- Examine your vulva regularly so you'll be able to identify potential problems easily.
- Itching, pain, or bleeding that doesn't seem to have another cause and doesn't go away after a week or two could be a symptom of cancer.
- Visit your doctor as soon as possible if there's an abnormality that worries you. Treatments are more effective if you catch the problem early.
- If you're a smoker, 60-75 years old, infected with HPV or HIV, or have a family history of skin cancer, you may have a slightly higher risk of contracting vulvar cancer.
What is the vulva?
The vulva is the skin between your legs around your vagina. Often, when people talk about the "vagina," they're actually talking about the vulva. While everybody's vulva looks a little different, all vulvas are made up of the same basic parts: the inner and outer vaginal lips (labia), urethral and vaginal openings, and clitoris. Vulvar cancer most often occurs on the outer vaginal lips (labia majora), but it can also show up on the inner lips or clitoris.
Symptoms of Vulvar Cancer
Vulvar itching that doesn't go away. Itching is a common symptom of a lot of other, less serious conditions. But if you have severe itching that persists no matter what you do, make an appointment to have your doctor look at it.
Unexplained pain or tenderness of the vulva. This is consistent pain or tenderness that might lessen or worsen, but never completely goes away. The pain might get worse when you have sex or go to the bathroom.
Bleeding that isn't from menstruation. If you're still menstruating, make sure the bleeding isn't related to your menstrual cycle. Then, call your doctor as soon as possible—this is a more advanced symptom of vulvar cancer, as well as some other genital cancers.
Excessive discharge not related to your menstrual cycle. Only you know what discharge is normal for you. If your discharge changes in color, consistency, or volume and there's nothing that would explain that change, make an appointment with your doctor.
Changes in the color or thickness of the vulva. Changes to your vulvar skin are among the most common symptoms of vulvar cancer. Typically, your skin will be redder or whiter than it normally is for you. It might also have a rougher texture than normal.
A lump or open sore on or around your vulva. This could be a single lump or a group of small lumps that look similar to genital warts. If you have an open sore that doesn't heal within a few weeks to a month, that could also signal vulva cancer.
Changes in an existing mole. Moles typically aren't any cause for concern, but if they change in shape or size, that could indicate the presence of cancer. Use the ABCDE rule to tell if the mole is potentially cancerous: Asymmetry: one half doesn't match the other Border irregularity: the edges are ragged Color: not uniform; could include shades of tan, brown, or black or patches of red, blue, or white Diameter: wider than 1/4 inch (6 mm) Evolving: changes in size, shape, or color
Pelvic pain when you urinate or have sex. This is a symptom not only of vulvar cancer but of other genital and pelvic cancers. It's also a symptom of many other conditions that aren't quite as serious as cancer, but it's still a serious symptom. Call your doctor as soon as possible and schedule an appointment so they can evaluate your situation.
Diagnosis and Treatment
Check your vulva regularly for abnormalities. It's so important to be familiar with this part of your body. Use your hands and your eyes to explore and examine your vulva. Gently feel your vulva for lumps or other irregularities. A hand mirror can help you see details more clearly. Remember: there's nothing gross or shameful about knowing your own body. Many symptoms involve something that isn't normal for you—that means you need to know what is normal for you.
Mention possible symptoms to your primary care doctor or gynecologist. If you have a symptom that persists for 2 weeks or longer, make an appointment to get it checked out. Describe your symptoms in detail, including how long you've had it and anything you've done to try to treat it on your own. Your doctor will do a complete pelvic exam and also talk to you about your medical history. This helps them determine your risk for developing vulvar cancer.
Undergo a biopsy to determine the presence of cancer. A biopsy involves your doctor cutting away a small piece of the affected vulvar tissue and looking at it under a microscope for signs of cancer. A biopsy is the only way to get a diagnosis of vulvar cancer—it's also the only way to definitively rule out cancer.
Discuss treatment options based on your biopsy results. If your biopsy is negative for cancer, you'll likely still want to treat your symptoms. Your doctor will work with you to come up with a plan that best suits your needs. Your doctor might recommend surgical removal of any lump or growth, even if it's not cancerous. If the biopsy reveals cancer, you'll likely have other tests to determine if the cancer has spread to other parts of your body.
Risk Factors
Age Most people diagnosed with vulvar cancer are 65-75 years old. But at the same time, it can also develop in people under 40 years of age. Vulvar cancer often takes many years to develop, which is part of the reason age is a significant risk factor.
Human papillomavirus (HPV) infection HPV is a sexually-transmitted infection (STI) that's been linked to vulvar cancer as well as cervical cancer and other genital cancers. Exposure to HPV, as well as other STIs, could increase your risk of developing vulvar cancer.
HIV infection HIV weakens your immune system, which makes you more susceptible to many other infections and conditions. It can also increase your risk of developing vulvar cancer.
A family history of melanoma The most common types of vulvar cancer are skin cancers. A family history of skin cancer puts you at an increased risk of developing skin cancer yourself, including vulvar cancer. The risk is even greater if you've already had skin cancer somewhere else on your body.
Vulvar intraepithelial neoplasia (VIN) VIN is considered a precancerous condition, although the vast majority of people diagnosed with VIN don't ever develop vulvar cancer. Treatment for VIN significantly reduces your risk of developing vulvar cancer.
Other genital cancers or precancerous conditions If you've had abnormal Pap test results or have a family history of cervical or vaginal cancer, that might increase your risk of vulvar cancer. Vulvar cancer is also linked to the human papillomavirus (HPV), so you're considered at higher risk if you've tested positive for HPV or if you haven't been vaccinated against it. Lichen sclerosus is a skin condition that makes the vulvar skin thin and itchy. About 4% of the people diagnosed with lichen sclerosus develop vulvar cancer.
Smoking Smoking or vaping tobacco could increase your risk of vulvar as well as other cancers. If you smoke, make a plan to quit.
Prevention
Use a condom every time you have sex. Exposure to STIs might increase your risk of developing vulvar and other genital cancers. Use condoms as barriers to protect yourself from that risk. If you and your long-term partner want to stop using condoms with each other, make sure you both get tested for STIs first.
Get the HPV vaccine if you're under 45 years of age. The HPV vaccine is approved for everyone from 12 to 45. Most people get this vaccine when they're between 12 and 14 years old, but if you missed it, you can still get it when you're older. Older teens and adults might need multiple rounds of the vaccine to get the same level of protection as 12-14-year-olds who take the vaccine.
Have a pelvic exam yearly or as recommended by your doctor. If you have a higher risk or if you have a precancerous condition, your doctor might want to see you more frequently. Regardless, contact your doctor as soon as possible if you have symptoms that are bothering you. Remember: any cancer is easier to treat if you get to it early. The longer you wait, the more involved treatment will be.
Delay intercourse until your late teens or older. There's a correlation between having sex earlier and having sex with multiple partners and developing vulvar cancer. Part of this correlation might be due to the increased exposure to STIs. Regardless, making the decision to wait until you're older to have sex can lower your risk of developing vulvar cancer later in life.
Avoid risk factors you have control over. Some risk factors, like aging, you can't do anything about. But you can control your sexual activity and general health. Make good decisions that promote your health and well-being and you can help limit your risk of developing vulvar or other cancers.
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