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 2025.

Treatment

Because vulvar cancer is rare, it is recommended that you are treated in a specialist centre for gynaecological cancer. The multidisciplinary treatment (MDT) team may include a:

  • surgeon (usually a gynaecological oncologist)
  • radiation oncologist
  • medical oncologist
  • specialist nurses, and
  • allied health professionals, such as a physiotherapist or psychologist.

The treatment recommended by your doctor will depend on the results of your tests, the type of cancer, where the cancer is, whether it has spread, your age and your general health.

Understanding the disease, treatments, possible side effects and costs can help you weigh up the treatment options and make a well-informed decision. You may want to get a second opinion from another specialist to confirm the treatment options.

Surgery

Surgery is the main treatment for vulvar cancer. A gynaecological oncologist will try to remove all of the cancer along with some of the surrounding healthy tissue (called a margin). This helps reduce the risk of the cancer coming back. Some lymph nodes in your groin may also be removed.

How much of the vulva is removed depends on the location of the tumour and how far the cancer has spread. Your gynaecological oncologist will talk to you about the risks and possible complications of surgery, as well as side effects. 

“I asked my husband to take pictures of my vulva so we could see it and talk about what happened. This helped him understand what I’d been through.” Trudy

Types of vulvar surgery
Wide local excision Used for precancerous changes; the surgeon cuts out the precancer only.
Radical local excision Used for small cancers; the surgeon cuts out the cancer and a margin of healthy tissue.
Partial radical vulvectomy Used when the cancer is on one side of the vulva only; the surgeon removes a large part of the vulva and nearby lymph nodes.
Complete radical vulvectomy Used when the cancer covers a large area of the vulva; the surgeon removes the whole vulva (including the clitoris), surrounding deep tissue and nearby lymph nodes.
Lymph node surgery

You may need to have lymph nodes in the groin removed to check for the spread of cancer. This may be through a:

  • sentinel lymph node biopsy – used for some cancers less than 4 cm to find the lymph node that the cancer is most likely to spread to first (the sentinel node). If cancer is found in the sentinel lymph node, you will need a separate procedure called a lymphadenectomy
  • lymphadenectomy (lymph node dissection) – to remove some or all of the lymph nodes from one or both sides of the groin.
Reconstructive surgery You may be able to have the skin around the wound drawn together with stitches. These will dissolve and disappear as the wound heals. If a large area of skin is removed, you may need a skin graft or skin flap. In this case, flaps of skin in the vulvar area are moved to cover the wound. Rarely, the surgeon may take a thin piece of skin from another part of your body (usually your abdomen or thigh) and stitch it over the wound.

 

Recovery after surgery

How long recovery takes will depend on the type of surgery you had and your general health. If only a small amount of skin is removed from the vulva, the wound is likely to heal quickly and you may go home in 1–2 days. If the surgeon removed a large amount of vulvar skin or some lymph nodes, recovery will take longer. You may spend up to a week in hospital.

  • Drains: If lymph nodes are removed, you may have a tube placed into the groin to drain fluid from the surgical site into a bag. This is called a surgical drain and it may be removed before you leave hospital. If you go home with the drain still in place, nurses will show you how to look after the drain and your doctor will tell you when it can be removed.
  • Pain: You will be given medicine to control any pain. Your doctor will tell you how soon you can stand up and walk after surgery, and how to avoid the stitches coming apart. It may be more comfortable to wear loose-fitting clothing without underwear.
  • Catheter: You may have a tube called a catheter to drain urine from your bladder into a bag. The catheter may be removed the day after surgery or stay in place for several days, depending on how close the surgery was to the opening of the bladder.

