The vulva, which is part of a woman’s genitals, is at the opening of the vagina, or the birth canal. Vulvar cancer is classified based on the types of cells where it begins.
The vulva includes the following main parts:
Two skin folds around the opening of the vagina:
- Outer lips (labia majora), which are larger and have hair
- Inner lips (labia minora), which are small and do not have hair
Clitoris, which helps a woman feel sexual stimulation.
Bartholin glands, which help lubricate the vagina during sex. One is on each side of the opening of the vagina.
Cancers can form in any of these sites and tumors may extend beyond a single site.
The main types of vulvar cancer are:
- Squamous cell carcinoma, which originates from the cells that line the vulva. One subtype of squamous cell carcinoma is verrucous vulvar cancer, which can be a wart-like growth. Squamous cell carcinoma is the main type of vulvar cancer.
- Adenocarcinoma, which usually starts in the Bartholin glands or sweat glands in the vulva. These make up about 8% of vulvar cancers. Some patients can have diseases like Paget's disease of the vulva that can increase their risk of developing adenocarcinoma.
- Melanoma, a skin cancer that starts in cells that make pigment.
- Sarcomas, which may be found in children as well as adults. These rare types of vulvar cancer start in the soft tissue.
Vulvar cancer statistics
Vulvar cancer is rare. According to the American Cancer Society, about 6,500 women in the United States are diagnosed with it each year. Vulvar cancer usually grows slowly and may begin as precancerous changes that can be treated before they become cancer. The median age of diagnosis for vulvar cancer is 69, and the disease's five-year survival rate is about 71%.
Vulvar cancer causes & risk factors
Anything that increases your chance of getting vulvar cancer is a risk factor. These include:
- Age: More than half of women who develop vulvar cancer are over 70 years old.
- Human papilloma virus (HPV): About half of vulvar cancers are caused by HPV. HPV infections are very common and rarely lead to cancer. In cases of vulvar cancer caused by HPV, the HPV virus integrates into cells and causes changes that can lead to cancer development. The virus is no longer infectious. Learn more about HPV and cancer.
- Vulvar intraepithelial neoplasia (VIN), a precancerous condition usually caused by HPV
- Smoking tobacco
- HIV (human immunodeficiency virus)
- Cervical cancer: Women who have had cervical cancer have a higher risk of developing vulvar cancer.
- Melanoma or atypical moles on other parts of the body: These conditions increase the chance of developing vulvar cancer.
- Family history of melanoma
- Vulvar skin conditions such as Lichen sclerosis and Lichen planus
Not everyone with risk factors gets vulvar cancer. However, if you have risk factors, it’s a good idea to discuss them with your health care provider.
Learn more about vulvar cancer:
Gynecologic oncologist: Why I’m passionate about cancer care at MD Anderson
I’ve always sought out opportunities to advocate for women and women’s health. That’s what drew me to the field of gynecologic oncology.
As a gynecologic oncologist at MD Anderson, I treat cancers of the female reproductive system, including endometrial cancer, cervical cancer, ovarian cancer, vulvar cancer and vaginal cancer. My passion aligns with MD Anderson’s mission to end cancer. I’m thankful I get to work with so many incredible people who share my passion and dedication to Making Cancer History® and improving the lives of our patients.
Connecting with patients is crucial to personalized care
As an oncologist, I’ve learned that there’s no one-size-fits-all approach to treating cancer.
Cancer treatment is a personal experience. As cancer care evolves, we often have multiple ways to approach a challenge. We need to understand how the cancer is affecting the person in front of us so we can make a treatment plan that will get them through treatment and beyond.
That’s why I start by asking questions. I want to get to know my patients and their caregivers. I want to understand what their goals are. After that, I can determine what diagnostic tests we need to do. Then we can create a treatment plan that aligns with best practices and meets the needs of the patient and their support system.
MD Anderson’s multidisciplinary care sets us apart from other institutions. We offer the best specialized care, whether it's medical oncology, surgical oncology or radiation oncology. Having multiple specialists review your care plan before we start treatment means that you're going to receive the right care at the right time and have the best chance for a positive outcome.
Why I value my team at MD Anderson
When you become a gynecologic oncology patient at MD Anderson, you have an entire team supporting you, including nurses, advanced practice providers, medical assistants or my colleagues in the operating room.
I'm always inspired when I come to work because I know that my team is incredible, they're energized and they care about our patients as much as I do.
I think the key to having an effective team is respecting and trusting one another. For example, I know that if I need to have a difficult conversation with one of my patients, I can rely on my team to handle everything outside of that room so that I’m able focus on the patient and their loved ones.
I hear from my patients all the time about how much they love their care team and feel like they can always turn to them with questions or concerns.
My guiding principle when caring for each patient is, ‘Would I be doing the same if this patient was my family member?’ We get to know our patients so well – through surgery, chemotherapy, surveillance and survivorship. We do consider them family. We’re there through the highs and lows of treatment, and it’s a privilege to be able to offer support and guidance to them during that time.
