Vulval Cancer

Vulval cancer is a relatively rare condition, affecting 2 in 100,000 women in Australia. (Source: Cancer Australia)

Vulval cancer usually affects post-menopausal women (women who have gone through the menopause) between the ages of 55 and 75 years old. However, it can occur in younger or older women and is becoming more common in younger women due to Human papillomavirus (HPV) infection, which also causes cervical cancer.


Often, vulval cancer develops from vulval pre-cancer: VIN (Vulval Intra-Epithelial Neoplasia). VIN may have no symptoms, but there is usually itching around the vulva, burning, and raised patches of skin that are different colour from unaffected areas.

Treatment and Surgery

VIN treated appropriately will prevent its progression to a cancer. This will usually involve surgical removal of affected tissue (excision). There is also new evidence to suggest that the use of creams formulated with agents to boost the immune system may be effective to reverse VIN or reduce its size so a smaller surgical excision is required. However, their use will be limited to patients with lesions deemed to be at low risk of progression to cancer.

The treatment of vulval cancer will involve a ‘radical / wide local excision’ of the lesion on the vulva to ensure all of the affected tissue is removed.

Unless the cancer is in its very early stages, it is advisable to also remove the lymph nodes in the groin. This may be performed either as a full groin node dissection or a sentinel lymph node procedure. Our gynaecologic oncologist will discuss the two different approaches, which each has its advantages and disadvantages.

Chemotherapy and / or Radiation Therapy

Depending on whether an adequate clearance margin around the cancer is achievable or whether the lymph nodes are positive for tumour, radiation therapy after the surgery may be required to achieve a cure or prevent recurrence.

After Surgery and Treatment

After treatment for vulval cancer, our gynaecologic oncologist will recommend a minimum follow-up of five years as recurrence is common, and further surgical excision may be necessary.

It was previously common to do vulval smears as part of follow-up, but these have never been proven to be of benefit. A more effective approach is to perform a vulvoscopy (examining the vulva using a colposcope / microscope) at subsequent visits.

Cessation of smoking after treatment of vulval cancer will halve the risk of recurrence.

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