Vulvar Cancer

A number of factors can increase a woman’s risk of developing vulvar cancer: 

• Being older than age 50
• Carrying the human papilloma virus (HPV), a common infection that is transmitted sexually or through skin-to-skin contact. There are many types of HPV. Types linked to vulvar cancer include HPV 16 and HPV 18. 
• Having a precancerous condition of the vulva called vulvar intraepithelial neoplasia (VIN). 
• Having a condition called lichen sclerosus, which can cause the skin on the vulva to become thin and itchy
• A history of cervical cancer or precancerous cervical conditions
• Having a rare skin disease called vulvar Paget’s disease, which causes redness and scaliness.

Vulvar cancer does not always cause symptoms in the early stages. That’s why it’s important for women to get regular pelvic exams. During the exam, the gynecologist will check the vulva for any abnormalities. Women can also get an HPV test as part of a pelvic exam to see if they carry the HPV virus.

Women should also see a doctor if they experience any signs of the following symptoms, which may be signs of vulvar cancer:  

• Itching around the vulva that doesn’t go away 
• A burning feeling or other pain in the vulva
• Any bumps, lumps or other growths
• A sore in the vulva that doesn’t heal for a month or longer
• A change in color or texture (for example, a part of the vulva appears lighter, darker, or thicker than the area around it)
• Unexpected bleeding or discharge. 

When vulvar cancer is suspected, we typically conduct a biopsy, or remove a small piece of suspicious tissue. Our experienced pathologists, who are specially trained in diagnosing gynecologic cancers, use various laboratory tests to determine if the cells are cancerous and what subtype of vulvar cancer it is. There are four subtypes: 

• Squamous cell carcinomas: Most vulvar cancers begin in the squamous cells, which are the primary type of skin cells.  
• Adenocarcinomas: About 8% of vulvar cancers are adenocarcinomas. These start in gland cells.
• Melanoma: About 6% of vulvar cancers are melanomas, which is a skin cancer that grows in pigment-producing cells. 
• Sarcomas: About 2% of vulvar cancers are sarcomas, which start in tissue, bone and muscle cells. 
• Basal cell carcinoma: While very rare, basal skin cancer can form in the vulva. 

We may also conduct imaging tests, including MRIs and CT scans, to determine how far the cancer has spread and gain other critical information needed to guide treatment.