Symptoms
Symptoms may include:
- Persistent vulval itching, burning or soreness
- A lump, ulcer or sore that does not heal
- Changes in skin colour or thickened areas of skin
- Bleeding or discharge from a vulval lesion
- Pain or discomfort during intercourse
These symptoms are often caused by benign conditions. However, persistent or unexplained changes should be assessed by a doctor.
Tests and diagnosis
Assessment involves examination of the vulva and usually a small tissue sample (biopsy), which can often be performed in the consulting rooms under local anaesthetic.
If cancer is diagnosed, further investigations such as ultrasound, CT, MRI or PET imaging may be recommended to assess the extent of disease and whether lymph nodes are involved.
Treatment
Treatment depends on the type, size and location of the cancer, whether it has spread, and individual circumstances. Management is generally planned through a multidisciplinary team.
Surgery is the main treatment for most early-stage vulval cancers. The aim is to remove the cancer completely while preserving as much normal tissue and function as possible.
Assessment of the lymph nodes in the groin may also be recommended. In selected patients, a sentinel lymph node biopsy can identify the first lymph nodes most likely to contain cancer, avoiding more extensive lymph node surgery where appropriate.
Radiotherapy, sometimes combined with chemotherapy, may be recommended for more advanced disease or following surgery when there is an increased risk of recurrence.
Treatment is individualised, taking into account both cancer control and the potential effects on vulval appearance, sensation and sexual function.
Precancerous conditions
Some vulval cancers develop from precancerous changes, including vulval intraepithelial neoplasia (VIN). These changes may be associated with HPV infection or chronic skin conditions such as lichen sclerosus.
Management may involve surveillance, topical treatments or surgery, depending on the type and extent of the abnormality.
Common questions
Does persistent vulval itching mean I have cancer?
No. Most vulval itching is caused by benign conditions. However, persistent symptoms, particularly when associated with skin changes or a lesion that does not heal, should be investigated.
Will surgery change how the vulva looks or feels?
This depends on the size and location of the cancer and the extent of surgery required. Treatment aims to preserve normal tissue and function wherever possible. Reconstructive techniques may be considered when more extensive surgery is necessary.
Is vulval cancer associated with HPV?
Some vulval cancers are associated with HPV, while others develop independently of HPV, often in association with lichen sclerosus or related skin changes.
Do I need a referral?
Yes. A referral from your GP or specialist is needed for a Medicare rebate. Please address this to Dr Shaun McGrath at Arc Specialist Care.
Further information and support
- Cancer Australia: Vulval cancer
- Cancer Council Australia: Vulval cancer
- Cancer Council NSW: Vulval cancer information
Cancer Council provides free information and support on 13 11 20.
Seeing us in Brisbane
Ask your GP or specialist for a referral to Dr Shaun McGrath at Arc Specialist Care, then call us to book.
This information is general in nature and does not replace individual medical advice. Investigation and treatment recommendations depend on your specific circumstances.