Taking care of yourself at home after surgery

  • Wound care: Before you leave hospital, the nurse will show you how to look after the wound at home. You will need to wash it with water 4 times a day using a handheld shower head or soft, squeezable plastic water bottle. You will also need to rinse the vulva after urinating or having a bowel movement. Dry the vulva well by patting dry with a clean towel or using a hairdryer on a low setting. If the area is numb, be careful when patting it dry. Infection is a risk after vulvar surgery, so report any redness, pain, swelling, wound discharge or unusual smell to your doctor or nurse.
  • Using the toilet: If the opening to your urethra is affected, you may find that going to the toilet is different. The urine stream might spray in different directions or go to one side. It may help to sit down towards the back of the toilet seat or adjust your position to control the flow of urine. You can also use a female urinary device, which is a soft funnel that helps direct the flow of urine. You can buy these at camping stores or online.
  • Rest: You will need to take things easy and get plenty of rest in the first week. Avoid sitting for long periods of time if it is uncomfortable, or try sitting on a pillow or two rolled towels to support the buttocks and reduce pressure on the wound.
  • Emotions: If part of your genital area is removed, you may feel a sense of loss and grief. You may also think differently about your body. It may help to share your feelings with someone you trust or seek professional support.
  • Exercise: Check with your treatment team about when you can start doing your regular activities. You may not be able to lift anything heavy, but gentle exercise such as walking can help speed up recovery. Because of the risk of infection, avoid swimming until your doctor says you can.
  • Driving: You will need to avoid driving after the surgery until your wound has healed and you are no longer in pain. Discuss this issue with your doctor. Check with your car insurer for any restrictions about driving after surgery.
  • Sex: Sexual activity needs to be avoided for about 6–8 weeks after surgery. Ask your doctor when you can restart sexual activity, and explore other ways you and your partner can be intimate.

“My vulva is uneven now, which makes peeing difficult. I used paper toilet seat covers as an instant fix and I purchased a female urination device. It works like a funnel.” Nadine

Radiation therapy

Also known as radiotherapy, radiation therapy uses a controlled dose of radiation to kill or damage cancer cells. The radiation is usually from x-ray beams.

Whether you have radiation therapy depends on the stage of the cancer, its size, and if it has spread to the lymph nodes. You may have radiation therapy:

  • after surgery to help destroy any remaining cancer cells and reduce the risk of the cancer coming back
  • before surgery to shrink the cancer and make it easier to remove
  • as the main treatment for advanced vulvar cancer, often combined with chemotherapy.

Radiation therapy for vulvar cancer is usually delivered from outside the body (external beam radiation therapy or EBRT). You will lie on a treatment table while a machine, called a linear accelerator, directs radiation towards the affected areas of the pelvis. You will have a planning session, including a CT or MRI scan, to work out where to direct the radiation beams. This may take up to 45 minutes. The actual treatment takes only a few minutes each time and is painless.

EBRT for vulvar cancer is usually given daily, Monday to Friday, over 5–6 weeks. Your radiation oncologist will discuss your treatment plan and side effects.

Chemotherapy

Chemotherapy uses drugs to kill or slow the growth of cancer cells. The aim is to destroy cancer cells while causing the least possible damage to healthy cells. You may have chemotherapy:

  • during a course of radiation therapy, to make the radiation treatment more effective (known as chemoradiation or chemoradiotherapy)
  • to control cancer that has spread outside the vulva.

The drugs are usually given by injection into a vein (intravenously). You will usually have several treatment sessions, with rest periods in between. Treatment is usually given during day visits to a hospital or clinic as an outpatient. Rarely, you may need to stay in hospital for a couple of nights.

Vulvar cancer clinical trials

Cancer clinical trials are research studies that test whether a new approach to prevention, screening, diagnosis, or treatment works better than current methods and is safe.

There are clinical trials for vulvar cancer open to recruitment in Victoria. This list shows the most recently updated vulvar cancer studies on the Victorian Cancer Trials Link (VCTL).

Visit the VCTL to find more vulvar cancer clinical trials.

Treatment side effects

All treatments can have side effects. Some side effects go away quickly; others can take weeks, months or even years to improve. Your treatment team will discuss the likely side effects with you before treatment starts.

Let your treatment team know about any symptoms or side effects you have. They may be able to suggest ways to reduce or manage any discomfort.

Common treatment side effects

  • Surgery: fatigue; change in how the genitals look; scar tissue; difficulty urinating; lymphoedema (if lymph nodes removed); pain; sexual problems; trouble controlling the flow of urine (urinary incontinence); bowel changes
  • Radiation therapy: fatigue; skin reactions (dry, itchy and tender skin, peeling skin); sore and swollen vulva; changes to the vagina (dryness, shortening, narrowing); vaginal discharge; loss of pubic hair; bladder and bowel changes; urinary incontinence; lymphoedema; sexual problems; menopause (when periods stop)
  • Chemotherapy: fatigue; nausea; increased risk of infection

See our booklets on surgery, radiation therapy and chemotherapy for ways to manage common side effects.

