If You Have Vulvar Cancer
What is vulvar cancer?
Cancer can start any place in the body. Vulvar cancer starts in the vulva. It starts when cells in the vulva grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.
Cancer cells can spread to other parts of the body. Cancer cells in the vulva can sometimes travel to the bladder and grow there. When cancer cells do this, it’s called metastasis. To doctors, the cancer cells in the new place look just like the ones from the vulva.
Cancer is always named for the place where it starts. So if vulvar cancer spreads to the bladder (or any other place), it’s still called vulvar cancer. It’s not called bladder cancer unless it starts from cells in the bladder.
The vulva
Ask your doctor to use this picture to show you where the cancer is.
The vulva
The vulva is the outside part of a woman’s genitals:
- On the outside are 2 folds of skin. The outer folds are called the labia majora. The inner folds are called the labia minora. The folds cover and protect the opening of the urethra (the tube that carries urine out of the body) and the vagina (the opening to the female organs inside the body).
- The inner folds form a hood of skin called the prepuce or the hood of the clitoris.
- Below the prepuce is the clitoris. This is a sensitive piece of tissue that swells with blood when stimulated.
- The fourchette is at the bottom of the inner folds where they meet.
- The perineum is the skin between the fourchette and the anus, which is where stool leaves the body.
Different kinds of vulvar cancer
There are a few kinds of vulvar cancer. The most common kind is squamous cell carcinoma. This kind starts in the cells that cover the surfaces of the vulva.
Your doctor can tell you more about the kind you have.
Questions to ask the doctor
- Why do you think I have cancer?
- Is there a chance I don’t have cancer?
- Would you please write down the kind of cancer you think I might have?
- What will happen next?
How does the doctor know I have vulvar cancer?
Some signs of vulvar cancer are skin changes in part of the vulva, a new bump, skin feeling thick or rough, itching, burning, an open sore, and new bleeding, spotting, or discharge from the vagina. The doctor will ask you questions about your health and do a physical and pelvic exam.
Tests that may be done
If signs are pointing to vulvar cancer, tests will be done. Here are some of the tests you may need:
Biopsy: In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have cancer.
Pelvic exam under anesthesia: Drugs may be used to make you sleep while the doctor takes a close look at the vulva and looks for signs that the cancer has spread.
MRI scan: Uses radio waves and strong magnets instead of x-rays to make detailed pictures. This test may be used to see if the cancer has spread.
CT or CAT scan: This test uses x-rays to make detailed pictures of the inside of your body. This test may be done to look for cancer or to see if it has spread.
PET scan: PET scans use a kind of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. This test looks at the whole body. It can help if the doctor thinks the cancer has spread but doesn’t know where.
Questions to ask the doctor
- What tests will I need?
- Who will do these tests?
- Where will they be done?
- Who can explain them to me?
- How and when will I get the results?
- Who will explain the results to me?
- What do I need to do next?
How serious is my cancer?
If you have vulvar cancer, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage is based on how much the cancer has grown or spread through the vulva. It also tells if the cancer has spread to other parts of your body.
Your cancer can be stage 0, 1, 2, 3, or 4. Stage 0 is also called carcinoma in situ. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the vulva. Be sure to ask the doctor about the cancer stage and what it means for you.
Questions to ask the doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think I’ll live?
- What will happen next?
What kind of treatment will I need?
Treatment for vulvar cancer depends mainly on the stage of the cancer.
Surgery is the main treatment for most women. Sometimes other treatments are also used. The treatment plan that’s best for you will depend on:
- The type of vulvar cancer
- The stage of the cancer
- The chance that a type of treatment will cure the cancer or help in some way.
- Your age and ov