Vulvar Cancer

What Is Vulvar Cancer?

Vulvar cancer starts in the vulva, the outer part of the female genital area. This includes the labia, clitoris, and the opening of the vagina. Because the vulva is visible, some changes can be noticed earlier than in other cancers, but many people still delay care because symptoms may feel embarrassing, confusing, or easy to dismiss.

This cancer usually develops slowly over time, often beginning with precancerous changes in the skin before becoming invasive. In other cases, it can grow more quickly and require prompt treatment.

The important thing to know is that vulvar changes should not be ignored. A lump, sore, rash, or area of itching that lingers for weeks deserves medical attention.

Signs and Symptoms of Vulvar Cancer

The symptoms may begin subtly and slowly. Common signs include:

• Persistent itching in the vulvar area

• Burning or soreness

• Thickened, red, white, or dark patches of skin

• A lump, wart-like growth, or ulcer

• Pain during urination

• Pain during sex

• Bleeding that is not normal

• Skin changes that do not improve

• Tenderness or swelling in the groin if lymph nodes are involved

Because these symptoms can resemble infections or skin conditions, they are sometimes treated repeatedly without the underlying problem being found right away.

Why Does Vulvar Cancer Happen?

Vulvar cancer develops when cells in the vulvar skin or tissue begin growing abnormally. In some women, this is related to HPV infection. In others, it may develop from chronic skin conditions or long-term irritation.

Risk factors may include:

• HPV infection

• Older age

• Smoking

• Weakened immune system

• Vulvar skin conditions such as lichen sclerosus

• History of precancerous vulvar changes

• Previous cervical or vaginal cancer

• Chronic inflammation or irritation

Diagnosis of Vulvar Cancer

Diagnosis usually starts with a physical examination, especially if the patient notices itching, pain, or a visible skin change.

• Vulvar examination: The doctor carefully inspects the vulva for lesions, colour changes, or thickened skin.

• Biopsy: A sample of abnormal tissue is taken and examined. This is the most important test.

• Colposcopy or vulvoscopy: Helps the doctor examine the area more closely.

• HPV testing: May be done in some cases.

• Imaging tests: CT, MRI, or PET scan may be used if there is concern about spread.

• Lymph node evaluation: Sometimes required if the cancer appears more advanced.

A biopsy provides the clearest answer and guides the rest of the treatment plan.

Treatment Options for Vulvar Cancer

Treatment depends on the stage and size of the cancer, as well as whether nearby lymph nodes are affected.

• Surgery: The most common treatment, ranging from local removal to more extensive surgery.

• Radiation therapy: May be used before or after surgery.

• Chemotherapy: Sometimes combined with radiation for more advanced cases.

• Sentinel lymph node biopsy: May be done to check whether the cancer has spread.

• Reconstructive surgery: May be needed after more extensive cancer removal.

Treatment is often highly individualised because preserving comfort, urinary function, and sexual health can be an important part of care.

Recovery and Follow-Up

Recovery depends on the size of the surgery and whether radiation or chemotherapy is needed. Some people recover relatively quickly after a small procedure, while others may need more time and support.

Follow-up may include:

• Wound care after surgery

• Pain control

• Monitoring lymph nodes

• Checking for recurrence

• Managing skin sensitivity or dryness

• Emotional and sexual health support

When to Seek Medical Help

You should not wait if you notice:

• Vulvar itching that does not go away

• A sore or lump that persists

• Burning, pain, itching or tenderness

• Skin that looks white, red, dark, or thickened

• Bleeding or discharge from the vulvar area

• Painful urination or sex