Vulval cancer (cancer of the vulva) is an uncommon cancer. It usually affects women over 55 although it can also affect younger women. The commonest symptoms are a persistent itch or pain in the vulval area. Many vulval cancers start as a sore or lump in the vulva. Vulval cancer is usually treated by an operation to remove the cancer. Most vulval cancers can be cured. The outlook is good in women who have small cancers that have not spread.
Vulval cancer can occur on any part of the vulva. It most commonly develops on the inner edges of the labia majora and the labia minora. It can also sometimes affect the clitoris or the Bartholin glands (small glands on each side of the vagina). It can also occasionally start on the perineum (the skin between the vulva and the anus).
Most vulval cancers are squamous cell cancers. This means they have developed from the skin cells in the outer layer of the vulva. Around 4 in 100 cases of vulval cancers are due to a melanoma which develops from cells in the skin that cause pigmentation.
Causes of Vulval Cancer
Vulval cancer is an uncommon cancer. There are around 1000 new cases each year in the UK. It usually affects women between the ages of 55 and 75. However, it is becoming more common in younger women. In many cases, the reason why a vulval cancer develops is not known. However, there are factors which are known to alter the risk of vulval cancer developing. These include:
- Age. Most cases develop in people over the age of 55.
- A condition called VIN (vulval intraepithelial neoplasia) can occur in the skin of the vulva. The most common symptom of VIN is a persistent itch. Areas of skin affected by VIN can look thickened and swollen, with red, white or dark coloured patches. Around one third of vulval cancers develop in women who have VIN.
- Human papilloma virus (HPV). This is an infection which is passed between people during sex. Some types of HPV, including types 16, 18 and 31 can lead to VIN developing. However, more that half of all vulval cancers are not related to HPV infection.
- Lichen sclerosus and lichen planus. These are two conditions that cause long-term inflammation of the skin in the vaginal area. Although almost two-thirds of vulval cancers occur in women who have lichen sclerosus, only between one and two in a hundred women who have lichen sclerosus will develop vulval cancer.
- Genital herpes. Infection with the genital herpes virus type 2 increases the risk of vulval cancer. However, most women who have genital herpes do not develop vulval cancer.
- Smoking. Smoking increases the risk of developing both VIN and vulval cancer.
Note: vulval cancer is not an inherited condition and does not usually run in families.
Symptoms of Vulval Cancer
The symptoms of vulval cancer can vary between women. They may include:
- A persistent itch.
- Pain or soreness in the vulval area.
- Thickened, raised, red, white or dark patches on the skin of the vulva.
- An open sore or growth that does not improve.
- Burning pain when you pass urine.
- Vaginal discharge or bleeding.
- A lump or swelling in the vulva.
- A mole on the vulva that changes shape or colour.
Note: All these symptoms can be caused by other conditions which are not cancer. If you have any of these symptoms, then you should see your doctor.
Vulval cancer can take many years to develop as it usually grows slowly. As with other cancers, it is easier to treat and cure if it is diagnosed at an early stage.
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