Symptoms of Vulvar Cancer

By Dr Ananya Mandal, MD

Vulvar cancer is a relatively less common type of cancer affecting the external female genitalia. The cancer commonly is of the squamous cell variety and affects the labia majora or minora.

Common symptoms of vulvar cancer

The common symptom of vulvar cancer is a continuous itch.

Distinctive symptoms of vulvar cancer

Some of the other more distinctive symptoms of the condition include (1-5);

  • Long term itch over the vulva. This is a nonspecific complaint that may be seen in various conditions and is usually not a diagnostic symptom of vulvar cancer.
  • Some women may develop a mass, swelling or lump over the vulva. This is usually over the labia or near it.
  • There may be pain and discomfort in the vulva especially on urination or during sexual intercourse.
  • There are raised, reddish or whitish or even blackened skin patches.
  • There may be bleeding or blood stained discharge from the vulva or vagina. This is usually unrelated to menstrual periods.
  • There may be a mole or wart over the vulva that has recently changed in shape, size or color.
  • Some women may develop lesions with ulcers over the vulva. This is an open sore that persists for more than a month.
  • If the lesion is advanced and spreading it may affect the nearest lymph nodes of the groin. These lymph nodes may appear swollen and rubbery.

Spreading of vulvar cancer

Spread may occur to the vagina, urethra and anal canal as well. This called local spread.

If the cancer has spread to the urinary tract there may be difficulty in urinating. If the cancer has spread to the anal canal there may be problems with bowel motions etc.

Around 5% cases show a more distant spread. This may involve major organs like lungs, liver and brain. The consequences are usually life threatening.

Spread to the liver manifests as jaundice and that to the lungs as fluid collection around the lungs and breathlessness. The cancer can also spread to bones causing bone pain and easy fractures.

Symptoms of Vulvar intraepithelial neoplasia (VIN)

Vulvar intraepithelial neoplasia (VIN) is the precancerous condition that in 80% cases may lead to vulvar cancer.

Symptoms of this condition include itching and soreness, burning or tingling feeling over the affected area.

There are areas of redness and whitish patches that are raised and warty in feel and appearance. In many cases there may be no symptoms at all.

History of conditions prior to Vulvar cancer

There may be a history of Human Papilloma virus infection (HPV infection) or a noncancerous skin condition like lichen sclerosus.

Symptoms of specific cancers

  • Verrucous carcinoma - This is a subtype of cancer that appears as cauliflower-like growths similar to herpes infected genital warts.
  • Vulvar melanoma - This commonly affects the cells that produce the pigment melanin producing cells of the vulvar skin. This appears as a darkly colored growth or a change in a mole. The mole is characteristically detected by the ABCD rule. A is for asymmetry, B is for irregular Borders, C is for abnormal color change. Moles are usually brown or tan or black. Changes in color are a warning sign. D is for Diameter. An affected mole usually changes in its size as well.
  • Bartholin gland cancer - This usually shows up as a lump on either side of the vaginal opening.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Further Reading

Sources

  1. http://www.nhs.uk/Conditions/Cancer-of-the-vulva/Pages/Symptoms.aspx
  2. http://www.patient.co.uk/doctor/Vulva-Neoplasia.htm
  3. http://www.cancer.org/acs/groups/cid/documents/webcontent/003147-pdf.pdf
  4. http://www.betterhealth.vic.gov.au/bhcv2/bhcpdf.nsf/ByPDF/Vulvar_cancer/$File/Vulvar_cancer.pdf
  5. http://www.cdc.gov/cancer/vagvulv/pdf/VagVulv_FS_0510.pdf
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