Staging and grading of vulval cancer

 

Grading Back to top

Grading refers to the appearance of the cancer cells under the microscope. The grade gives an idea of how quickly the cancer may develop. The most common system uses three grades:

• Low grade means that the cancer cells look very much like the normal cells of the vulva. They usually grow slowly and are less likely to spread.
• Moderate grade means the cells look more abnormal than low-grade cells but not as abnormal as high-grade cells.
• High grade means the cells look very abnormal. They are likely to grow more quickly and are more likely to spread.

Knowing the grade of the cancer helps doctors decide on the most appropriate treatment.

Staging Back to top

The stage of a cancer is a term used to describe its size and whether it has spread beyond the area of the body where it first started. Knowing the stage of the cancer will help you and your doctor to decide on the most appropriate treatment for you.

A commonly used staging system is described here:

Stage 1 The cancer is only in the vulva and/or perineum (the space between the opening of the rectum and the vagina). The affected area has a width of 2cm (about 1 inch), or less.

Stage 1 can be further divided into Stage 1a and 1b depending on how deeply into the skin of the vulva the cancer has grown.

• Stage 1a The cancer is 2cm or less across and has grown 1 millimetre (1mm) or less into the skin.
• Stage 1b The cancer is 2cm or less across and has grown more than 1mm into the skin.

Stage 2 The cancer is only in the vulva and/or the perineum. The affected area is more than 2cm (1 inch) wide.

Stage 3 The cancer is in the vulva and/or perineum and has spread to the lymph nodes in the right or left groin and/or to nearby tissues such as the lower part of the urethra (the tube which carries urine from the bladder), the vagina and the anus (the opening of the rectum).

Stage 4 The cancer has spread to the lymph nodes in both the left and right groin or to lymph nodes in the pelvis. Alternatively, it has spread beyond the urethra, vagina| and anus into the lining of the bladder|  or bowel| , or to other organs outside the pelvis.

Gynaecologists often refer to stage 1 and 2 cancers as early stage cancers and stage 3 and 4 cancers as advanced-stage cancers (some gynaecologists consider only stage 1 cancer as early stage cancer).