What is vulval cancer?
Vulvas are visible sex organs that surround the opening of the vagina outside the body.
Cancer of the vulva is rare. About 1,400 women are diagnosed with it each year in the UK.
Anyone with a vulva can develop vulval cancer. This includes women, transgender (trans) men and people assigned female at birth.
Vulval cancer is sometimes called vulvar cancer. It can affect any part of the vulva. The most common area for it to develop is the skin of the labia. It can also sometimes affect the tip of the clitoris or the Bartholin’s glands.
Types of vulval cancer
The most common type of vulval cancer is squamous cell carcinoma. 9 in 10 vulval cancers (90%) are this type. Squamous cell carcinoma can take many years to develop. It usually starts with pre-cancerous changes to the outer layer of the skin cells of the vulva.
There are other types of vulval cancer, but these are not as common.
-
Verrucous carcinomaThis is a very rare, slow-growing type of squamous cell carcinoma that looks like a large wart.
-
MelanomaThis is a type of skin cancer that develops from cells that produce the pigment that gives skin its colour. Rarely it can develop in the skin of the vulva.
-
Basal cell carcinomaThis is a cancer that develops from cells called basal cells. These are found in the deepest layer of the skin of the vulva.
-
AdenocarcinomaThis is a cancer that develops from cells that line the glands in the vulval skin.
-
Bartholin gland cancerThis is a cancer that develops in the Bartholin’s glands at the opening of the vagina.
-
Sarcoma
Sarcomas develop from cells in tissue such as:
- muscle
- fat
- blood vessels under the skin.
They tend to grow more quickly than other types of vulval cancer.
For more information about these, you can call our cancer information specialists.
Your doctor or nurse can explain more about the type of vulval cancer you have. If you would like to talk to someone about your diagnosis, you can chat to our trained advisors and cancer information specialist nurses on the Macmillan Support Line.
Related pages
Booklets and resources
Symptoms of vulval cancer
The most common symptoms of vulval cancer are:
- itching, burning or soreness of the vulva that does not go away
- a lump, swelling or wart-like growth on the vulva
- thickened, raised, red, white or dark patches on the skin of the vulva
- bleeding, or a blood-stained vaginal discharge, that is not related to periods
- burning pain when passing urine (peeing)
- vulval tenderness or pain
- a sore or ulcerated area on the vulva
- a mole on the vulva that changes shape or colour
- a lump in the groin.
Many people find it embarrassing talking about symptoms like these. But it is always important to get them checked by your GP.
Vulval cancer can take many years to develop. It usually starts with pre-cancerous cells that change slowly over several years into cancerous cells. As with other cancers, vulval cancer is easier to treat and cure if it is diagnosed early.
Causes of vulval cancer
The exact cause of vulval cancer is unknown. But some risk factors can increase the chances of developing it. Having one or more risk factors does not mean you will get cancer. And if you do not have any risk factors, it does not mean you will not get vulval cancer.
We have more information about the causes and risk factors of vulval cancer.
Vulval cancer diagnosis
If you have symptoms, you usually begin by visiting your GP. If they think that your symptoms could be caused by cancer, they will refer you to a specialist clinic or doctor. This is often a gynaecological cancer specialist. This is a doctor who specialises in female reproductive system cancers.
The main tests for vulval cancer are an examination of the vulva and taking a small sample (biopsy) of any areas that look abnormal.
You can usually have these tests during an outpatient appointment. You may have them under a general anaesthetic if:
- there is a narrowing of the vagina due to lichen sclerosus (LS) or lichen planus (LP)
- the vulva is too sore for a full examination.
Waiting for test results can be a difficult time. We have information and support that may help while you are waiting.
Further tests
If the biopsy result shows cancer, your doctor will arrange further tests to check if the cancer has spread. This is called staging. The results will help you and your doctor decide on the best treatment for you. Some tests may be repeated during and after treatment to check your progress.
Your doctor or specialist nurse will explain which of the following tests you may need.
We have more information about other tests you may have.
Lymph node tests
A common place vulval cancer may spread to is the lymph nodes in the groin. Your doctor may suggest you have tests to check the groin lymph nodes. These may include:
-
Ultrasound and a fine needle aspiration
If the ultrasound shows abnormal lymph nodes, the doctor may do a fine needle aspiration.
-
Sentinel lymph node biopsy
The sentinel nodes are the first lymph nodes that fluid drains to from the vulva. If the cancer has spread to nearby nodes, these sentinel nodes are most likely to be affected. Your doctor may suggest checking the sentinel nodes for cancer cells with a test called a sentinel lymph node biopsy (SLNB).
We have more information about lymph node tests.
Staging and grading of vulval cancer
The stage of a cancer explains its size and whether it has spread beyond the area it first started. Grading is how the cancer cells look under the microscope compared with normal cells.
Knowing the stage and grade will help you and your doctor decide on the best treatment for you.
We have more information about the staging and grading of vulval cancer.
Related pages
Treatment for vulval cancer
Treatment for vulval cancer may include surgery, radiotherapy and chemotherapy. Your cancer team will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.
Your treatment plan is based on:
- the type of vulval cancer
- the stage and grade of the cancer
- your general health
- your personal preferences.
After your test results, you and your doctor start to talk about your treatment. Your doctor usually meets with other specialists to get their opinions too. A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
The MDT will usually include the following professionals:
- A gynaecological oncologist is a surgeon who treats cancers of the female reproductive system.
- An oncologist is a doctor who treats people who have cancer.
- A clinical nurse specialist (CNS) is a nurse who gives information about cancer, and support during treatment.
- A plastic surgeon is a doctor who does operations (surgery) to repair or reconstruct tissue and skin.
- A radiologist is a doctor who looks at scans and x-rays to diagnose problems.
