Vulvar cancer is a relatively uncommon gynecologic cancer, yet its impact on a woman’s physical health, emotional well-being, body image, and sexual function can be profound. Because symptoms may resemble common skin conditions, irritation, or infections, the disease is not always recognized immediately. Some women live with itching, soreness, or changes to their vulvar skin for months before learning that something more serious is happening.
A diagnosis can bring fear, uncertainty, and difficult decisions about treatment. Surgery, radiation therapy, and other treatments may be lifesaving, but they can also affect sensation, comfort, mobility, and the ability to experience intimacy.
For many women, the challenges do not end when treatment is complete. Healing may involve managing physical changes, coping with fear of recurrence, rebuilding confidence, and discovering new ways to experience pleasure and connection.
Understanding vulvar cancer, recognizing its warning signs, and learning about available treatment and supportive care can help women navigate this experience with greater knowledge and confidence.
What Is Vulvar Cancer?
The vulva is the external portion of the female genital anatomy. It includes the labia majora (outer lips), labia minora (inner lips), clitoris, the opening of the vagina, the opening of the urethra, and nearby glands and tissues.
Vulvar cancer occurs when abnormal cells in this area grow uncontrollably and form a malignant tumor. It is different from vaginal cancer, which begins inside the vaginal canal, and cervical cancer, which begins in the cervix.
In the United States, approximately 7,130 new cases of vulvar cancer are estimated for 2026. Although it is uncommon, it can have significant consequences when diagnosis or treatment is delayed. Most cases occur in older women, but younger women can also develop the disease.
Types of Vulvar Cancer
There are several types of vulvar cancer, classified according to the cells in which the cancer begins.
Squamous cell carcinoma is the most common type, accounting for approximately 90% of vulvar cancers. It develops in the thin, flat cells that cover the vulvar surface.
Other, less common types include:
- Vulvar melanoma: Develops from pigment-producing cells and may appear as a dark or changing lesion, although not all lesions are dark.
- Vulvar adenocarcinoma: Develops in glandular tissue, including certain glands in the vulvar area.
- Vulvar basal cell carcinoma: A relatively uncommon skin cancer that often grows slowly.
- Rare vulvar sarcomas and other tumors: Develop from connective tissue or other cell types.
The specific cancer type matters because it influences how the disease behaves and which treatments may be appropriate.
What Causes Vulvar Cancer?
There is no single cause of vulvar cancer. Several factors can contribute to its development.
Human papillomavirus (HPV): Persistent infection with certain high-risk HPV types contributes to many vulvar cancers, particularly those associated with vulvar precancerous changes.
Age: Vulvar cancer becomes more common with increasing age, although HPV-associated cases may occur in younger adults.
Vulvar intraepithelial neoplasia (VIN): This is a precancerous condition in which abnormal cells develop in the vulvar skin. Certain forms of VIN can progress to invasive cancer if not appropriately managed.
Lichen sclerosus and chronic inflammation: Lichen sclerosus is a long-term inflammatory skin condition that can cause itching, fragile skin, pain, and scarring. It is associated with an increased risk of certain types of vulvar squamous cell carcinoma.
Smoking and immune suppression: Smoking and conditions or medications that weaken the immune system can increase risk in some circumstances.
Having one or more risk factors does not mean a woman will develop vulvar cancer. Some women diagnosed with the disease have no obvious risk factors.
HPV is common, and an HPV-associated diagnosis is not evidence of infidelity or wrongdoing. HPV may remain undetected for years before causing a problem.
Recognizing the Symptoms of Vulvar Cancer
One of the difficulties with vulvar cancer is that its early symptoms can resemble benign conditions, including yeast infections, dermatitis, eczema, or other inflammatory skin disorders.
Symptoms may develop gradually and can vary from one person to another.
Possible warning signs include:
- Persistent vulvar itching that does not improve with appropriate treatment.
- Burning, soreness, or tenderness around the vulva.
- A lump, thickened area, or wart-like growth.
- A sore, ulcer, or wound that does not heal.
- Changes in skin color, including red, white, dark, or unusually pigmented areas.
- Bleeding that is not associated with an expected menstrual period.
- Unusual discharge or persistent moisture from a lesion.
- Pain during sexual activity.
- Pain or burning when urinating.
- Swelling in the vulva or groin.
- A new lump in the groin, which may indicate enlarged lymph nodes.
Not everyone experiences all these symptoms. Some women have little or no discomfort in the early stages.
Persistent or unexplained vulvar changes deserve medical evaluation. A clinician may examine the area and recommend a biopsy if a suspicious lesion is present. A biopsy is often necessary to determine whether cancer is present; symptoms or appearance alone cannot establish the diagnosis.
Do not assume that persistent itching is simply an infection, especially when treatment has not helped. Early assessment can make a meaningful difference.
How Is Vulvar Cancer Diagnosed and Staged?
Diagnosis usually begins with a discussion of symptoms and medical history, followed by an examination of the vulva and surrounding areas.
If an abnormal area is identified, a biopsy may be performed to examine the tissue under a microscope. Additional examinations or imaging may be needed to determine the extent of the disease.
Doctors assess whether the cancer is limited to the vulva, has spread to nearby lymph nodes, or has reached more distant parts of the body.
The stage influences treatment planning and prognosis. Early-stage disease may be treated with surgery alone, while more extensive disease may require a combination of surgery, radiation therapy, and chemotherapy.
In many cases, vulvar cancer can be treated with the goal of cure, especially when detected before it spreads to lymph nodes or distant organs.
Citations.
Empowering Intimacy
Foundation for Women’s Cancer
ACS
Mayo Clinic