From the Guidelines
Vulvar cancer typically presents with symptoms such as persistent itching, pain, burning, or tenderness in the vulvar area, and risk factors include increasing age, human papillomavirus (HPV) infection, and smoking, as outlined in the NCCN Clinical Practice Guidelines in Oncology 1. The signs and symptoms of vulvar cancer can vary, but common presentations include:
- Visible changes such as lumps, sores, warts, or skin discoloration
- Abnormal bleeding or discharge not related to menstruation
- Changes in the appearance of moles or freckles on the vulva
- Persistent itching, pain, burning, or tenderness in the vulvar area These symptoms require immediate medical attention as early detection significantly improves treatment outcomes 1. Risk factors for vulvar cancer include:
- Increasing age, with most cases occurring in women over 60
- Human papillomavirus (HPV) infection
- Smoking
- A weakened immune system
- Chronic vulvar conditions like lichen sclerosus
- History of precancerous vulvar conditions
- Previous skin cancer or melanoma Regular gynecological examinations are essential for early detection, especially for women with multiple risk factors 1. Preventive measures such as HPV vaccination can help prevent the infections that may lead to vulvar cancer, and practicing safe sex reduces the risk of HPV transmission 1. Maintaining good vulvar hygiene and avoiding irritants can help prevent chronic inflammation that might contribute to cancer development 1. Women should perform regular self-examinations and report any unusual changes to their healthcare provider promptly 1.
From the Research
Signs and Symptoms of Vulvar Cancer
- Pruritus is the most common symptom of vulvar cancer, as reported in studies 2, 3, 4, 5
- Other symptoms include bleeding, skin color change, skin lesions, and dysuria 2, 5
- Vulvar pain or a lump/ulcer may also be present 3, 4
- Some cases of vulvar cancer may be asymptomatic 3, 4
Risk Factors for Vulvar Cancer
- Human papillomavirus (HPV) infection is a risk factor for vulvar intraepithelial neoplasia (VIN) and squamous cell vulvar cancer 2, 5
- Cigarette smoking is a risk factor for VIN and vulvar cancer 2
- Chronic inflammatory skin disorders, such as lichen sclerosus, are associated with an increased risk of vulvar cancer 2
- Immunosuppression is also a risk factor for VIN and vulvar cancer 2
Types of Vulvar Cancer
- Squamous cell carcinoma is the most common type of vulvar cancer, accounting for the majority of cases 2, 3, 4, 5
- Malignant melanoma is the second most common type of vulvar cancer 2
- Other types of vulvar cancer include basal cell carcinoma and Paget disease of the vulva 6
Diagnosis and Treatment of Vulvar Cancer
- Diagnosis is typically made by skin biopsy 2, 3, 4
- Treatment depends on the type and stage of cancer, and may include surgical excision, chemoradiation, or other therapies 2, 3, 4, 5
- Early detection and treatment are important for improving prognosis, with a 5-year survival rate of greater than 85% for stage I cancer 2