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Vulval cancer

Find out about vulval cancer, including common symptoms and treatments.

If these symptoms are severe, persistent or worsening, seek medical advice promptly.

This page provides general information and does not replace a doctor’s consultation. If symptoms are severe, persistent or worsening, seek medical advice promptly.

Find out about vulval cancer, including common symptoms and treatments.

What is vulval cancer?

  • Vulval cancer (also called vulvar cancer) is cancer that's found anywhere in the vulva.
  • The vulva is the area around the opening of the vagina, including the inner and outer lips around the vagina (labia) and the clitoris.
  • Vulval cancer is rare and mostly affects women over 65 years old.
  • It can affect anyone who has a vulva.
  • Vulval cancer may be caused by certain types of human papillomavirus (HPV), or by skin conditions that affect your vulva.
  • How serious it is depends on how big it is, if it has spread and your general health.

Symptoms of vulval cancer

Main symptoms of vulval cancer

Symptoms of vulval cancer can affect any part of your vulva, but they're most common on the inner and outer lips (labia) around the opening of your vagina.

Symptoms can include:

  • a lump
  • a sore, growth (this may look and feel like a wart) or ulcer
  • bleeding from your vulva, or blood-stained vaginal discharge, that is not related to your periods
  • itching that does not get better
  • changes to your skin, such as red, white or dark patches (these may be harder to see on brown or black skin), or an area of thickened or raised skin
  • a mole that changes shape or colour
  • burning pain when you pee

See a GP if:

  • you have any symptoms of vulval cancer

Try not to be embarrassed – the GP will be used to talking about these symptoms.

Important

These symptoms are very common and can be caused by many different conditions.

Having them does not definitely mean you have vulval cancer. But it's important to get them checked by a GP.

This is because if they're caused by cancer, finding it early means treatment is more likely to be successful.

What happens at the GP appointment

The GP may ask to examine you.

You can ask for a female doctor when you book your appointment. You can have a friend, family member or other member of staff in the room with you during your exam if you want.

You'll be asked to undress from the waist down, behind a screen. You'll be given a sheet to put over you.

The GP may:

  • look at the area around the opening of your vagina (vulva)
  • feel for any lumps on your vulva (they'll be wearing gloves)
  • feel inside your vagina with 2 fingers while pressing on your tummy
  • gently put a smooth, tube-shaped tool (a speculum) into your vagina so they can see your cervix (the opening between your vagina and your womb)

It should not be painful, but you may find it uncomfortable. Talk to the GP if you're feeling uncomfortable.

Important

You are in control and can ask the doctor to stop at any time.

Referral to a specialist

You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms which could be cancer. This does not definitely mean you have cancer.

Causes of vulval cancer

Main causes of vulval cancer

It's not always known what causes vulval cancer.

But many vulval cancers are caused by an infection with certain types of human papillomavirus (HPV).

You can get HPV from:

  • any skin-to-skin contact of the genital area
  • vaginal, anal or oral sex
  • sharing sex toys

Some skin conditions that affect your vulva can also lead to vulval cancer. These include:

Who is more likely to get vulval cancer

Vulval cancer mostly affects women over 65 years old, but you can get it at any age. Anyone with a vulva can get vulval cancer.

You might also be more likely to get vulval cancer if you:

  • smoke
  • have a weakened immune system, for example if you have a health condition such as HIV or you're having treatments that affect your immune system
  • have had cervical cancer

How to lower your chance of getting vulval cancer

You cannot always prevent vulval cancer. But there are things you can do to lower your chances of getting it.

These include:

  • getting treatment for any skin conditions that affect your vulva
  • using condoms, which lower your chance of getting HPV – but they do not cover all the skin around your genitals so you're not fully protected
  • quitting smoking – smoking can weaken your immune system and the chemicals in cigarettes can also cause cancer
  • eating a balanced diet to help support your immune system

For younger people, HPV vaccination is the best way to protect yourself from vulval cancer.

All children aged 12 to 13 are offered the HPV vaccine. It helps protect against all cancers caused by HPV, as well as genital warts.

It's important to get any symptoms of vulval cancer checked by a GP.

