Facts
Vulvar cancer appears as a lesion or ulcer on the external genitalia, or vulva. Cancer of the vulva is rare. It most often occurs in women older than age 60 and may often be found during periodic pelvic exams after menopause.
In the United States, vulvar cancer accounts for about 4 percent of cancers in the female reproductive organs and 0.6 percent of all cancers in women.
The American Cancer Society estimates that 3,490 cases of vulvar cacner will be diagnosed in the United States in 2007. About 880 deaths due to vulvar cancer are expected in the same year.
Most vulvar cancers are a type of skin cancer. But occasionally, a tumor in the vulva may arise from glandular structures in that part of the body. When vulvar cancer is detected early, it is highly curable. The overall five-year survival rate when the lymph nodes are not involved is 90 percent.
Types
Most cancers of the vulva and vagina are a type of skin cancer. In their earliest form, they are precancer, also called dysplasia.
Symptoms
Some women report itching, pain, or bleeding, while others say they have no symptoms.
Diagnosis
Regular gynecologic exams, no matter what your age, help ensure that vulvar cancer will be detected early. Early diagnosis increases your chances of a cure, and it means less disfiguring surgery as well.
Your doctor will recommend a biopsy of any lesions that look like they could be cancerous. Tissue samples from your cancer will be removed either in the clinic or during surgery, and examined by a pathologist. Fred Hutchinson Cancer Center has a dedicated pathologist who only works with gynecologic cancer patients.
Stages
Stage 0 – Pre-cancerous stage, also known as dysplasia
Stage I - Cancer is local to the vulva, less than 2cm (1 inch) in size
Stage II – Cancer is local to the vulvar, greater than 2cm (inch) in size
Stage III – Cancer has spead to local tissues, such as the urethra or vagina or is in lymph nodes
Stage IV – Cancer has spread to lymph nodes both groins, or has spread distantly, such as the lungs
Risk Factors
The causes of the type of vulvar cancer that affects older women (ages 70s to 90s) is unknown. Diabetes and chronic vulvar irritation are possible risk factors.
Vulvar cancer related to HPV (the same virus that causes cervical cancer) is on the rise among younger (30s to 60s) American women and accounts for about half of all cases of vulvar cancer.
Women who smoke, are immune-suppressed or have a history of abnormal Pap smears are at risk for this type of vulvar cancer. About 70 to 80 percent of the younger women diagnosed with vulvar cancer are smokers. Some women report itching, pain, or bleeding, while others say they have no symptoms.
