Vulval Cancer

Vulval cancer is rare and affects around 1300 people a year in the UK. Around 80% of people diagnosed are over 60; however we are increasingly seeing more people being diagnosed at a younger age. If you were born with a vulva you are at risk of vulval cancer. This is relevant to you if you’ve not undergone genital surgery, or if you’ve had a phalloplasty or a metoidioplasty (both sometimes referred to as bottom surgery), as part or all of the vulva is kept and remodelled.

The vulva describes the external genitals, including the soft tissue (labia minora and labia majora), the clitoris, and the Bartholin’s glands.

Symptoms:

  • A lasting itch on the external genitalia
  • Pain or soreness on the external genitalia
  • Thickened, raised, red, white or dark patches on the skin of the external genitalia
  • An open sore or growth visible on the genital skin
  • A mole on the external genitalia that changes shape or colour
  • A lump or swelling on the external genitalia

All these symptoms can be caused by other more common conditions, such as infection, but if you have any of these, you should see your GP. It is unlikely that your symptoms are caused by a serious problem but it is important to be checked out… remember non- cancerous conditions can be uncomfortable and so much better when treated!

Risk Factors:

Skin conditions that cause inflammation may sometimes develop into an early cancer. The two most common of these being vulval intraepithelial neoplasia (VIN) and Lichen Sclerosus. Some of these cell changes will go away without the need for any treatment; however, finding these abnormal cells early can help to prevent cancer.

Smoking
Smoking increases your risk of developing VIN and vulval cancer. This may be because smoking makes the immune system less effective, and less able to clear the HPV virus from your body and more vulnerable to the effects of the virus.

Vulval intraepithelial neoplasia (VIN)
VIN is potentially a pre-cancerous condition. This means there are changes to certain cells that aren’t cancerous, but could become a cancer at a later date if left untreated. This is a gradual process that usually takes well over 10 years.

There are two types of VIN:

  • Usual or undifferentiated VIN – this typically affects people under 50 and is thought to be caused by an HPV infection
  • Differentiated VIN (dVIN) – this is a rarer type, usually affecting people over 60, associated with skin conditions that affect the area, and is more likely to be associated with cancer.

Human papilloma virus (HPV)
HPV is present in at least 40% of cases, which suggests it may increase your risk of developing the condition. HPV is known to cause changes in the cells, which is known as VIN.