Vulvar Cancer

What Is It?

Vulvar cancer occurs in the vulva, the external genital area of a woman's reproductive system. Vulvar cancer can affect any part of the vulva, including the labia, the mons pubis (the skin and tissue that cover the pubic bone), the clitoris, or the vaginal or urethral openings. Most commonly, it affects the inner edges of the labia majora or labia minora.

According to the American Cancer Society, more than 90 percent of vulvar cancers are squamous-cell carcinomas. This type of cancer originates in the squamous cells, the primary type of cells that make up the skin. Squamous-cell cancer usually develops slowly over many years. The condition commonly is preceded by the development of abnormal cells in the surface layer of the skin, called the epithelium. Development of abnormal cells on the surface layer of the skin is called vulvar intraepithelial neoplasia.

The second most common form of cancer of the vulva is melanoma. The American Cancer Society estimates that melanoma accounts for about 4 percent of vulvar cancers and usually occurs on the labia minora or the clitoris. More uncommon forms of vulvar cancer include Bartholin gland adenocarcinoma and Paget's disease. Less than 2 percent of vulvar cancers are sarcomas, cancer of the connective tissue underlying the skin. Sarcomas can occur at any age.

According to the American Cancer Society, vulvar cancer is uncommon, accounting for approximately 4 percent of cancers of the female reproductive system and 0.6 percent of all cancers in women. Seventy-five percent of women who have vulvar cancer are over 50 years old, and two-thirds of women are older than 70 when first diagnosed. However, more cases are occurring in younger women; 15 percent of new cases appear in women under 40 years of age.

Symptoms

Common symptoms of vulvar cancer and vulvar intraepithelial neoplasia include:

• Persistent itching or burning pain anywhere on the vulva
• A red, pink, or white lump with a wartlike or raw surface
• A white and rough area on the vulva
• Painful urination or bleeding
• A discharge not associated with your period
• An ulcer that lasts more than a month

Signs of vulvar melanoma may include a black or brown raised area or a change in the size, shape or color of a pre-existing mole.

Signs of a Bartholin's gland adenocarcinoma include a lump at the opening to the vagina. A lump can also be the more common benign cyst, but you should have an evaluation to make sure it is not cancerous. A sore, red, scaly area of the vulva can signal Paget's disease.

Keep in mind that some signs and symptoms of vulvar cancer also can occur with other, noncancerous conditions, such as infection or trauma.