Tests and next steps for vulval cancer

Main tests for vulval cancer

If you have symptoms of vulval cancer, you'll usually be referred for a test to have a closer look at the area around the opening of your vagina (your vulva). This is called a vulvoscopy.

You'll be asked to undress from the waist down, behind a screen. You'll be given a sheet to put over you.

You can have a friend, family member or other member of staff in the room with you during your vulvoscopy if you want.

During a vulvoscopy:

  1. The specialist nurse or doctor will ask you to lie back on a bed, usually with your legs bent, knees up and legs apart. You may be asked to rest your legs on supports.
  2. They'll use a magnifier called a colposcope (similar to a microscope) to look closely at your vulva from the outside. This will help them find any small changes that may be difficult to see.
  3. They may also need to look inside your vagina and womb. If they do, they'll gently put a smooth, tube-shaped tool (a speculum) into your vagina so they can see your cervix with the colposcope.
  4. If the nurse or doctor sees anything unusual, they'll usually collect a small sample of cells (biopsy) to send to a laboratory. They'll give you an injection of local anaesthetic first, to numb your vulva.

It should not be painful, but you may find it uncomfortable. Talk to the nurse or doctor if you're feeling uncomfortable.

If you had a biopsy, you may have a small amount of bleeding or soreness afterwards.

Getting your results

It can take several weeks to get the results of your vulvoscopy and biopsy.

You may be asked to go to the hospital to get your results, or they may be sent to you in the post.

Try not to worry if your results are taking a long time to get to you. It does not mean anything is wrong.

You can call the hospital or GP if you're worried and they may be able to update you if your results are ready.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have vulval cancer

Being told you have vulval cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, treatment and beyond.

This will include a clinical nurse specialist, who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Next steps

If you've been told you have vulval cancer, you'll usually need more tests.

These, along with the vulvoscopy and biopsy, will help the specialists find out the type of vulval cancer, the size of the cancer, and how far it's spread (called the stage).

You may need:

  • blood tests
  • scans, such as a CT scan, MRI scan or PET scan

You may not have all these tests.

The specialists will use the results of these tests and work with you to decide on what treatment is best for you.

Treatment for vulval cancer

Main treatments for vulval cancer

Vulval cancer is often treatable.

The treatment you have will depend on:

  • the size and type of vulval cancer you have
  • where the cancer is
  • if it has spread
  • your general health

The main treatment for vulval cancer is usually surgery. You may also have radiotherapy or chemotherapy.

The specialist care team looking after you will:

  • explain the treatments, benefits and side effects
  • work with you to create a treatment plan that's best for you
  • help you to manage the side effects of treatment

If you have any questions or worries, you can talk to your specialist team. You do not have to wait for your next appointment.

Surgery

Surgery is usually the main treatment for vulval cancer, especially if the cancer is found early.

Surgery may involve removing:

  • the cancer and an area of tissue around it
  • part of your vulva
  • the whole of your vulva, including the labia and sometimes the clitoris

You may also need to have some lymph nodes in your groin removed. These are part of the body's drainage system.

After removing the cancer, the surgeon will repair your vulva using the remaining skin. In some cases a specialist doctor (plastic surgeon) will need to reconstruct your vulva. They'll do this by using skin or muscle from other parts of your body.

You'll be supported through surgery and recovery by your specialist team.

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

You may have radiotherapy for vulval cancer:

  • before surgery, to shrink the cancer
  • after surgery, to help stop the cancer coming back
  • if you cannot have surgery
  • if the cancer has spread to other parts of your body

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for vulval cancer:

  • before surgery, to shrink the cancer
  • after surgery, to help stop the cancer coming back
  • if you cannot have surgery
  • to treat your symptoms if the cancer has spread

What happens if you've been told your cancer cannot be cured

If you've been diagnosed with advanced vulval cancer, it may be hard to treat and not possible to cure.

The aim of treatment will be to slow down the growth and spread of the cancer, to help with the symptoms, and help you live longer.

Finding out cancer cannot be cured can be very hard news to take in.

You'll be referred to a team of doctors and nurses called a symptom control team or palliative care team.

They will help you to manage your symptoms and make you feel more comfortable.

The palliative care team can also help you and your loved ones get any other support you need.

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