Understanding vulval cancer

Vulval cancer is a rare gynaecological cancer that forms on the vulva, the external female genitals. It often starts in the labia, the folds of skin around the opening of the vagina. Vulval cancer most commonly affects older women, but it can happen at any age. Finding it early makes a significant difference to treatment and outcome, so it is worth knowing the signs.

Symptoms of vulval cancer

The symptoms of vulval cancer can look like common skin problems, which is why they are sometimes ignored. See a doctor if you notice:

• persistent itching, burning or pain in the vulva
• a lump, sore or wart-like growth on the vulva that does not heal (see vulval and vaginal lumps)
• changes in the colour or texture of the skin, such as thickening, or a patch that looks lighter or darker
• bleeding or discharge that is not part of your period
• pain when passing urine or during sex

Most of these symptoms turn out to have a less serious cause, such as an infection or a skin condition. Even so, any symptom that persists, or keeps coming back after treatment, should be examined properly.

How is vulval cancer diagnosed?

Diagnosis begins with a conversation about your medical history and a careful examination:

• Pelvic examination: a close look at the vulva to find any abnormal areas.
• Biopsy: a small sample of tissue is taken from the suspicious area, usually under local anaesthetic, and examined for cancer cells. A biopsy is the only way to confirm vulval cancer.
• Imaging: CT, MRI or PET scans may be used to find out whether the cancer has spread.

Sometimes a colposcopy is used to examine the vulva in more detail. Cancer Research UK explains the symptoms of vulval cancer and when to see a doctor.

Treatment options for vulval cancer

Treatment depends on the stage and position of the cancer and on your overall health. Common approaches include:

• Wide local excision: removal of the tumour together with a margin of healthy tissue around it.
• Vulvectomy: partial or complete removal of the vulva, usually for larger or more advanced cancers. Our radical vulvectomy and groin node surgery page explains this in detail.
• Lymph node surgery: vulval cancer can spread to the lymph nodes in the groin, so these are often checked or removed (see lymphadenectomy).
• Radiotherapy: high-energy rays that destroy cancer cells, often used before or after surgery.
• Chemotherapy: medicines that shrink tumours or destroy cancer cells, usually for advanced or recurrent cancer.
• Targeted therapy: for some cancers with specific genetic changes, targeted drugs may be an option.

Recovery and support

Surgery for vulval cancer can affect how you feel about your body, as well as your comfort and sex life. Those feelings are completely understandable, and support is available. Your team will explain what to expect, help you manage pain and wound care, and talk openly with you about recovery. Do not be afraid to ask questions at every stage.

Why acting early matters

If you notice persistent symptoms, seek medical advice promptly. Early treatment is key to a better outcome and quality of life, and smaller cancers usually need less extensive surgery. Our post on what vulval cancer is explains the surgical options in more depth.

Cancer Research UK sets out the treatment options for vulval cancer, and our vulval cancer page has more detail. To book a consultation with Mr Jaf Abu at The Park Hospital, Nottingham, please get in touch.