Vulva cancer

Wednesday 30 November, 2011

On this page: What is vulva cancer? ι What are the symptoms? ι How common is it? ι What are the causes? ι More information ι Information reviewed by

The vulva is part of the female reproductive system.

The vagina is a muscular tube that is sometimes called the birth canal. It extends from the opening of the uterus to the external part of a woman's sex organs (vulva).

The vulva is a general term describing a woman's external sex organs. The main parts of the vulva are the:

  • mons pubis (mount of Venus) - the soft, fatty mound of tissue covered with pubic hair, above the labia
  • labia - two large, outer lips (the labia majora), which surround two smaller, thinner inner lips (the labia minora)
  • clitoris - a highly sensitive organ found where the labia minora join at the top. When stimulated, the clitoris fills with blood and enlarges in size.

Stimulation of the clitoris can result in sexual excitement and orgasm or climax.

The opening of the vagina is below the clitoris. There are also small glands near the opening of the vagina, called Bartholin's glands, that produce mucus to lubricate the vagina. The skin between the vulva and anus is called the perineum. 

The vulva and vagina What is vulva cancer?

This type of cancer is also known as vulvar cancer or vulval cancer.

Cancer of the vulva can start in any part of the external female sex organs. The most common areas for cancer to develop are the labia minora, the inner edges of the labia majora and the perineum. Less often, vulvar cancer may involve the clitoris. It can also begin in or spread to the Bartholin's glands.

There are several types of vulvar cancer:

  • Squamous cell carcinoma - The most common type, making up about 90% of all cases. It affects the skin cells of the vulva.
  • Vulvar melanoma - A type of skin cancer that develops from the cells that give the skin its colour. About 2% to 4% of vulvar cancers are melanoma.
  • Adenocarcinoma - Cancer that begins in the glandular cells lining the skin of the vulva.
  • Verrucous carcinoma - Slow-growing cancer that looks like a large wart.
  • Sarcomas - Cancers that develop from tissue cells, including muscle, fat under the skin and connective tissue. Sarcomas tend to grow faster than other types of vulvar cancer.

What are the symptoms?

There are often no obvious symptoms of vulvar cancer. However, you may have one or more of the following symptoms:

  • bloody, pussy or smelly vaginal discharge not related to your menstrual period
  • itching, burning and soreness or pain in the vulva
  • a lump, sore, swelling or wart-like growth on the vulva
  • thickened, raised, red, white or dark brown skin patches
  • a mole on the vulva that changes shape or colour.

Many women don't look at their vulva, so they do not know what is normal for them. Some women don't look because it is difficult to see. Others feel uncomfortable or think that their vulva is ugly.

However, if you feel any pain in your genital area or notice any of the above symptoms, you should schedule a checkup with your GP.

How common is it?

Each year, about 280 Australian women are diagnosed with vulvar cancer. It usually affects post-menopausal women between the ages of 55 and 75, but it can sometimes occur in younger or older women.

"Why do we have to be ashamed about having vulvar cancer? No one is embarrassed when they have breast cancer. When you connect with another woman who has had vulvar cancer, you soon find out that there is no need for shame or embarrassment." — Patient

What are the causes?

The exact cause of vulvar cancer is unknown, but there are some factors known to increase the risk of developing it:

Vulvar intraepithelial neoplasia (VIN) - This is a pre-cancerous condition of the vulva. The skin of the vulva changes and may itch, burn or feel sore. VIN may disappear without treatment, but it can sometimes become cancerous. About one in three women who develop vulvar cancer has VIN.

Human papillomavirus (HPV) - Sometimes known as the wart virus, HPV is a sexually transmitted infection that can cause women to develop VIN. Although having HPV increases the risk of vulvar cancer, most women with HPV don't develop it.

Other skin conditions - Non-cancerous (benign) skin conditions such as vulvar lichen sclerosus, vulvar lichen planus and extramammary Paget's disease can cause itching and soreness, and after many years, may develop into cancer.

Smoking - Cigarette smoking increases the risk of developing VIN and cancer of the vulva. This may be because smoking can make the immune system work less effectively.

Vulvar cancer is not contagious and it can't be passed to other people through sexual contact.
It is also not caused by an inherited faulty gene so it can't be passed on to children.

More information

Being given a diagnosis of vulval cancer can be very upsetting. Your doctor will explain your cancer and its treatment to you. You can also call the Cancer Council Helpline on 13 11 20 and speak with a cancer nurse. We can provide information and tell you about support services for people with cancer and their families and friends.

You may also find it helpful to visit the following websites:

This information was reviewed by:

Dr Greg Robertson, Gynaecological Oncologist, Royal Hospital for Women and St George Hospital; Jonathan Carter, Prof of Gynaecological Oncology, The University of Sydney and Head of Sydney Gynaecological Oncology Group, Sydney Cancer Centre; Belinda Fern, Consumer; Alicia Hiron, Consumer; Jayne Maidens, Clinical Nurse Consultant, Gynaecological Oncology Department, Royal North Shore Hospital; Anne Mellon, Clinical Nurse Consultant, Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital; Fiona Pearce, Cancer Council NSW Helpline; Ann Tocker, Cancer Voices.

for