Vulvar cancer most often affects the labia, the folds of skin outside the vagina. In some cases, vulvar cancer starts on the clitoris or in glands on the sides of the vaginal opening.

Most vulvar cancers begin in skin cells called squamous cells. Other types of cancers found on the vulva are:

  • Adenocarcinoma
  • Basal cell carcinoma
  • Melanoma
  • Sarcoma

Vulvar cancer is rare. Risk factors include:

  • Human papilloma virus (HPV, or genital warts) infection in women under age 50
  • Chronic skin changes such as lichen sclerosis or squamous hyperplasia in women over age 50
  • History of cervical cancer or vaginal cancer
  • Smoking

Women with a condition called vulvar intraepithelial neoplasia (VIN) have a high risk of developing vulvar cancer that spreads. Most cases of VIN, though, never lead to cancer.

Vulvar Cancer Symptoms

Women with this condition will often have itching around the vagina for years. They may have used different skin creams. They may also have bleeding.

Other skin changes that may occur around the vulva:

  • Mole or freckle, which may be pink, red, white, or gray
  • Skin thickening or lump
  • Skin sore (ulcer)

Other symptoms:

  • Pain or burning with urination
  • Pain with intercourse
  • Unusual odor

Vulvar Cancer Diagnosis

The following tests are used to diagnose vulvar cancer:

  • Biopsy
  • CT scan or MRI of the pelvis to look for cancer spread
  • Pelvic examination to look for any skin changes

Vulvar Cancer Treatment

If you have early-stage vulvar cancer, our doctors will recommend surgery to remove the vulva, vagina and cervix. Associated lymph nodes will also be removed to prevent the spread of the cancer cells. If your vulvar cancer is advanced, treatment will involve chemotherapy and radiation, including some of our advanced clinical trials.

Our gynecologic oncologists work as part of an experienced multidisciplinary team within the Wake Forest Baptist Comprehensive Cancer Center. Together with other oncology specialists, they discuss your case and decide on the most advanced, personalized treatment for you.