Vulvar cancer

The term “vulvar cancer” refers to cancer of a woman’s external genital tissues, known as the vulva. Vulvar cancer is rare in the United States, accounting for less than 1 percent of cancers in women. Most vulvar cancers begin in the cells of the outer vulva lips. Vulvar cancer develops slowly, first making precancerous changes called vulvar intraepithelial neoplasia (VIN).

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Symptoms

Women with VIN usually do not have symptoms. However, once this cancer develops, almost all women have symptoms. Vulvar cancer signs and symptoms can include:

• Abnormal vaginal bleeding
• Changes in the color or texture of the vulva
• Chronic vulvar itching
• Vaginal pain, burning, or tenderness
• Painful urination
• Persistent lump, growth, or sore on the vulva
• Wart-like growths

Women with general symptoms, such as itching, may not realize it could be a symptom of a serious condition. Many of these symptoms are also present with more common conditions, such as infections. Visiting your gynecologist for a diagnosis is the only way to know for sure. Whatever the cause, seeking early treatment generally improves outcomes.

Causes

There are several risk factors for vulvar cancer, but a distinct cause has not yet been identified. Many cancers are caused by DNA mutations. Mutations pertaining to cancer of the vulva are not inherited at birth but instead appear during the course of life. These mutations can be random or acquired from exposure to cancer-causing chemicals, such as those in tobacco smoke.

In many cases of vulvar cancer, exposure to human papillomavirus (HPV) seems to have an important role. Vulvar cancers in younger women are often linked to HPV. In older women, lichen sclerosis, a vulvar skin disorder, may be related to the development of cancerous cells.

Risk factors

Certain risk factors can increase your likelihood of developing vulvar cancer. These include:

• Being over 50 years old (vulvar cancer in younger women is usually related to human papillomavirus, or HPV, infection)
• HPV infection, which may be responsible for about half of vulvar cancer cases
• Lichen sclerosis, a vulvar skin disorder
• A history of melanoma or precancerous changes in the vulva, vagina, or cervix
• A history of smoking
• A weakened immune system, which may be due to medication or HIV infection

Some of these risk factors you can control, like whether or not you smoke, but many are not controllable, such as age.

Prevention

While vulvar cancer cannot be entirely prevented, there are steps you can take to lower your risk. The best thing that you can do is avoid HPV infection. HPV is quite common and can be hard to avoid. It is spread through skin-to-skin contact. Using condoms can lower your risk of acquiring HPV, but will not protect you entirely. There are also vaccines that protect you against certain HPV infections.

Additionally, you can avoid smoking and get regular pelvic checkups. When your doctor performs a Pap test, they check the cells of the cervix to see if they are normal. Pelvic exams also allow your medical provider to make sure your other reproductive organs are healthy.

Finally, you may conduct a monthly self-exam of your vulva. Many women choose to use a mirror so they can be aware of any changes in pigmentation, any areas that are white, dark, red, or irritated, and the addition of bumps or ulcers.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.