Vulvar Cancer

Expert vulvar cancer care focused on your needs.

Female gynecological oncologist reviews vulvar cancer information with patient

What you need to know about vulvar cancer

Vulvar cancer is a rare disease in which cancer develops on the outside of female genitals. The cancer can develop over many years. It sometimes begins as a condition called vulvar intraepithelial neoplasia (VIN). 

What is vulvar intraepithelial neoplasia (VIN)? 

Vulvar intraepithelial neoplasia (VIN) is a precancerous change in your vulva. VIN means there are changed cells, but not cancer. If VIN isn't treated it can turn into cancer. Intraepithelial means that the precancer cells are only in the surface of the vulvar skin.

Another name for VIN is dysplasia. This term isn't used much anymore.

The last stage of VIN before it becomes invasive cancer is called carcinoma in situ. The cell changes become more serious as they progress toward cancer. But this process may take many years. This is why regular health checkups are important. Finding and treating VIN can keep it from becoming cancer.

VIN seldom causes symptoms. So, most women don't know they have it. These may be signs of VIN:

  • Mild to severe itching or burning on the vulva that doesn't go away
  • Changes in the skin color on the vulva. It may be white, pink to red, gray, or dark brown.
  • Thickening of the skin on the vulva
  • A lump or bump on the vulva
  • A sore or cracked skin on the vulva

Your healthcare provider may believe you have VIN after looking at your vulva. But you’ll need a biopsy to be sure of the diagnosis. Getting regular pelvic exams can help reduce your risk of vulvar cancer. VIN develops slowly. Regular checkups mean your healthcare provider can find VIN while it’s small and easier to treat. Finding and treating VIN early helps reduce the chance that the changed cells will progress to cancer.

Symptoms of vulvar cancer

You can have vulvar cancer without having any symptoms, but most women do notice changes. These are some symptoms of the most common type of vulvar cancer, squamous cell carcinoma:

  • Vulvar itching that doesn't get better
  • A change in skin color around your vulva. Your skin may become redder, lighter, or darker in color than the surrounding skin.
  • A change in the feel of your skin around your vulva. Your skin may feel thicker, scalier, rougher, or bumpier than the surrounding skin.
  • Wartlike bump or bumps, cauliflowerlike growths, or ulcers or sores on the vulva that last for more than a month
  • Pain when urinating
  • Burning or bleeding and discharge that isn't related to your menstrual cycle
  • Enlarged lymph glands in your groin

Many of these symptoms can be caused by other health problems. But it's important to see your healthcare provider if you have these symptoms. Only a provider can tell if you have cancer.

Gynecological cancer experts

Legacy Cancer Institute, located in Portland, OR, ranks among the nation’s best cancer programs. We have a team of gynecological cancer specialists who work together to diagnose vulvar cancer, and develop a personalized treatment plan for you. Find the right provider and treatment close to home.

Legacy Cancer Institute is accredited as an integrated network cancer program by the American College of surgeons Commission on Cancer (CoC). Learn more about our quality cancer care.

Our team features some of the region’s most recognized specialists.

Next steps after a vulvar cancer diagnosis

Following a diagnosis of vulvar cancer, you may have more tests to help your doctor understand how far your cancer may have spread and your cancer stage.

Cancer staging involves identifying where the cancer is located, if or where it has spread and if it is affecting other parts of your body. Knowing the stage allows your doctor to develop your personalized treatment plan.

At this point, you've likely had a physical exam and reviewed your health history with your provider. You may have also had a biopsy to confirm your diagnosis.

Some tests your doctor may now recommend include:

  • Colposcopy, cystoscopy and proctoscopy: Using a special instrument, the doctor looks for abnormal areas in the vagina and cervix, the bladder and urethra and the anus and rectum. Tissue samples may be taken and checked under a microscope.
  • CT scan, MRI or positron emission tomography (PET) and X-rays: Imaging technology to look inside the body
  • Intravenous pyelogram (IVP): X-rays of the kidneys, ureters and bladder can find out if the cancer has spread. A contrast dye is used to see if there are blockages. This procedure is also called intravenous urography.
  • Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum to see if the cancer has spread. Your provider will look at the vagina and cervix for signs of disease and may do a Pap test of the cervix.
  • Sentinel lymph node biopsy: By looking at the first lymph node where cancer has likely spread, a pathologist can determine if other lymph nodes should be removed. The procedure can be done during the surgery to remove a tumor.  

Customized treatment plans

Because each person and every cancer is different, your doctor uses your tests and exams to come up with an individual treatment plan. How long this takes depends on how complex your case is and your treatment goals. During this time, you build a relationship with your cancer doctors. You become a team for your care.

Open, honest communication can only benefit your relationship with your doctors. These tips can also help you get the most from this partnership:

  • Prepare in advance: Write down your questions ahead of your visits. A few examples of smart questions:
    • Why are we doing these tests?
    • Why do you think this treatment is right?
    • What side effects might this treatment cause?
  • Find trustworthy resources: If you’re looking to learn more, rely on this website or sources your team recommends, so you can make decisions based on good information.
  • Take a partner: Bringing a friend or family member to appointments can make you feel more confident and help you remember important details.

Treatment options

There are several ways to treat vulvar cancer depending on the type and location of the tumor. Options may include surgery, chemotherapy or radiation. Women often receive a combination of treatments. Some patients may be candidates for targeted therapy.

Talk to your doctor to see if a clinical trial (research study) may be right for you.

More support

You are not alone. Legacy offers support throughout your cancer journey, as well as care for your emotional, social and spiritual needs.

Nurse navigators
Legacy Cancer Healing Center 
Support groups and classes
Cancer rehabilitation 
Survivorship services