Vulvar cancer is one of the least talked about gynecologic cancers — and that silence costs lives. Many women ignore its early symptoms out of embarrassment or assume they are caused by a minor skin condition. But early diagnosis of vulvar cancer makes an enormous difference in treatment outcomes. This blog is here to break the silence.
What Is Vulvar Cancer?
Vulvar cancer is a cancer that develops on the outer surface of the female genitalia (the vulva), which includes the labia majora, labia minora, clitoris, and the vaginal opening. It accounts for about 4% of all gynecologic cancers. While it is less common than cervical or uterine cancer, it is absolutely serious — and it is treatable when caught early.
Warning Signs of Vulvar Cancer
The following symptoms should prompt a visit to a doctor — especially if they persist for more than a few weeks:
- Persistent itching of the vulva that does not respond to creams or treatments
- A lump, bump, or thickening on the vulvar skin
- A sore or ulcer that does not heal
- Skin changes — redness, darkening, or white patches on the vulvar skin
- Pain or burning sensation in the vulvar area
- Bleeding or discharge not related to menstruation
- Pain during urination
These symptoms are often mistaken for a yeast infection, lichen sclerosus, or eczema. If you have been treating a skin condition in the vulvar area that is not improving, please see a specialist.
What Causes Vulvar Cancer?
Two main pathways lead to vulvar cancer:
HPV-Related Vulvar Cancer
About 40% of vulvar cancers are caused by certain strains of the Human Papillomavirus (HPV), particularly HPV 16 and HPV 18. These tend to occur in younger women (under 50) and are often preceded by a condition called VIN (Vulvar Intraepithelial Neoplasia) — a pre-cancerous change in the vulvar skin.
Non-HPV-Related Vulvar Cancer
In older women, vulvar cancer is more commonly associated with chronic skin conditions like lichen sclerosus — a condition that causes white, itchy patches on the vulvar skin. Women with longstanding lichen sclerosus have a slightly increased risk of developing vulvar cancer, which is why these conditions should be monitored by a doctor.
Risk Factors
- HPV infection
- History of cervical cancer or CIN (cervical pre-cancer)
- Lichen sclerosus
- Smoking
- Weakened immune system
- Age over 60 (risk increases with age)
How Is Vulvar Cancer Diagnosed?
If your doctor notices a suspicious area on examination, they will perform a vulvar biopsy — a simple procedure where a small piece of tissue is removed under local anaesthesia and sent for analysis. This is the only way to definitively diagnose vulvar cancer.
Treatment Options
Treatment depends on the stage and location of the cancer, but typically includes:
- Surgery — the primary treatment; the extent depends on the tumour size and spread
- Radiation therapy — often used before or after surgery
- Chemotherapy — sometimes combined with radiation
When vulvar cancer is caught at stage I, the 5-year survival rate exceeds 85%. At later stages, treatment becomes more complex and outcomes less predictable.
Do Not Let Embarrassment Delay Your Diagnosis
The most important message in this blog is this: please do not let embarrassment stop you from seeking help. Persistent vulvar itching, a sore that will not heal, or a lump — these are symptoms your doctor needs to know about. There is no shame in taking care of your health.
Dr. Monisha Gupta is a Gynecologic Oncologist at Fortis Hospital, Shalimar Bagh, New Delhi, offering compassionate, expert care for all gynecologic cancers including vulvar cancer.
