The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 2, 2021.

About vulvar cancer

Vulvar cancer begins in the tissues of the vulva, which is the external part of the female genitalia. The vulva includes the labia minora and labia majora (inner and outer lips, or skin folds), clitoris and vaginal opening. Vulvar cancer most often affects the vaginal lips.

Cancer is diagnosed when healthy cells mutate (abnormally change) and form a mass. Precancerous cells typically develop on the vulva in the early stages of the disease. A patient with a persistent lesion on the vulva should be seen by a gynecologist.

Cancer of the vulva is relatively rare. The American Cancer Society estimates that more than 6,120 women in the United States will be diagnosed with this form of cancer in 2021. Squamous cell cancer is the most common type of vulvar cancer.

What causes vulvar cancer?

While the exact cause of vulvar cancers is not known, several factors may increase the risk of developing the disease.

Risk factors for vulvar cancer may include:

  • Tobacco use
  • Lichen sclerosus, characterized by thin, itchy vulvar skin
  • Vulvar intraepithelial neoplasia (VIN), previously called vulvar dysplasia, a precancerous condition in which abnormal cells are restricted to the top layer of skin of the vulva (also known as the epithelium)
  • Human papillomavirus (HPV infection)
  • Previous diagnosis of cervical cancer

Learn about risk factors for vulvar cancer

Who gets vulvar cancer?

Approximately 80 percent of vulvar cancer cases occur in women over the age of 50. More than half of cases occur in women aged 70 or older. Women who smoke are at increased risk of vulvar cancer.

Vulvar cancer types

Types of vulvar cancer may include:

  • Squamous cell carcinoma, the most common type of vulvar cancer
  • Adenocarcinoma, which usually begins in the Bartholin's glands, just inside the opening of the vagina, and is related to Paget’s disease, a skin cancer where adenocarcinoma cells are restricted to the layer of the skin of the vulva
  • Vulvar melanoma and basal cell carcinomas and sarcomas, which may also be forms of vulvar adenocarcinomas

Learn more about vulvar cancer types

Vulvar cancer symptoms

Symptoms of vulvar cancer may include:

  • Red, pink or white bump(s) with a raw or wart-like surface
  • A white area that feels rough
  • Persistent itching
  • Pain or a burning feeling while urinating
  • Bleeding and discharge not associated with menstruation
  • An open sore or ulcer that lasts more than a month
  • Cauliflower-like growth similar to a genital wart (in women with the verrucous carcinoma subtype of squamous cell vulvar cancer)
  • Lump on either side of the vaginal opening (in women with Bartholin gland cancer)
  • Soreness and a red, scaly area (in women with Paget’s disease of the vulva)

Learn about vulvar cancer symptoms

Diagnosing vulvar cancer

The first step in diagnosing vulvar cancer involves a thorough pelvic exam. The doctor will examine your vulvar area, perineum, anus, rectum, bladder, ovaries, vagina and uterus for unusual changes. A Pap test and/or HPV test may also be performed.

Diagnostic tests to evaluate vulvar cancer may also include:

  • X-ray
  • Computed tomography scan (CT scan)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)/CT scan
  • Proctosigmoidoscopy, colposcopy and cystoscopy
  • Sentinel lymph node biopsy

Learn about diagnostic procedures for vulvar cancer

Vulvar cancer treatments

According to the American Cancer Society, the five-year survival rate for vulvar cancer ranges from 19 percent for cancer that has spread to distant parts of the body to 86 percent for cancer that has not spread beyond the vulva.

Treatment options for vulvar cancer may include:

  • Laser surgery to remove precancerous cells
  • Local excision, also called wide excision, which removes the cancer cells and some of the nearby tissue (the margin), and possibly nearby lymph nodes
  • Vulvectomy, removing all or part of the vulva and sometimes the surrounding supporting tissue (radical vulvectomy)
  • Pelvic exenteration, an extensive, rare type of surgery that may remove the uterus, cervix, vagina, ovaries, bladder, rectum and nearby lymph nodes if cancer returns after radiation therapy
  • Chemotherapy
  • Radiation therapy, including external beam radiation therapy (EBRT), high-dose rate (HDR) brachytherapy (internal radiation) and TomoTherapy®

Learn about treatment options for vulvar cancer