Vulvar cancer is quite uncommon, accounting for just 0.7% of all cancers in women. The American Cancer Society's estimates that about 6000 women will be diagnosed with this form of cancer in 2019, and more than half will develop in women over age 70. Vulvar cancer affects the outer part of the female genitals, the vulva, but it can also spread to the inner part of labia majora or the labia minora. The type of cancer affecting this area — squamous cell carcinoma ( the most common), adenocarcinoma, or melanoma — determines the symptoms a woman will experience.
One of the first symptoms of vulvar cancer is an itch in the affected area that does not go away. Some women find the sensation becomes worse at night, interrupting sleep, or that it is worse with movement. This symptom is caused by the tumor growing. A burning sensation may accompany the itchy feeling, and bleeding may occasionally present.
The severity of pain from vulvar cancer depends on the specific location of the growths and the extent to which it has spread. Accompanying the pain may be a lump at or near the affected area, or an open sore. Pain often develops alongside itching and bleeding.
Patches on the Skin
When vulvar cancer is caused by melanoma, a woman may notice dark spots on the skin of the vulva, usually black or dark brown, though they may also appear white, pink, or red. The patches may be evenly distributed throughout the vulva, though they are most often seen around the clitoris, labia majora, and labia minora. To determine if a patch or mole is cancerous, use the ABCDE rule to distinguish between benign and malignant spots: asymmetry, border irregularity, color, diameter, and evolving size or shape.
Open Sore or Growth
An open sore on either side of the opening to the vagina can be an indication of Bartholin gland carcinoma, which is a form of vulvar cancer. In most cases, lumps in this area are actually due to non-cancerous Bartholin gland cyst. Other symptoms that may accompany the cysts include bleeding or vaginal discharge. The presence of a growth may cause pain that radiates into the hips.
Pain While Urinating
Another common, early symptom of vulvar cancer is a burning sensation or discomfort when urinating. The pain is often described as a tingling feeling. Many conditions, both serious and benign, can lead to pain during urinating, including yeast infections and some STIs. It is always important to see a doctor if the pain lasts more than a couple of days.
Vaginal Discharge or Bleeding
Vaginal discharge is a natural part of the female reproductive system, helping keep the vagina free of dead cells and bacteria, preventing infections. However, changes in discharge can indicate a medical problem, including vulvar cancer. If there is an inordinate amount of discharge, changes in color, consistency, or smell, or if the discharge no longer follows a previous pattern, vulvar cancer is one possible cause. Any unusual bleeding from the vagina may also indicate vulvar cancer.
Vulvar intraepithelial neoplasia is considered a precancerous lesion, as it can increase a woman's risk of getting vulvar cancer. The condition describes unusual cells in the vulva that are at greater risk of turning cancerous. If this occurs, swelling may develop, and lumps may or may not be discernable. A lump may be present but may not always be felt, as well as pain, discomfort during sex, and changes to the vulvar skin, such as red or white discoloration.
Changes in Shape or Color
In the ABCDE rule, the E stands for evolution — in other words, how a vulvar lesion progresses over time. Like on other parts of the body, women should regularly investigate any moles or other skin markings they notice in the vulvar area. If a mole grows rapidly, it could indicate vulvar cancer. The color of a mole or patch of skin may also indicate illness.
Many people with vulvar cancer report skin ulcers that last for more than a month. These ulcers may appear in different parts of the vagina but are mostly seen on the labia majora. They may also cause itching and irritation, and some cause limited bleeding, discharge, and pain during urination. Routine inspection and prompt reporting to a medical practitioner can identify problematic growths early, or set one's mind at ease if the cause is less serious.
Amongst the diagnosed cases of vulvar cancer, a symptom that affects many women is a plaque or mole on the skin that is asymmetrical in shape. The plaques may be moist and red and surrounded by inflammation. They may also secrete liquid.