Cancer of the vulva typically occurs in the vaginal lips, and less often in the clitoris or nearby glands. Approximately 4,000 American women are diagnosed each year, with five variations of the disease:
- Carcinoma of the squamous cells - Grows in the main type of skin cell, and is the most prevalent kind of vulvar cancer.
- Adenocarcinoma - Begins in gland cells
- Melanomas - Found in the cells that give skin its color
- Sarcomas in muscle or connective tissue - Very rare but can develop in patients at any age.
- Basal cell carcinoma - The most common form of skin cancer, and one occasionally found in the vulva.
Roughly half of vulvar cancers are tied to infections younger women acquire from certain kinds of human papilloma virus, or HPV. The virus can be passed during genital-to-genital contact or oral sex, though two approved vaccines prevent infection. Other vulvar cancer risk factors include:
- Age - Risk increases as women age, with more than half of patients older than 70.
- Smoking - Smoking is particularly risky for women with a history of HPV infections.
- HIV/AIDS - A damaged immune system makes women more susceptible to HPV.
- Lichen sclerosus - Thin and itchy skin on the vulva that appears to slightly raise the risk for vulvar cancer.
- Other genital cancers - Smoking and HPV are also linked to cervical cancer.
- Melanoma or atypical moles - If found elsewhere on the body, they may show up on the vulva. Family history of melanoma also increases risk.
Vulvar Intraepithelial Neoplasia: VIN
Previously called vulvar dysplasia, VIN is the development of abnormal cells on the vulva’s outer layer of skin that can become cancerous. One type occurs in younger women and is caused by a human papilloma virus (HPV) infection. The other type is found in older women and is not tied to the virus. While most cases of VIN do not become malignant, it’s best to see a doctor to determine how often to be monitored.
Vulvar cancer is highly curable if caught early. While rare, vulvar cancer is a disease that the Northwell Health expert team has experience diagnosing and treating effectively.
Symptoms of vulvar cancer include:
- Persistent itching, burning or bleeding of the vulva
- Skin changes that often look like rashes or warts
- Pelvic pain or pressure, especially during sex or bathroom use
- Moles or unusual growths
In order to begin the process of diagnosis, a doctor will perform a complete physical exam, including a pelvic exam.
If symptoms and exam results point to vulvar cancer, the doctor will recommend a biopsy. By examining a small piece of tissue under a microscope, a doctor will know about the growth and if it’s cancer.
After the patient receives local anesthesia, a gynecologic oncologist will remove the abnormal growth if small, or just a sample if larger. A pathologist will then study the cells and determine if the growth is malignant.
If the growth is cancerous, the patient will likely need scans to determine if it has spread. These may include:
- CT scans