Definition

Vulvar cancer is cancer that starts on the outer female genitals. The vulva includes the labia, clitoris, and vaginal opening. There are different types of vulvar cancer. They are:

• Squamous cell carcinoma—cancers of the skin cells, the most common type
• Adenocarcinoma—from fluid producing glands, less common

Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

The risk of this condition increases with age. It is most common in women 70 to 80 years old.

Other things that raise the risk are:

• HPV infection
• Vulvar intraepithelial neoplasia
• Multiple sex partners
• Long term irritation or skin problems, such as:
  • Lichen sclerosus
  • Lichen simplex chronicus
• Smoking
• A weak immune system, such as with HIV

Symptoms

Symptoms may include:

• Sores, scales, lumps, or ulcers on the vulva
• Intense itching of the vulva
• Pain or burning, especially when urinating
• Changes in the color or feel of the vulvar skin

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This will include an exam of the uterus, ovaries, cervix, and vagina.

Tests may include:

• Blood tests
• Biopsy—a sample of tissue is removed for testing
• Pap test—to look for cancer in nearby tissue

Imaging tests such as x-rays, a CT scan, an MRI may be done. They will look for spreading of the tumor.

The exam and test results are used for staging. Staging outlines how far and fast cancer has spread.

Treatment

The goal is to get rid of the cancer. Treatment depends on the site, type, and stage of the cancer. A combination of treatments may be used.

Options may be:

• Surgery to remove:
  • The cancer and surrounding tissue
  • All or part of the vulva
  • Lymph nodes in the area
  • Other structures—if the cancer has spread
• Radiation therapy—to kill cancer cells and shrink tumors
• Chemotherapy by pills, injections, or IV—to kill cancer cells

Prevention

Vulvar cancer cannot always be prevented. The risk may be reduced by:

• The HPV vaccine
• Safe sex—limiting sex partners and using latex condoms
• Not smoking