Translate this page: EnglishEspañol
Formerly known as California Oncology of the Central Valley Request an Appointment
Translate this page: EnglishEspañol
Formerly known as California Oncology of the Central Valley Request an Appointment

Vulvar Cancer

What Is Vulvar Cancer?

The vulva consists of the labia, clitoris, mons pubis, vestibule, and perineum. When vulvar cells grow out of control, they form a tumor known as vulvar cancer. Most vulvar cancers involve the labia majora, or outer lips. The cancer is present in multiple locations in about 5% of cases. It most commonly affects post-menopausal women, but because HPV is a risk factor, the rate of vulvar cancers seen in younger women has been increasing.

Diagram of the vulva, vagina, labia, and clitoris

Types of Vulvar Cancer

As with the vagina, the vulva is mostly made up of epithelial skin cells, so many of the cancers that affect the vulva are skin-related.

Vulvar Squamous Cell Carcinoma

This is the most common type of vulvar cancer, comprising about 90% of the diagnoses. It develops at the edges of the labia or in the vagina, usually growing slowly. Vulvar intraepithelial neoplasia (VIN) is a precancerous skin condition that can eventually develop into vulvar squamous cell carcinoma if left untreated.

Vulvar Melanoma

Melanoma, a type of skin cancer, is the second most common type of vulvar cancer, making up less than 5% of cases.

Vulvar Soft Tissue Sarcoma

Stromal tissue holds the ovary together and produces hormones. Tumors that develop in this tissue can result in an overproduction of female hormones, a notable symptom. 

Vulvar Adenocarcinoma

Even more rare are vulvar adenocarcinomas, which form in the glands near the vulva, most often the Bartholin’s glands at the opening of the vagina.

Vulvar Cancer Diagnosis

Risk factors for this type of cancer include an HPV infection, HIV, smoking, having gone through menopause, and having previously had another gynecologic cancer or melanoma. VIN is also a risk factor.


  • Itching
  • Abnormal bleeding
  • Abnormal vaginal discharge
  • Lesions or skin growths
  • Pain during intercourse

Tests & Exams

Some tests are performed by primary care providers or OB/GYNs as part of routine screenings, while others are done after receiving abnormal results to learn more.

  • Biopsy
  • CT scan
  • MRI
  • Endoscopy


Staging is a measurement system based on the size of the tumor and how far it has spread in the body. Using the TNM system, all of the information from tests and examinations is then combined and assessed to determine the stage, from I (one) to IV (four). Generally, the higher the stage, the more serious the cancer.

TNM System

(Tumor – node – metastasis system)

  • T: shows how far the main tumor has spread into nearby tissue
  • N: shows whether or not the nearby lymph nodes have cancer in them
  • M: shows if the cancer has spread (or metastasized) to distant organs in the body
Stage 0
Stage I
Stage II
Stage III
Stage IV

Stage 0

If left untreated, these cells will likely become invasive vulvar cancer. This stage is also called carcinoma in situ or vulvar intraepithelial neoplasia (VIN).

Grade 0 Vulvar Cancer

Stage I

Cancer cells have formed and can be found in the vulva and/or perineum.

Stage I Vulvar Cancer

Stage II

Cancer cells have spread to the anus, the lower portion of the vagina, or the lower portion of the urethra.

Stage II Vulvar Cancer

Stage III

Cancer has spread to the anus, lower vagina, lower urethra, and/or nearby lymph nodes.

Stage III Vulvar Cancer

Stage IV

Cancer has spread beyond nearby tissues to other organs and/or lymph nodes in the body, or it has caused lymph nodes to become stuck or grow ulcers.

Stage IV Vulvar Cancer


The grade of an illness refers to how the cancer cells look when compared to normal cells. The lower the number, the more cancer cells look like the normal cells. This means the cancer is less likely to spread and may be easier to treat. Grade 3 looks very different from normal cells and is likely to grow and spread faster.

Diagram showing the prognosis based on grade of cancer

Vulvar Cancer Treatment

Like vaginal cancer, vulvar cancer is primarily treated with chemotherapy, radiation, surgery, or some combination. Each person’s treatment plan is customized based on their cancer type and stage.

In-Office Therapies

Other Courses of Treatment

Radiation Therapy

This type of treatment uses radiation to kill cancer cells or stop them from growing. The method and dosage of radiation therapy are dependent on the extent of the cancer.


In more serious cases of vulvar cancer, surgery may be used in conjunction with other forms of treatment to remove the cancerous cells. A vulvectomy is the removal of part or all of the vulva, sometimes including the surrounding lymph nodes and tissue.