Understanding Vulvar Cancer: Recognising the Signs and Navigating Treatment

Vulvar cancer is a relatively rare but serious form of cancer that affects the external female genital organs. While it accounts for only around 5% of all gynaecological cancers in the UK, awareness and early recognition are crucial to improving outcomes. According to Cancer Research UK and the NHS, early detection can dramatically increase survival rates and reduce the extent of treatment required.

In this blog, well explore the signs of vulvar cancer, discuss the prognosis based on UK research, and outline the treatment options available through the NHS and other UK-based health providers. The aim is to empower women with reliable information so they can make informed decisions about their health.

Signs of Vulvar Cancer

Recognising the early signs of vulvar cancer is essential, especially since many symptoms can be mistaken for less serious conditions like infections or skin irritations. The vulva includes the outer lips of the vagina (labia majora and labia minora), the clitoris, and the opening of the vagina. Symptoms can appear in any of these areas, and any unusual changes should not be ignored.

The most commonly reported symptom is persistent itching, which often leads women to seek medical advice. However, the condition may also present itself in more subtle ways. Pain, tenderness, or a burning sensation in the vulvar area may occur, particularly during urination or sexual intercourse.

Visible changes can be particularly telling. Women may notice lumps, thickened patches of skin, ulcers, or open sores that dont heal. Discolouration or a change in texture of the vulvar skin, especially if accompanied by bleeding or discharge unrelated to the menstrual cycle, should also be taken seriously.

Some women experience swelling or the development of a wart-like growth. In more advanced stages, vulvar cancer may present with enlarged lymph nodes in the groin area or significant discomfort when walking or sitting. These symptoms, while alarming, may still be manageable with prompt diagnosis and treatment.

It is important to remember that many of these symptoms can also be caused by benign conditions like vulvar dermatitis, infections, or skin disorders. However, if symptoms persist for more than a few weeks or worsen over time, it is vital to consult a GP or gynaecologist.

The NHS advises all women, particularly those postmenopause, to perform regular vulvar self-examinations and report any changes immediately. The earlier vulvar cancer is detected, the more effective treatment is likely to be.

Cancer of the Vulva Prognosis

The prognosis of vulvar cancer depends on several key factors: the stage at which the cancer is diagnosed, the specific type and location of the tumour, and the patients general health.

According to the most recent data from Cancer Research UK, survival rates have improved due to earlier diagnosis and advances in treatment. Around 80% of women diagnosed at stage 1when the cancer is still confined to the vulvasurvive for five years or more. However, this figure drops significantly if the cancer is diagnosed at a later stage, particularly if it has spread to the lymph nodes or beyond.

There are different types of vulvar cancer, with squamous cell carcinoma being the most common, making up about 90% of cases. Other types, such as melanoma or adenocarcinoma of the vulva, are rarer but may have differing outcomes. Squamous cell carcinoma tends to develop slowly and may be preceded by vulvar intraepithelial neoplasia (VIN), a pre-cancerous condition.

Age is another influential factor. Most cases of vulvar cancer occur in women over 60, and older patients may have a less favourable prognosis due to coexisting health conditions or a reduced ability to tolerate aggressive treatments.

HPV infection, particularly types 16 and 18, is also linked to an increased risk of vulvar cancer. In younger women, vulvar cancer often develops as a result of long-standing HPV infection. Public health efforts like the HPV vaccination programme have helped reduce the incidence of HPV-related vulvar cancers in the UK, especially among women under 40.

Furthermore, patients who receive early, appropriate treatment and attend regular follow-up appointments are more likely to achieve long-term remission. NHS guidelines emphasise the importance of continued surveillance post-treatment to monitor for recurrence, which occurs in up to 20% of cases, especially within the first two years.

Cancer of the Vulva Treatment

Treatment for vulvar cancer in the UK is typically provided through the NHS in specialist gynaecological oncology units. The type of treatment recommended will depend on the stage of the cancer, the exact location and size of the tumour, and the womans overall health.

Surgery is the most common and effective form of treatment, especially in early-stage cancer. In some cases, a simple excision may be sufficient, removing the cancerous area along with a margin of healthy tissue. However, more extensive cases may require a vulvectomy, which involves removing part or all of the vulva. Sentinel lymph node biopsy or removal of groin lymph nodes may be performed to assess whether the cancer has spread.

While surgery is often curative, it can have physical and emotional impacts, including changes to sexual function, body image, and urinary or bowel function. The NHS provides psychological support and physiotherapy to help women adjust after treatment.

Radiotherapy may be used either before surgery to shrink the tumour or after surgery to reduce the risk of recurrence. It is particularly useful in cases where lymph nodes are involved or where the surgical margins are not clear. Side effects can include skin irritation, fatigue, and long-term changes to the skin and tissues of the vulva and pelvic region.

Chemotherapy is less commonly used in vulvar cancer than in other gynaecological cancers, but it may be appropriate in advanced stages or if the cancer does not respond to surgery or radiotherapy. It is often combined with radiation (chemoradiation) to enhance its effectiveness.

Targeted therapies and immunotherapy are being explored in clinical trials, particularly for HPV-related vulvar cancers. Though not yet standard care, these emerging treatments may offer hope for women with recurrent or metastatic disease.

Multidisciplinary teams within NHS hospitals ensure a personalised approach, involving gynaecological oncologists, radiologists, pathologists, and specialist nurses. The National Institute for Health and Care Excellence (NICE) provides treatment guidelines, ensuring that patients receive evidence-based care regardless of their location in the UK.

Post-treatment rehabilitation is also a key component of care. The NHS offers vulvar reconstruction surgery for those who need it, and ongoing support services are available to address emotional wellbeing, intimacy concerns, and quality of life.

Conclusion

Vulvar cancer, though rare, is a serious condition that requires increased public awareness and proactive healthcare. Recognising early signssuch as persistent itching, skin changes, or unexplained paincan make all the difference in catching the disease at a treatable stage.

The prognosis for vulvar cancer is significantly improved with early detection and prompt treatment, as evidenced by survival data from leading UK organisations like Cancer Research UK and NHS England. With a range of effective treatments available, from surgery to radiotherapy and emerging therapies, many women go on to lead full and healthy lives post-diagnosis.

However, early diagnosis depends on awareness. Routine self-examinations, regular cervical screenings (which can also detect HPV), and paying attention to vulvar health are critical steps for every woman, particularly those over 60.

If you experience persistent symptoms or notice any unusual changes in your vulvar area, do not hesitate to contact your GP. Early consultation can help rule out serious conditions or ensure that treatment starts as soon as possible.