Expert content reviewers:

Prof Alison Brand AM, Director, Gynaecological Oncology, Westmead Hospital, NSW; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Dr Ming-Yin Lin, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Dr Lisa Mackenzie, Clinical Psychologist Registrar, HNE Centre for Gynaecological Cancer, Hunter New England Local Health District, NSW; Anne Mellon, CNC – Gynaecological Oncology, HNE Centre for Gynaecological Cancer, Hunter New England Local Health District, NSW; A/Prof Tarek Meniawy, Medical Oncologist, Sir Charles Gairdner Hospital and The University of Western Australia, WA; Dr Archana Rao, Gynaecological Oncologist, Senior Staff Specialist, Royal Brisbane and Women’s Hospital, QLD; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Anita Tyrrell, Consumer; Maria Veale, 13 11 20 Consultant, Cancer Council QLD.

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The information on this webpage was adapted from Understanding Vulvar Cancer (2023 edition). This webpage was last updated in October 2023.

Diagnosis

To diagnose vulvar cancer, you're likely to have some of the following tests:

Physical examination – Your doctor will look at the vulva and examine your groin and pelvic area. They may also insert an instrument with smooth, curved sides (speculum) into your vagina, so the doctor can check the vagina and cervix for cancer.

Cervical screening test – This test looks for cancer-causing types of HPV in a sample of cells taken from the cervix or vagina. During the physical examination, the doctor uses a small brush or swab to remove some cells from the surface of the cervix. This test replaced the Pap test in 2017.

Colposcopy – This uses a magnifying instrument called a colposcope to look at the vulva, vagina and cervix. The colposcope is placed near your vulva but does not enter your body.

Biopsy – During a colposcopy, your doctor will usually take a small tissue sample (biopsy) from the vulvar area and possibly the vaginal area. A biopsy may be done under local anaesthetic, which numbs the area, or general anaesthetic, which sends you to sleep. The tissue sample will be sent to a laboratory for testing, and your doctor will explain how much bleeding to expect afterwards and how to care for the wound.

Imaging scans – If vulvar cancer is found, you may have one or more imaging scans to check if it has spread. These may include a chest x-ray, CT or MRI scan of the pelvis, or PET–CT scan. 

What are lymph nodes?

Lymph nodes are part of your body’s lymphatic (drainage) system, a network of vessels, tissues and organs that helps to protect the body against disease and infection. There are large groups of lymph nodes in the neck, armpits and groin. Sometimes vulvar cancer can travel through the lymphatic system to other parts of the body. To work out if the vulvar cancer has spread, your doctor may check the lymph nodes.

Staging

Staging describes the size of the cancer and how far it has spread. Knowing the stage helps doctors recommend the best treatment for you.

  • Stage one: Cancer is found only in the vulva; no spread to lymph nodes.
  • Stage two: Cancer is found in the vulva and has also spread to the lower urethra, the lower vagina or the lower anus; no spread to lymph nodes.
  • Stage three: Cancer is found in the vulva and/or perineum and has also spread to one or more of the following areas: the upper urethra, upper vagina, the lining of the bladder or rectum, or lymph nodes in the groin.
  • Stage four: Cancer has spread to the bone or more distant parts of the body, or has spread to nearby lymph nodes causing them to become fixed (stuck to other tissue) or ulcerated (open sores).

Questions for your doctor

  • What type of vulvar cancer do I have? Has the cancer spread?
  • What treatment do you recommend? What are the risks and possible side effects?
  • Are there any other treatment options for me?
  • Are there any clinical trials or studies I could join?
  • Will the treatment affect my sexual function or pleasure? Will the treatment affect my fertility?
  • Do I have HPV? Can I pass on HPV to my partner? Should I or my partner get vaccinated against HPV?
  • How often will I need check-ups after treatment?
  • What will happen at each follow-up appointment?
  • If the cancer comes back, how will I know? What treatments could I have then?

Understanding Vulvar Cancer

Download our Understanding Vulvar Cancer fact sheet to learn more and find support

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Diagnosing vulvar cancer