Vulvar Cancer: A Comprehensive Guide
Medically reviewed by Andre Stone | MD, University of Pittsburgh School of Medicine on August 24th, 2026.
Published on April 10th, 2026. Updated on August 28th, 2026.
Key Takeaways
Vulvar cancer affects the external female genital area and most commonly occurs after menopause
Persistent itching, unusual lumps, or changes in vulvar skin texture are warning signs that need medical attention
Some vulvar cancers develop from precancerous changes over time, but others may progress more quickly. Report persistent vulvar symptoms or skin changes promptly rather than waiting for a routine checkup.
Treatment often involves surgery, with radiation or chemotherapy used in advanced cases
Early-stage vulvar cancer has excellent survival rates when caught and treated promptly
Overview
Vulvar cancer is a type of cancer that develops in the vulva, the external female genital area. The vulva includes the outer and inner lips of the vagina, the clitoris, and the opening to the vagina. This cancer typically affects older women, with most cases occurring after age 65.
While vulvar cancer is relatively rare, accounting for about 4% of all gynecologic cancers, it's important to recognize its signs early. The disease often develops slowly over many years. Most vulvar cancers are squamous cell carcinomas, which begin in the thin, flat cells that line the vulva's surface.
Early detection makes a significant difference in treatment outcomes. When diagnosed at an early stage, vulvar cancer generally has a better prognosis and may require less extensive treatment. Regular gynecologic exams help identify changes that could indicate cancer development. Finding vulvar cancer early means simpler treatment and better outcomes. Many women don't realize that small changes in their skin can be important warning signs. Your doctor can help you understand what's normal and what needs closer attention.
Symptoms & Signs
Vulvar cancer symptoms can be subtle at first and may be mistaken for other conditions. Many women experience symptoms for months before seeking medical care. Understanding what to look for can help ensure early detection and better treatment outcomes.
Primary Symptoms
Persistent itching or burning that doesn't improve with typical treatments
A lump, bump, or growth on the vulva that may be painful or painless
Skin changes including thickening, color changes, or rough patches
Unusual bleeding or discharge not related to menstruation
Pain or tenderness in the vulvar area, especially during urination or intercourse
When to Seek Care
Contact your healthcare provider if you notice any persistent changes in your vulvar area. Don't ignore symptoms that last more than two weeks or gradually worsen. Pay special attention to any new growths, unusual bleeding, or skin changes that don't heal.
Some symptoms may feel embarrassing to discuss, but doctors see these concerns all the time. It's better to get checked out and find out everything is fine than to wait. Many vulvar problems are not cancer, but only a doctor can tell for sure. Keep notes about your symptoms, including when they started and what makes them better or worse. This information helps your doctor understand what's happening. Be honest about all your symptoms, even if they seem minor.
When to Schedule a Prompt Evaluation
Schedule a prompt medical evaluation if you experience persistent vulvar symptoms that don't respond to basic care measures within two weeks.
Causes & Risk Factors
Age
Most common after age 65, though it can occur in younger women
Genetics
Established risk factors include older age, persistent high-risk HPV infection, smoking, vulvar precancer, immune suppression, and conditions such as lichen sclerosus.
Lifestyle
Smoking increases the risk of vulvar cancer, particularly HPV-related disease, and may make it harder for the immune system to clear HPV.
Other Conditions
Lichen sclerosus, HIV infection, or previous cervical cancer increase vulnerability
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How Vulvar Cancer Is Diagnosed
Diagnosis
Medical History & Physical Examination
Your doctor will ask detailed questions about your symptoms, including when they started and how they've changed over time. They'll inquire about your sexual history, previous HPV infections, and any family history of gynecologic cancers. A thorough pelvic examination allows the doctor to visually inspect the vulvar area for unusual growths, color changes, or texture abnormalities.
During the physical exam, your healthcare provider will carefully examine the entire vulvar region. They may use a magnifying glass or special lighting to get a better view of suspicious areas. The examination also includes checking nearby lymph nodes for signs of cancer spread.
Diagnostic Testing
Biopsy removes a small tissue sample for laboratory analysis to confirm cancer presence
Colposcopy uses a special magnifying device to examine the vulva more closely
Imaging studies like CT scans or MRIs help determine if cancer has spread to other areas
Blood tests may be performed to assess overall health before treatment planning
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Treatment Options
Treatment for vulvar cancer depends on the cancer's stage, size, and location, as well as your overall health. The goal is to remove all cancer cells while preserving as much normal function as possible.
Conservative Treatments
Local excision removes the tumor and a small margin of healthy tissue around it
Laser treatment may be used for selected vulvar precancers after invasive cancer has been ruled out. It is not a standard treatment for invasive vulvar cancer.