Clinical trials help us better treat patients
Clinical trials are a critical part of our work to end cancer. There’s so much that we need to understand, learn and improve on to conquer a disease that is always changing. Clinical trials help us do that.
It's important for patients to have access to clinical trials, so we can offer them the very best cancer treatments. In addition, we may be able to extend their life and improve their quality of life.
MD Anderson is doing a lot of research in the field of gynecologic oncology. I encourage all patients to ask their doctors about clinical trials to see if they would be a good option for you.
Why you should come to MD Anderson for cancer treatment
MD Anderson only focuses on cancer, so we're able to provide the best comprehensive care to patients from the moment they're diagnosed through their treatment and onto survivorship. You won't be a number here or just another patient. We'll develop a multidisciplinary treatment plan that's right for you.
Because we focus only on cancer, we understand the highs and lows our patients go through better than anyone else. We focus on cancer care, we specialize in cancer care, and I believe we provide the very best cancer care there is.
Jolyn Taylor, M.D., is a gynecologic oncologist at MD Anderson.
Request an appointment at MD Anderson online or call 1-877-632-6789.
What is a vulvectomy? Purpose, procedure and recovery
The vulva is part of the female genitalia and sits at the opening of the vagina. Sometimes benign or cancerous growths can develop on the vulva. When that happens, a patient may need a vulvectomy to surgically remove those growths.
Here, I’ll share common types of vulvectomies, when they’re used for treatment and what you can expect during and after the procedure.
Reasons for a vulvectomy
Doctors may perform a vulvectomy to treat conditions such as:
- Vulvar intraepithelial neoplasia (VIN) or vulvar dysplasia, a precancerous condition where abnormal cells form on the skin of the vulva. VIN is not cancer, but sometimes it can turn into vulvar cancer.
- Vulvar cancer
Types of vulvectomies
The type of vulvectomy you get will depend on whether the lesion is cancerous, its size and its location.
Your doctor will talk to you about which surgery is right for you.
Simple vulvectomy
A simple vulvectomy is often referred to as a wide local excision. At MD Anderson, we use this procedure to treat precancerous lesions on the vulva. We may also do a simple vulvectomy if you’ve been treated for vulvar cancer and develop a new lesion that we suspect may be cancerous.
During a simple vulvectomy, your doctor will remove the lesion and some of the tissue under the skin. Tumor margin is the healthy tissue bordering the tumor that’s removed during surgery. For a simple vulvectomy, we want to get a tumor margin between 0.5 cm and 1 cm.
Radical partial vulvectomy
A radical partial vulvectomy is used to treat vulvar cancer. During the procedure, the doctor removes the lesion and deeper layers of tissue under the skin. The tumor margin for a radical partial vulvectomy is 2 cm. This margin may be limited due to neighboring structures.
At the time of a vulvectomy, your doctor may also recommend a lymphadenectomy or sentinel lymph node biopsy to remove some of your lymph nodes, depending on where the lesion is and how deep it goes into the vulva.
Why come to MD Anderson for vulvar cancer care?
A team of some of the nation's top experts gives you its full attention when you are treated for vulvar cancer in MD Anderson's Gynecologic Oncology Center. They concentrate on customizing your care to include the most advanced treatments while minimizing negative side effects.
Our physicians target vulvar cancer with the latest technology and treatments while focusing on quality of life. To personalize care and optimize outcomes, each team includes doctors from many specialties, including radiation oncology, radiology, pathology, and plastic and reconstructive surgery. They are joined by a support staff specially trained in caring for women.
As one of the nation's top cancer centers, we care for more women with vulvar cancer each year than many oncologists see in a lifetime. This gives us an extraordinary level of expertise, which may help you have a higher chance of successful treatment. At MD Anderson, you are surrounded by the strength of the nation's largest and most experienced comprehensive cancer centers, which have all the support and wellness services needed to treat the whole person – not just the disease.
Surgical skill
Experience is especially important if you need surgery for vulvar cancer, which often is complex and delicate. MD Anderson surgeons, among the nation's best, are highly skilled in the least invasive procedures, which are good options for some women.
If you are a candidate for reconstructive surgery after treatment for vulvar cancer, our plastic surgeons use the most advanced techniques available. They are specialized and experienced – which can greatly impact surgical success.
Innovative vulvar cancer research
MD Anderson has led the development of many of the current therapies and diagnostic methods for vulvar cancer, including less-invasive surgery, sentinel node biopsy and surgical reconstruction. And we continue to investigate newer, more advanced treatments for vulvar cancer. We are one of the top research sites in the country, which means we offer several clinical trials for vulvar cancer.
What you have endured can give others hope.
MD Anderson vulvar cancer patients can get treatment at the following locations.
The Gynecologic Oncology Center at MD Anderson