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Vulvar cancer

Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia. The vulva is the area of skin that surrounds the urethra and vagina, including the clitoris and labia.

Vulvar cancer commonly forms as a lump or sore on the vulva that often causes itching. Though it can occur at any age, vulvar cancer is most commonly diagnosed in older women.

Vulvar cancer treatment usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. Sometimes vulvar cancer surgery requires removing the entire vulva. The earlier vulvar cancer is diagnosed, the less likely an extensive surgery is needed for treatment.

Symptoms Causes Risk factors Prevention

Signs and symptoms of vulvar cancer may include:

  • Itching that doesn't go away
  • Pain and tenderness
  • Bleeding that isn't from menstruation
  • Skin changes, such as color changes or thickening
  • A lump, wart-like bumps or an open sore (ulcer)

When to see a doctor

Make an appointment with your primary care doctor or gynecologist if you experience any vulvar signs or symptoms that worry you, such as:

  • Abnormal bleeding
  • Burning
  • Itching
  • Pain

It's not clear what causes vulvar cancer. In general, doctors know that cancer begins when a cell develops mutations in its DNA. The mutations allow the cell to grow and divide rapidly. The cell and its offspring go on living when other normal cells would die. The accumulating cells form a tumor that may be cancerous, invading nearby tissue and spreading to other parts of the body.

Types of vulvar cancer

The type of cell in which vulvar cancer begins helps your doctor plan the most effective treatment plan. The most common types of vulvar cancer include:

  • Vulvar squamous cell carcinoma. This cancer begins in the thin, flat cells that line the surface of the vulva. Most vulvar cancers are squamous cell carcinomas.
  • Vulvar melanoma. This cancer begins in the pigment-producing cells found in the skin of the vulva.

Although the exact cause of vulvar cancer isn't known, certain factors appear to increase your risk of the disease, including:

  • Increasing age. The risk of vulvar cancer increases with age, though it can occur at any age. The average age at diagnosis is 65.
  • Being exposed to human papillomavirus (HPV). HPV is a sexually transmitted infection that increases the risk of several cancers, including vulvar cancer and cervical cancer. Many young, sexually active women are exposed to HPV, but for most the infection goes away on its own. For some, the infection causes cell changes and increases the risk of cancer in the future.
  • Smoking. Smoking cigarettes increases the risk of vulvar cancer.
  • Being infected with the human immunodeficiency virus (HIV). This sexually transmitted virus weakens the immune system, which may make you more susceptible to HPV infections, thereby increasing your risk of vulvar cancer.
  • Having a history of precancerous conditions of the vulva. Vulvar intraepithelial neoplasia is a precancerous condition that increases the risk of vulvar cancer. Most women with vulvar intraepithelial neoplasia will never develop cancer, but a small number do go on to develop invasive vulvar cancer. For this reason, your doctor may recommend treatment to remove the area of abnormal cells and periodic follow-up checks.
  • Having a skin condition involving the vulva. Lichen sclerosus, which causes the vulvar skin to become thin and itchy, increases the risk of vulvar cancer.

Reduce your risk of sexually transmitted diseases

To reduce your risk of vulvar cancer, reduce your risk of sexually transmitted infections such as HPV and HIV. To reduce your risk of these diseases:

  • Limit your number of sexual partners. The more sexual partners you have, the greater your risk of exposure to HPV.
  • Use a condom every time you have sex. A condom can protect you from HIV transmission. Condoms may reduce your risk of contracting HPV but can't fully protect against it.
  • Consider the HPV vaccine. Girls and young women may want to consider getting the HPV vaccine to protect against the strains of the virus that are thought to cause the most cases of vulvar cancer.

Ask your doctor about pelvic exams

Ask your doctor how often you should undergo pelvic exams. These exams allow your doctor to visually examine your vulva and manually examine your internal reproductive organs to check for abnormalities. Talk to your doctor about your risk factors for vulvar cancer and other pelvic cancers in order to determine the most appropriate screening exam schedule for you.

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