Vulva cancer is one of the rarer female cancers, but this little-talked about condition still has over 1,000 cases diagnosed in the UK each year. With one in seven women unable to name a single gynaecological cancer, it's no surprise that few know the symptoms of vulva cancer or the risk factors of the condition.
What is vulval cancer?
Vulval cancer affects the skin of a woman's external genitals. 'This includes the lips surrounding the vagina – the two inner lips (the labia minora) and two outer lips (the labia majora), the clitoris and the Bartholin's glands,' explains Miles.
The pre-cancerous form of the condition – vulva intraepithelial neoplasia (VIN), where cells in the vulva are abnormal – tends to be diagnosed in women aged 30 to 50. This pre-cancerous form doesn't necessarily mean that you'll get vulva cancer, but it may develop into a cancer, so it should be closely monitored.
'Many of the pre-cancerous stages of vulva cancer can be treated if they are caught early enough, so it's important to be aware of the signs and symptoms of the disease,' says Miles. 'Pre-cancerous changes known as VIN 1, 2 or 3 (graded by severity) can be treated by minor skin surgery or topical treatments and monitored.'
Who is at risk of vulval cancer?
In younger women, vulva cancer is frequently associated with human papilloma virus (HPV), which is passed from one person to another during sexual contact. Smoking and inflammatory skin conditions affecting the vulva, particularly lichen sclerosus (a common dry skin condition) can also increase your chances of developing the condition.
The exact cause of vulval cancer is unclear, but your risk of developing it increases with age. Around 80 per cent of vulval cancers are diagnosed in women over 60, but it can be seen in younger women too.
Vulva cancer symptoms
Despite being a lesser known cancer, it's important to recognise any changes to your vulva. 'Most women don't inspect their vulvas, and even if they do the majority are unaware as to what's normal,' says McKenna.
According to Miles, the key signs and symptoms of vulva cancer include the following:
• Changes in the appearance of vulva skin
It's important to be aware of skin changes. This includes changes to the texture or colour, as well as irritation, ulceration and thickened, raised red, white or dark patches and broken and non-healing skin.
• Vulva pain or soreness
Sometimes this can present itself as a prickly feeling, a discomfort or tender area.
• A lasting vulva itch
Of course, itchiness can be caused by other conditions, like thrush, but it's always worth getting it checked out.
• An open sore or growth visible on the vulva skin
This may be raised, itchy, painful or bleeding.
• A mole on the vulva
Notice any changes in shape or colour of any moles that you have on the vulva.
• A lump or swelling in the vulva
Check for any lump or swelling that you're just not used to having there. It may just be an ingrown hair, but better to get checked out.
⚠️ If you have any of these symptoms or recognise any changes to your vulva, see your GP.
Vulva cancer treatment
Caught early, vulva cancer is completely curable and a very simple (and quick) skin biopsy is usually all that is required to diagnose it, explains Miles.
'In addition, if the biopsy identifies a non-cancerous condition, the doctor will be able to prescribe the correct ointments or creams to resolve the discomfort.'
Can you prevent vulva cancer?
Awareness and taking action if something doesn't seem right are the keys to early detection. According to the Eve Appeal, a shockingly high two-thirds of women can't identify their vulva. Learning about your anatomy and regularly self-examining by using a mirror and good light are paramount to reducing your risk.
'If you don't know about your anatomy, you're inevitably not going to be able to tell what's normal and what's not. In addition, if something doesn't seem right, don't shy away about showing it to your doctor,' explains Miles. 'It's impossible to totally eliminate all cancer risk, but not smoking, undergoing a HPV vaccine, practising safe sex and self-checking all help.'
Although it's important to attend your cervical screening, you shouldn't rely on these alone to protect your gynaecological health – and that means the health of your womb, your ovaries, as well as your vulva. 'Smears can only pick up pre-cancerous cells of the cervix,' says Miles.
'I see a lot of women who think that because they've had a gynaecological test, ie a smear, they're in the all clear. Any changes of the skin should be checked independently of having a smear done.'
Further help and support
If you have any concerns about your sexual health, your GP should be your first port of call. Alternatively, try one of the following resources:
- Find a sexual health clinic near you.
- Try Brook's Find a Service tool.
- Call the national sexual health line 0300 123 7123.
- Call Worth Talking About on 0300 123 2930 (for under-18s).
Last updated: 14-11-19