OHSU

Vulvar Cancer

Overview

The vulva is the part of the female reproductive system visible outside the body. It is connected to the vagina. The vulva includes two sets of skin flaps: a larger set called the labia majora, and a smaller set called the labia minora. These skin flaps meet to protect the vaginal and urethral openings and the clitoris.
When it is found early, most vulvar cancer can be cured. If cancer has not spread to the lymph nodes, 90 percent of patients survive five years or longer. Most women diagnosed with vulvar cancer are older than 50.

Diagnosis

Vulvar cancer can be detected early by regular pelvic examinations. The doctor will examine the vulva with a magnifying device called a colposcope, and take a small sample (biopsy) of any tissue that could be cancer. If cancer is found, it is important to see a doctor who specializes in cancer of the female reproductive system. The earlier a cancer is found, the less treatment may be needed and the more likely the cancer will be cured. Once cancer of the vulva has been diagnosed, more tests will be done to determine whether it has spread to other parts of the body. This process is called staging, and it helps doctors determine the best treatment modalities. The stages of vulvar cancer include:

  • Stage 0 — Precancerous cells, vulvar intraepithelial neoplasia (VIN), are present; VIN often forms slowly.
  • Stage I — The cancer is 2 cm (about 1 inch) or less and found only in the vulva or perineum (the tissue between the vagina and the anus). The stage is further classified as Stage IA or IB depending on how deeply the cancer has invaded underlying connective tissue.
  • Stage II — The cancer is greater than 2 cm but is still found only in the vulva or perineum. No cancer has been found in the lymph nodes.
  • Stage III — The cancer has spread to the adjacent urethra (the opening from the bladder) or to nearby lymph nodes on one side of the vulva or groin.
  • Stage IV — Cancer has spread to other organs. The stage is classified as stage IVA or IVB depending on which part(s) of the body the cancer has invaded.

Treatment Options

Treatment for vulvar cancer depends on the stage of the disease. Gynecologists use surgery, laser treatments and radiation to treat most vulvar cancers.

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