- A pathologist is a doctor who looks at cells or body tissue under a microscope to diagnose cancer.
Your cancer doctor or specialist nurse will explain the different treatments.
Treatments may include:
-
Surgery
The surgery you have will depend on the size and position of the cancer. If surgery is possible, this is usually the main treatment. The aim is to completely remove the cancer. We have more information about what happens before and after surgery.
-
Radiotherapy
Radiotherapy uses high-energy rays, such as x-rays, to treat cancer cells. This treatment may be used before or after surgery.
Radiotherapy can be given with chemotherapy. This is called chemoradiation. Or you may have radiotherapy on its own. Radiotherapy and chemotherapy may be given after surgery to reduce the risk of the cancer coming back. Sometimes radiotherapy may be used to shrink the cancer before surgery. Sometimes it is used as the main treatment with chemotherapy if you cannot have surgery.
Radiotherapy may also be used to manage any symptoms caused by the cancer and improve quality of life.
-
Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. This treatment may be used before or after surgery. Chemotherapy may be used with radiotherapy or by itself to treat vulval cancer. Chemotherapy can be given with radiotherapy (chemoradiation) after surgery to reduce the risk of the cancer coming back. Sometimes chemotherapy may be used to shrink the cancer before surgery.
Chemotherapy can be given with radiotherapy (chemoradiation) as the main treatment if surgery is not possible.
Chemotherapy may also be used to manage any symptoms caused by the cancer and improve quality of life.
You may have some treatments as part of a clinical trial.
Cancer that comes back may be treated again with surgery, radiotherapy or chemotherapy.
-
Immunotherapy
Immunotherapy drugs help stimulate the immune system to recognise and destroy cancer cells. Sometimes, this type of treatment is used to treat vulval cancer.
Your cancer doctor will explain whether this treatment is suitable for you. You may have it as part of a clinical trial.
Treatment for advanced vulval cancer
After vulval cancer treatment
After your treatment has finished, you will have regular check-ups with your cancer doctor or nurse. Your appointments will usually be every few months at first. Later they may only be once a year.
Your cancer doctor or specialist nurse will check your vulva and groin area. You can talk to them about any problems or worries at these check-ups. But if you notice any new symptoms or have any problems between appointments, contact them for advice.
If you had a vulval skin condition such as vulval lichen sclerosus (LS) or lichen planus (LP) before vulval cancer, you should keep seeing your specialist for those conditions too. After cancer treatment, you may still need ongoing treatment for the skin. Your doctor will advise you about this.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
We have more information about follow-up care after treatment.
Macmillan is also here to support you. If you would like to talk, you can:
- Call the Macmillan Support Line on 0808 808 00 00.
- Chat to our specialists online.
- Visit our vulval cancer forum to talk with people who have been affected by vulval cancer, share your experience, and ask an expert your questions.
Lymphoedema
After vulval cancer treatment, some people may develop lymphoedema. Lymphoedema is swelling that develops because of a build-up of lymph fluid in the body’s tissues. The lymph nodes are part of the body’s immune system and help fight infection. A fluid called lymph fluid normally flows through these nodes. Lymphoedema may develop if the nodes:
- stop working normally because of radiotherapy
- are removed during surgery.
Fluid may collect and cause swelling in one or both legs, or the pubic area.
Not everyone gets lymphoedema after treatment for cancer of the vulva. But it can start months or years later.
There are treatments that help manage swelling. There are also things you can do to reduce your risk of getting lymphoedema. Your doctor or nurse may plan for you to meet with a specialist for advice.
Late effects of radiotherapy for vulval cancer
Radiotherapy to the pelvic area can sometimes cause effects months or years after treatment. These are called late effects. They may be permanent. If they happen, there are ways to manage and treat them.
Radiotherapy to the pelvis affects the ovaries. If you have not already been through the menopause, this treatment may cause an early menopause. This means your periods will stop and you will no longer be able to get pregnant.
We have more about this in our information about late effects of pelvic radiotherapy and menopause.
Sex and relationships
Life after cancer treatment is often challenging. It can be especially difficult to cope with changes to something as personal as your sex life. Treatment may have changed the way your genital area looks or feels. This may affect how your body responds sexually or how sex feels. It may also affect how you feel about your body, sex and your relationships.
It is common to have questions about sex or need more help after treatment. These things are not always easy to talk about. There is support available. Do not be afraid or embarrassed to ask for advice. Your cancer doctor or nurse can help or arrange for you to see a specialist.
Well-being and recovery
Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.
Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.
More information and advice
We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with:
Many people find it helpful to connect with others and learn practical ways to cope with cancer or after cancer treatment. The HOPE programme is a free 6 week course that can support people in developing techniques and strategies to manage aspects of living with cancer. Topics include ways to manage fatigue and stress, and improve wellbeing. You can join the online HOPE programme or email ServiceOpsSupport@macmillan.org.uk to find out more about the face to face programmes in your area.
The Eve Appeal
Tel 020 7605 0100
Email office@eveappeal.org.uk
The Eve Appeal is a UK national charity raising awareness and funding research into the five gynaecological cancers – ovarian, womb, cervical, vaginal and vulval.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
-
References
Below is a sample of the sources used in our vulval cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Morrison J, Baldwin P, Hanna L, Andreou A, Buckley L, Durrant L, et al. British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023. European Journal of Obstetrics and Gynaecology and Reproductive Biology. 2024;292: 210–238. Available from: www.doi.org/10.1016/j.ejogrb.2023.11.013 [accessed July 2026].
The Royal College of Radiographers. The Royal College of Radiologists expert panel recommendations for radiotherapy treatment for vulval cancer. 2024. Available from: www.rcr.ac.uk/media/l1zjohkm/rcr-vulval-cancer-treatment-recommendations.pdf [accessed July 2026]
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.