Being diagnosed with vulval cancer

If you have symptoms that might be due to a vulval cancer, your doctor will usually refer you to a specialist in women’s cancers. You may also have a blood test and a chest x-ray to check your general health.

The specialist will examine your vulva. To do this, a nurse will help you position yourself on a couch. Sometimes leg supports are used. The doctor may use a bright light and a magnifier to examine the vulval area. They will also do an internal examination to look at the vagina and the cervix. Let your doctor know if you feel uncomfortable at any time before or during the examination.

Your doctor will probably remove a small sample of cells (biopsy) from any abnormal areas to be examined under a microscope. This can be done under local or general anaesthetic. You doctor or nurse can tell you more about having a biopsy.

Waiting for test results can be difficult. It may help to talk to someone close to you or one of our cancer support specialists.

How cancer of the vulva is diagnosed

You will usually see your GP first. They will examine you and arrange any tests you need.

If there is a possibility that you have vulval cancer, you should be referred to a specialist in women’s cancers (gynaecological cancer specialist). Your doctor may also arrange for you to have a blood test and chest x-ray to check your general health.


Vulval examination

The gynaecological cancer specialist will ask you about your general health. They will also examine your vulval area. This can usually be done during an outpatient appointment.

The vulva is an intimate and private part of the body. Some women find it embarrassing or upsetting to have a vulval examination. If you feel this way, let your doctor or nurse know so they can give you support.

Before the examination, a nurse will help you position yourself on a couch. There may be special leg supports. The doctor may use a bright light and a magnifier to examine your vulva. This helps them see the skin more clearly. They may take small samples of tissue (biopsies) from any areas that look unusual. You may have a local anaesthetic for this.

The doctor will also do an internal examination to check your vagina and cervix for any abnormalities. They will use a plastic or metal instrument called a speculum. This holds the vaginal walls open. A liquid will be dabbed on to your cervix to help show up any abnormal areas more clearly. You may also have a small sample of cells taken from the cervix. The doctor may also examine your back passage (anus).

If you have narrowing of the vagina due to lichen sclerosus, or if your vulva is too sore for a full examination, the specialist can arrange to examine you while you’re under a general anaesthetic.


Biopsy

A biopsy is the best way to diagnose cancer of the vulva. A doctor takes a small sample of tissue from the affected area of the vulva.This is sent to a laboratory to be examined under a microscope.

You can have a biopsy as an outpatient. Before the biopsy, you will have a local anaesthetic injected into the skin of your vulva to numb it. This may sting for a few seconds. There shouldn’t be any pain when the sample of tissue is taken from your vulva, but you may feel a little discomfort. Your doctor may put one or two stitches in the area where the biopsy was taken from.

Occasionally, if your vulval area is very painful, you may have your biopsy taken under a general anaesthetic.

After the biopsy, you may have some bleeding. This should gradually stop. If it gets worse or continues, tell your doctor. You may also feel sore. Painkillers or a warm bath can help.

It will probably take about 7–10 days for the results of your tests to be ready. Waiting for your results can be a difficult time. It may help to talk to a relative or close friend.

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Further tests after diagnosis

If you’ve been diagnosed with vulval cancer, you will need further tests to find out more about the cancer and your general health.