Vulval cancer begins as an abnormal growth of cells on the vulva — the external part of the female genital area surrounding the urethra and vagina, including the clitoris and labia.

It is uncommon and usually diagnosed in postmenopausal women, though it can occur at any age. When detected early, treatment is highly effective and surgery is often curative.

Early changes are often subtle and may be mistaken for benign skin conditions. Common symptoms include:

• A lump, sore, or wart-like growth on the vulva
• Persistent itching or burning that doesn't settle with treatment
• Pain or tenderness of the vulval skin
• Bleeding or discharge not related to menstruation
• Skin changes such as thickening, discolouration, or texture changes
• A raised or ulcerated area
• Painful urination

If you notice any persistent vulval changes, seek medical assessment promptly. While these symptoms can be caused by benign conditions such as infections or skin disorders, persistent changes should always be evaluated by a specialist. Early detection significantly improves treatment outcomes.

Diagnosing vulval cancer typically involves:

• Detailed consultation and medical history
• Specialist examination of the vulva using magnification (vulvoscopy or colposcopy)
• Skin biopsy — a small tissue sample taken for laboratory analysis to confirm diagnosis
• MRI, CT, or PET scans if cancer is confirmed, to assess the extent of disease and guide treatment planning
• Lymph node assessment when indicated

All assessments are conducted by experienced specialists with results communicated clearly and compassionately.

Treatment depends on the type, stage, size, and location of the cancer, as well as your overall health and individual circumstances.

Surgical Treatment:

Most patients are treated surgically, with options including:

• Wide local excision — removal of the tumour with a margin of healthy tissue, preserving as much normal anatomy as possible
• Partial vulvectomy — removal of part of the vulva when larger areas are affected
• Radical vulvectomy — removal of all or most of the vulva for extensive disease
• Sentinel lymph node biopsy — checking nearby lymph nodes for cancer spread, which helps avoid unnecessary extensive surgery
• Reconstructive surgery — performed when needed to restore comfort, function, and appearance

Surgical approaches aim to remove all cancer while preserving function and quality of life wherever possible.

Additional Treatments:

Depending on the stage and characteristics of the cancer, your multidisciplinary oncology team may recommend:

• Radiation therapy to target cancer cells before or after surgery
• Systemic treatments coordinated through specialist oncology teams for advanced cases
• Combined treatment approaches for optimal outcomes

Treatment is personalized to balance effective cancer control with quality of life and recovery.

While the exact cause of vulval cancer isn't fully understood, certain factors may increase risk:

• Age — most cases occur after menopause
• Human papillomavirus (HPV) infection
• Smoking
• Weakened immune system (such as after organ transplant or with HIV infection)
• Precancerous vulval conditions such as vulval intraepithelial neoplasia (VIN)
• Chronic inflammatory skin conditions such as lichen sclerosus

Regular review and early treatment of vulval skin problems can significantly reduce the risk of cancer development. If you have risk factors or persistent vulval symptoms, regular specialist assessment is important.

Dr Mohamed Otify is a Consultant Gynaecological Oncologist and Robotic Surgeon with expertise in the surgical management of vulval cancer and related conditions. He works within multidisciplinary cancer teams to provide comprehensive, evidence-based care.

His approach prioritizes:

• Expert surgical management with advanced techniques
• Precision surgery to remove cancer while preserving function
• Reconstructive options to restore comfort and appearance
• Multidisciplinary team collaboration for optimal treatment planning
• Personalized care balancing effective cancer treatment with quality of life
• Compassionate support throughout diagnosis and treatment

If you notice any persistent vulval lump, sore, itching, or skin changes, book a consultation for expert assessment, accurate diagnosis, and personalized treatment planning.