Topical medications may be used for selected vulvar precancers, but invasive vulvar cancer generally requires other treatment.
Radiation therapy targets cancer cells with high-energy beams when surgery isn't suitable
Advanced Treatments
Wide local excision removes larger tumors along with surrounding healthy tissue margins
Radical vulvectomy removes part or all of the vulva when cancer is more extensive
Evaluation of nearby lymph nodes helps determine whether cancer has spread and guides further treatment. Depending on the cancer, this may involve sentinel lymph-node biopsy or removal of additional nodes.
Chemotherapy may be combined with radiation for advanced cases or when cancer has spread
Discuss symptom control and pain management with your healthcare team as part of your treatment plan.
Your treatment plan will be personalized just for you. Your doctor considers your age, overall health, and personal preferences. Treatment decisions should be made together with your healthcare team through careful discussion. Some women need only one type of treatment, while others benefit from a combination. Recovery time varies depending on what treatment you receive. Ask your doctor what to expect during and after treatment so you can prepare.
Living with the Condition
Daily Management Strategies
Keep the vulvar area clean and dry using mild, unscented soap and lukewarm water. Wear loose-fitting, breathable cotton underwear to reduce irritation. Avoid harsh chemicals, perfumed products, or douches that could worsen symptoms. Apply prescribed medications exactly as directed by your healthcare provider.
Use a barrier cream or petroleum jelly to protect sensitive skin during healing. Take prescribed pain medications as needed, but don't exceed recommended doses. Keep follow-up appointments with your healthcare team to monitor healing and watch for any changes.
Many women find that keeping a symptom diary helps them track their healing progress. This record is also helpful to show your doctor during checkups. Taking care of yourself emotionally is just as important as physical care during recovery.
Exercise & Movement
Gentle exercise can help maintain strength and improve mood during treatment and recovery. Walking and light stretching may be appropriate, depending on your treatment and recovery. Avoid swimming until surgical wounds have healed and your healthcare team says it is safe. Avoid activities that put pressure on the vulvar area, such as cycling or horseback riding, until your doctor gives clearance.
Listen to your body and rest when needed. Gradually increase activity levels as you heal. Discuss any exercise plans with your healthcare team to ensure they're appropriate for your specific situation.
Starting slowly with gentle activities helps you rebuild your strength safely. You might feel tired more easily than before, which is completely normal. Over time, most women return to their regular activities and routines.
Prevention
Keep up with recommended healthcare visits and report persistent vulvar symptoms or skin changes promptly. There is no routine screening test specifically for vulvar cancer.
Practice safe sex and limit the number of sexual partners to reduce HPV risk
Get HPV vaccination if you're eligible, as it protects against cancer-causing virus types
Quit smoking, as tobacco use significantly increases vulvar cancer risk
Treat chronic vulvar conditions like lichen sclerosus promptly and follow up regularly
Maintain good vulvar hygiene without using harsh or irritating products
Prevention starts with knowing your body and recognizing changes. Be familiar with your vulvar area and report any new growth, sore, bleeding, itching, or skin change that persists. Talking openly with your doctor about any concerns makes early detection possible. The HPV vaccine works best when given to people before they're exposed to the virus. Ask your doctor if vaccination is right for you based on your age and health history. Protecting yourself through vaccination is one of the most effective prevention strategies available.
Frequently Asked Questions
Vulvar cancer diagnosed before it has spread generally has a favorable outlook, but five-year survival varies by stage, tumor features, age, and overall health. The key is early detection and appropriate treatment. Advanced cases have lower survival rates, which is why regular checkups are so important.
Yes, vulvar cancer can recur, which is why regular follow-up care is essential. Recurrence is more likely during the first few years after treatment, but it can also occur later, so ongoing follow-up is important. Your healthcare team will schedule regular checkups to monitor for any signs of cancer returning.
Both cancers can be caused by HPV infection, but they are different diseases affecting different areas. Having one doesn't necessarily mean you'll develop the other. However, women with a history of cervical cancer may have a slightly higher risk of vulvar cancer.
While vulvar cancer is much more common in older women, younger women can develop it too. Women under 40 who develop vulvar cancer often have HPV-related disease. Regular gynecologic care is important for women of all ages.
Treatment may temporarily or permanently affect sexual function, depending on the extent of surgery needed. Many women can resume sexual activity after healing, though some adjustments may be necessary. Discuss concerns with your healthcare team, who can provide specific guidance and support.
Still have questions?
Consult with a healthcare professional for personalized advice about vulvar cancer screening, symptoms, and treatment options.