Longer-term side effects

Treatment for vulvar cancer can sometimes lead to long-term, life-changing side effects.

Changes to the vulva and vagina

Surgery to the vulva can cause physical changes. If the labia have been removed, you will be able to see the opening to the vagina more clearly. If scar tissue has formed around the outside of the vagina, the entrance to the vagina will be narrower. If the clitoris has been removed, there will now be an area of flat skin without the usual folds of the vulva.

Radiation therapy may make your skin dry, itchy and tender in the treatment area. Skin reactions will gradually improve after treatment finishes. Pelvic radiation therapy can also narrow the vagina, causing thinning of the vaginal walls and dryness. You may be offered vaginal dilators to help keep the vagina open and prevent it from closing over, potentially making sex and follow-up pelvic examinations more comfortable. Your treatment team may also suggest using hormone creams or vaginal moisturisers to help with vaginal discomfort and dryness.

Sex

Sometimes surgery or radiation therapy can affect nerves and tissue in the pelvic area, causing scarring, narrowing of the vagina, swelling and soreness. This can make sex painful. If you’ve had your clitoris removed, you may have difficulty reaching orgasm. Take time to explore and touch your body to find out what feels good. Using extra lubrication may make sexual activity more comfortable. Choose a water-based or silicone-based gel without perfumes or colouring. See Sexuality, Intimacy and Cancer for more information.

Sexual desire (libido)

Changes to the look and feel of your vulva can cause embarrassment, loss of sexual pleasure, and less interest in sex. The experience of having cancer can also reduce your desire for sex. You may wish to have counselling to help understand the impact treatment has had on your sexuality. A sex therapist or psychologist can help you (and your partner if you have one) adjust to changes and find new ways to express intimacy and enjoy sex. Ask your doctor for a referral.

Bladder changes

Incontinence is when urine leaks from your bladder without your control. Bladder control may change after surgery or radiation therapy to the vulva. Some people find they need to pass urine more often or feel that they need to go in a hurry. Others may leak a few drops of urine when they cough, sneeze, strain or lift. For ways to manage incontinence, talk to the hospital continence nurse or physiotherapist.

Lymphoedema

If the lymph nodes have been removed during surgery or scarred during radiation therapy, lymph fluid can build up in the tissues under the skin. This is called lymphoedema, and it can cause swelling in the legs, vulva or mons pubis. Lymphoedema may appear during treatment or months or years late. Not everyone who is at risk will develop swelling. It is important to seek help, because early diagnosis and treatment can lead to better outcomes. A lymphoedema practitioner can develop a treatment plan for you. 

Coping with your emotions

It is common to feel shocked and upset about having cancer in one of the most intimate and private areas of your body. You may feel a wide variety of emotions after the diagnosis and during treatment, including anger, fear, anxiety, sadness and resentment.

Having parts of your vulva, including the clitoris, removed can affect your self-image. If you decide to look at your vulva, it is natural to be shocked by any changes. You may find that your sense of femininity or identity has been affected.

Try to see yourself as a whole person (body, mind and personality), instead of focusing on the changes. It is important to give yourself and those around you time to deal with the emotions that a diagnosis of vulvar cancer can cause. For support, call Cancer Council 13 11 20 or see Emotions and Cancer.

Follow-up appointments

After treatment, you will have check-ups every 3–12 months for several years to monitor your health, manage any ongoing side effects and check that the cancer hasn’t come back or spread. Your doctor will talk to you about your follow-up schedule, which will depend on the risk of the cancer coming back.

Check-ups will become less frequent if you have no further problems. Let your doctor know immediately of any health concerns between appointments.

If the cancer comes back

For some people, vulvar cancer does come back after treatment, which is known as a recurrence. Depending on where the cancer recurs, treatment may include surgery, chemoradiation, radiation therapy or chemotherapy. You may also consider joining a clinical trial to try new treatments. For more information, talk to your doctor about suitable trials or visit australiancancertrials.gov.au.

In some cases of advanced cancer, treatment will focus on managing any symptoms, such as pain, and improving your quality of life without trying to cure the disease. This is called palliative treatment.

Understanding Vulvar Cancer

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

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Treatment for vulvar cancer