, or has features that make additional treatment appropriate.

Supportive care is also important. This may include pain control, wound care, help with urination or sexual health concerns, emotional support, and rehabilitation when needed. Because vulvar cancer can affect sensitive areas of the body and quality of life, open communication with the care team is essential.

When to See a Doctor

A healthcare professional should be consulted if there is persistent vulvar itching, pain, burning, a lump, skin color change, bleeding, or a sore that does not heal. It is especially important to seek care if symptoms last for more than a short time, keep coming back, or are getting worse.

Anyone with a history of vulvar, vaginal, or cervical precancerous changes, long-term vulvar skin conditions, or a weakened immune system should follow the examination schedule recommended by their doctor. Early medical assessment of unusual vulvar changes can help identify the cause and guide appropriate care.

If vulvar cancer is suspected or confirmed, seeing a specialist in gynecologic oncology can help ensure that diagnosis, staging, and treatment planning are coordinated carefully. Patients should feel comfortable asking questions about test results, treatment choices, possible side effects, recovery, and follow-up care.