Cancer of the Vulva

Cancer of the vulva (also called vulval cancer or vulvar cancer) is one of the rarer cancers with just over 1,000 cases diagnosed in the UK each year. Around 80% of vulval cancers are diagnosed in women over 60, but the non-invasiveprecancerous condition vulval intraepithelial neoplasia (VIN) which is the stage before a cancer has developed, tends to be diagnosed earlier, between a woman's 30s and 50s.

The term vulva refers to the external sex genital organs of a woman. The commonest cancer sites are the inner edges of the outer lips (labia majora) and the inner lips (labia minora).

Less often, vulval cancer may involve the clitoris or two small glands each side of the vagina, called the Bartholins glands. It is also sometimes diagnosed in the perineum (the skin between the vulva and the anus).

Vulval cancer does not form quickly. Usually, there is a gradual, abnormal change in the cells. which may develop into cancer. The presence of these abnormal cells is described as pre-cancerous changes. Some of these cell changes will go away without treatment but treatment, if necessary can prevent vulval cancer.

There are several different types of cancer of the vulva which can be identified by biopsy (removing a small piece of tissue):

Squamous cell carcinoma - by far the most common type. About 9 out of 10 vulval cancers (90%) are this type. It usually forms slowly over many years.

Vulval melanoma - the second most common type of vulval cancer. But it is much less common than the squamous cell type. Only about 4 out of every 100 vulval cancers (4%) are melanoma. Melanomas develop from the pigment-producing skin cells that give the skin its colour by producing pigment.

Adenocarcinoma - cancer that develops from glands in the vulval skin. Paget's disease of the vulva is a precancerous condition where adenocarcinoma abnormal cells spread out from these glands and across the skin of the vulva.

Basal cell carcinoma - basal cell carcinoma develops from the deepest layer of skin cells; the basal cells.

Verrucous carcinoma - a slow growing type of squamous cell carcinoma, this type of cancer looks like a large wart.

Sarcoma - cancer that starts in tissue such as muscle or fat under the skin. These cancers tend to grow quite quickly. There are several different types but fewer than 2 out of every 100 vulval cancers (2%) are sarcomas.