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Vulvar Cancer

What You Need To Know

Vulvar cancer refers to cancer found in the vulva, the outer part of the female genitals. Vulvar cancer only accounts for about 4% of gynecological cancers and affects about 4,300 women a year.

Similar to vaginal cancer, there are several types of vulvar cancers and they are named for the area in which they originate. Types of vulvar cancers include:

Squamous cell carcinomas

Squamous cell carcinomas is cancer of the squamous cells, the main type of skin cells that make up the vulva in the vaginal area. This type of cancer has a wart-like appearance and must be checked by performing a biopsy to determine its cancerous state.

Adenocarcinoma

Adenocarcinoma is cancer of the gland cells, which are often found just inside the opening of the vagina. Adenocarcinoma can often be mistaken for a cyst and unfortunately can be misdiagnosed.

Melanoma

Melanoma is cancer that develops in the pigment-producing cells that give skin its color. Although melanoma most commonly affects cells that are exposed to the sun, this cancer can occasionally be found in the internal organs and can affect the vulva. Melanoma accounts for about 6 of every 100 cases of vulvar cancer.

Sarcoma

Sarcoma is cancer that originates in the cells of bones, muscles, or connective tissue. Vulvar sarcomas can present at any age – even childhood and account for about 2 in every 100 cases of vulvar cancer.

Although there is no known cause for vulvar cancer, the following risks may be associated with the disease:

  • Age
  • Smoking
  • Other genital cancers or cases of melanoma
  • Human Papilloma Virus - HPV is a group of viruses that can infect HPV is passed from skin-to-skin contact and can infect skin cells, cause genital warts, or vulvar cancer. (See Cervical Cancer for more details)
  • HIV
The best way to prevent vulvar cancer is to avoid the risk factors noted above. Fortunately, women have the option of being vaccinated by Gardasil® or Cervarix®, two vaccines that protect against HPV infection. Gardasil® specifically, is approved to prevent vaginal and vulvar cancer (not just cervical cancer).

Most importantly, women should undergo an annual pap test and pelvic exam in addition to a self-examination once a month to spot any abnormal coloring or growths in the vaginal area.



What We Can Do To Help

As with most cancers, early detection is key. If a patient experiences the symptoms noted above, a St. John Providence specialist will conduct a complete physician exam including a pelvic exam, pap test, and possible biopsy (see below). Once a patient is diagnosed, the physicians at St. John Providence will help to choose the most effective options in treating your vulvar cancer. We provide comprehensive treatments in the form of medical therapies and surgical solutions, in addition to providing ongoing post-cancer care. Our range of services includes:

If you notice any discoloration, abnormal irritation, or abnormal growth in the vulva, your St. John Providence specialist will perform a complete medical exam including a pelvic exam and pap test to check for abnormalities. Other services may include:

  • Biopsy (vulvascopy)– In order to fully diagnose vulvar cancer, a sample of tissue from the suspicious area will be extracted and examined to determine whether or not it is cancerous.
  • Cystoscopy/Poctoscopy: In later stages of detection, cystoscopy is performed by inserting a thin tube with a lens into the bladder through the urethra. Poctoscopy is the same procedure inserted through the rectum.
  • Imaging Tests: Various imaging tests may be conducted to identify cancerous cells including CT scan, MRI, and PET scan

To determine how far the cancer has spread, your cancer care team uses a process of analysis known as staging. The stage of your cancer impacts your treatment and the prognosis for recovery. A number of different staging systems can be used to classify tumors.

The TNM staging system assesses tumors in three ways: size of the primary tumor (T), whether it has spread to lymph nodes (N), and whether it has spread (metastasized) to other organs (M). Once the T, N, and M are determined, a number of I, II, III, or IV is assigned, with stage I being early stage and IV being advanced.

In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, denotes a more serious case. Your doctor will review your test results and tell you the stage of your cancer.

Treatment options for vulvar cancer depend on the stage and progression of the cancer. St. John Providence physicians are trained to help determine the most effective treatment option that best suits you as our patient. We treat vulvar cancer with two primary options – surgical treatments and medical therapy treatments.

Surgical Treatment:

  • Vulvectomy – a surgical procedure where all or parts of the vulva are removed
  • Pelvic Exenteration – a surgical procedure where other organs in the pelvic area are removed depending on the stage of the cancer and how far the cancer has spread.
  • Lymphadenectomy – removal of the lymph nodes
   

Medical Therapy Treatment:

  • Chemotherapy
  • Radiation Treatment
  • Hormone Treatment

As part of our Center for Excellence in Cancer Care, St. John Providence utilizes cutting edge technology and the most innovative surgical procedures to treat cancer. In addition to the traditional surgical procedures noted above, our esteemed physicians also perform the following procedures:

Surgery using the daVinci Robot

Robert Morris, M.D., and Leigh Ann Solomon, M.D. are trained and experienced in using the daVinci® robot to make gynecologic surgery easier and more effective for women. Making tiny, 1-2 centimeter incisions and using specialized techniques along with the daVinci robot, they can perform precise surgeries with less pain, fewer complications and minimal scarring. Patients typically have shorter hospital stays and return to normal activities quicker than with traditional approaches. DaVinci surgeries include:

  • Simple and radical hysterectomies
  • Hysterectomy (removal of the uterus)
  • Lymph node dissections (for cancer staging)

Minimally Invasive Procedures

  • Hysteroscopy (used to diagnose and treat infertility and heavy bleeding, or to remove fibroids or polyps)
  • Laparascopy (used to diagnose and treat fibroids, tumors, and conditions such as endometriosis, ectopic pregnancy or pelvic inflammatory disease)

Specialized Surgical Solutions

  • Fertility sparing procedures for early stage cervical cancer
  • Pelvic reconstruction for advanced gynecologic cancer

The St. John Providence oncology team is here to support you on your road to recovery. Our goal is to help you attain a healthy body, mind, and spirit. Therefore, our treatment goes beyond surgeries and medical therapies. Your follow-up care can also include other services, including:

  • The Healing Arts Center
  • Support Groups
  • Treating cancer alone is not the only item on our agenda. At St. John Providence, our patients’ long-term health is our priority as well. Following treatment, our dedicated team will provide ongoing gynecological care to endure your health and well-being. These services may include annual exams and screenings and family planning.



We Have More to Learn

Although we offer the most advanced care for women in an award-winning hospital, our job of curing cancer is not yet done. At St. John Providence, we are proactively researching and experimenting new ways to help prevent, detect, diagnose, and treat cancer. Click Here to learn more about Vulvar Cancer Clinical Trials currently underway at St. John Providence.

For more general information about our research efforts, Click Here to read about the clinical trials and research initiatives at our hospitals.


 

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Your Are Unique

At St. John Providence Health System, we know that you’re a unique individual and not just a condition or a list of symptoms. We treat the whole person.

Get in touch with us so we can learn about you and give you the help you need for your individual situation.

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