Vulvar Cancer

Vulvar cancer is an uncommon cancer that develops on the vulva — the outer part of a woman’s genitalia. The vulva includes the labia majora (outer lips), labia minora (inner lips), clitoris, the vaginal opening, and the Bartholin’s glands (two small glands near the vaginal opening). Vulvar cancer most often forms on the labia, and it typically grows slowly. 

What causes vulvar cancer? 

Doctors don’t fully understand why vulvar cancer develops. The majority of vulvar cancers are caused by long-term exposure to human papilloma virus (HPV). In general, it begins when healthy vulvar cells develop changes in their DNA that cause them to grow and divide too quickly. Over time, these extra cells can build up into a mass, or tumor, which may become cancerous and, if left untreated, spread to other parts of the body. 

Types of vulvar cancer

Vulvar cancer is classified by the type of cell in which the cancerous changes originated. Along with many other factors, physicians consider the classification of the cancer when evaluating treatment options.

The types of vulvar cancer include:

• Squamous cell carcinoma. By far the most common type, forming in the thin, flat cells that cover the surface of the vulva. 
• Verrucous carcinoma. A rarer, slow-growing subtype of squamous cell carcinoma that can resemble a wart. 
• Adenocarcinoma. Develops in the Bartholin’s glands or the sweat glands of the vulva, usually near the vaginal opening. 
• Melanoma. A skin cancer that starts in the pigment-producing cells of the vulva, most often on the clitoris or labia minora.
• Sarcoma. A rare cancer that forms in the connective tissue beneath the vulvar skin.

Vulvar cancer symptoms

Vulvar cancer usually progresses slowly and may not cause any symptoms in its early stages. When symptoms do appear, they can include: 

• Persistent itching, pain, or burning in the vulvar area 
• A patch of vulvar skin that looks or feels different than the skin around it 
• A lump in the vulva or a swollen groin lymph node 
• Unusual vaginal discharge  
• Vaginal bleeding between periods or after menopause 
• A sore on the vulva that doesn’t heal within a few weeks and is not related to a herpes outbreak. 
• A mole on the vulva that changes in size, shape, or color 
• Wart-like growths 

Many of these symptoms are also caused by conditions that are not cancer, such as infections or skin irritation. Even so, it’s important to see a doctor promptly about any change so it can be properly diagnosed and, if needed, treated early. 

How vulvar cancer is diagnosed 

If your doctor suspects vulvar cancer, they will typically begin with a physical exam, including a pelvic exam, to closely examine the vulva and check the vagina, uterus, ovaries, bladder, and rectum for anything unusual. Depending on what they find, they may recommend: 

Biopsy. Removing a small sample of vulvar tissue so a pathologist can examine it under a microscope. This is the only way to confirm a diagnosis of cancer. 

Colposcopy. Using a lighted, magnifying instrument to closely examine the vulva, vagina, and cervix for abnormal areas. 

Imaging tests. A CT, PET, or MRI scan can help evaluate the size and location of a tumor; a chest X-ray can help check whether the cancer has spread to the lungs. 

Endoscopy. Using a thin, lighted tube to look inside the bladder or rectum if there is concern that the cancer may have spread nearby. 

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Risk factors

Researchers don’t know the exact cause of vulvar cancer, but some factors are linked to a higher risk, including: 

• Human papillomavirus (HPV) infection (sexually transmitted) and prevented by HPV vaccination 
• Smoking 
• A weakened immune system 
• Precancerous vulvar conditions, such as vulvar intraepithelial neoplasia (VIN)- HPV-related 
• Certain chronic skin conditions of the vulva, such as lichen sclerosus 

Having one or more of these risk factors does not mean you will develop vulvar cancer. Many women with these risk factors never do, and some women without any known risk factors are diagnosed. 

Moffitt’s approach to treating vulvar cancer

At Moffitt Cancer Center, women with vulvar cancer receive comprehensive, compassionate care from a team that focuses exclusively on gynecologic cancers. We know your time is valuable, so we bring together every specialist, test, and treatment you need in one convenient location. 

Our gynecologic oncologists are experienced, fellowship-trained and board-certified in their specialty, and they work alongside radiation oncologists, medical oncologists, pathologists, and supportive care providers to build a treatment plan around you — not a one-size-fits-all protocol. Moffitt is also recognized by the National Cancer Institute as a Comprehensive Cancer Center, which means our patients have access to the latest research and clinical trials, often before these treatments are available elsewhere. 

Whether you are newly diagnosed, seeking a second opinion, experiencing a recurrence, in need of a complex surgical procedure or simply seeking more information about vulvar cancer, Moffitt Cancer Center is here to help. To request an appointment, call 1-888-663-3488 or complete our new patient registration form. No referral is required.