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Vulval cancer is a cancer that arises from the tissues of the vulva. It can also be called cancer of the vulva, vulva cancer or vulvar cancer.

The vulva

The vulva is the external part of a woman’s sex organs.

It consists of soft fatty tissue covered with pubic hair called the Mons Pubis (Mount of Venus), which is above the labia. The labia have two outer larger lips (the labia majora), which surround two inner smaller and thinner lips (the labia minora).

At the top, where the labia minora join, is a highly sensitive organ called the clitoris. When stimulated, the clitoris fills with blood and enlarges in size. Stimulation of the clitoris can result in sexual excitement and orgasm, or climax.

Just below the clitoris is the opening through which women pass urine (the urethra) and below this is the vagina, a tubular passage through which menstrual blood flows, sexual intercourse occurs, and a baby is born.

The area of the skin between the vulva and anus is called the perineum. All these structures are visible from outside the body.

Cancer of the vulva may involve any of the external female sex organs. The most common areas for it to develop are the inner edges of the labia majora and the labia minora.

Less often, vulval cancer may also involve the clitoris or the Bartholin’s glands (small glands, one on each side of the vagina). It can also affect the perineum.

What is cancer?

Cancer is a group of many related diseases. All cancers begin in cells, the body’s basic building blocks.

Normally, cells grow and multiply in an orderly way. However, damaged genes can cause them to behave abnormally. They may grow into a lump called a tumour. Tumours can be benign (not cancer) or malignant (cancer).

A malignant tumour is made up of cancer cells. If these cells are not treated, they may spread beyond their normal boundaries and into surrounding tissues, becoming invasive cancer. This spread of cancer is called metastasis.

When cancer spreads from its original place to another part of the body, the new tumour has the same kind of abnormal cells and the same name as the primary tumour.

Types of vulval cancer

  • Squamous cell carcinoma: Most vulval cancers (90 per cent) develop from squamous cells, the skin cells of the vulva. These cancers usually grow very slowly over a few years.
  • Vulval melanoma: Vulval melanomas develop from melanin, the cells that produce pigment and give skin its colour. Only about 2 to 4 per cent of vulval cancers are melanoma.
  • Adenocarcinoma: These are very rare. They develop from cells that line glands in the vulval skin. Paget’s disease of the vulva is a pre-malignant condition where glandular cells spread outwards and across the vulval skin.
  • Verrucous carcinoma: This rare, very slow-growing type of cancer looks like a large wart.
  • Sarcomas: These are extremely rare. Sarcomas develop from cells in tissue, such as muscle or fat under the skin, and tend to grow more quickly than other types of cancer.

How common is vulval cancer?

Cancer of the vulva is rare. About 280 Australian women, or about two women in every 100,000, are newly diagnosed with vulval cancer each year. Vulval cancer accounts for less than one per cent of all cancers in Australian women.

Vulval cancer usually affects post-menopausal women (women who have gone through the menopause) between the ages of 55 and 75. However, it can occur in younger or older women and is becoming more common in younger women.