The number staging system is often used for vulval cancer. It may help to look at the diagram of the vulva below when you are reading this explanation. Stage 1 and 2 cancers are often called early-stage cancers. Stage 3 and 4 cancers are called advanced-stage cancers.
The cancer is only in the vulval area and has not spread to the lymph nodes.
- Stage 1A
The cancer is up to 2cm in size and has grown up to 1mm deep into the skin.
- Stage 1B
The cancer is more than 2cm in size. Or the cancer is any size and has grown more than 1mm deep into the skin.
- Stage 1A
The cancer is any size and has spread locally to nearby areas such as:
- the lower part of the tube you pass urine through (urethra)
- the lower part of the vagina
- the anus.
It has not spread to lymph nodes.
The cancer has spread to nearby lymph nodes.
- Stage 3A
The cancer has spread to one lymph node. Or the cancer has spread to two lymph nodes that are 5mm or more in size.
- Stage 3B
The cancer has spread to two or more lymph nodes that are less than 5mm in size. Or the cancer has spread to three or more lymph nodes that are 5mm or more in size.
- Stage 3C
The cancer has spread to the lymph nodes, and has also spread outside the capsule that surrounds the lymph node.
- Stage 3A
Stage 4 is divided into two stages.
- Stage 4A
The cancer is any size and has done any of the following:
- spread into the upper part of the urethra, the vagina, the bladder or the rectum
- become fixed to the pelvic bone
- spread to lymph nodes in the groin, and these lymph nodes have formed an ulcer or cannot be moved (have become fixed).
- Stage 4B
The cancer has spread to:
- the lymph nodes in the pelvis
- other parts of the body that are further away, such as the lungs.
- Stage 4A
Another system called TNM staging is sometimes used. TNM stands for tumour, node and metastases.
- T describes the size of the tumour. This is usually a number between 1 and 4. 1 is a small cancer and 4 is a larger or more advanced cancer.
- N describes whether the cancer has spread to the lymph nodes. The number can be between 0 and 3. 0 means there are no cancer cells in the lymph nodes. 3 means more lymph nodes are affected by cancer.
- M describes whether the cancer has spread to another part of the body (known as metastatic or secondary cancer). The number is either 0 or 1. 0 means the cancer has not spread to other parts of the body. 1 means it has spread.
Grading is how the cancer cells look under the microscope compared with normal cells. The grade helps your doctor decide if you need further treatment after surgery.
- Grade 1 or low-grade or well differentiated – The cancer cells look similar to normal cells and usually grow slowly and are less likely to spread.
- Grade 2 or moderate-or intermediate-grade – The cancer cells look more abnormal and are slightly faster growing.
- Grade 3 or high-grade or poorly differentiated – The cancer cells look very different from normal cells and may grow more quickly.
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 email@example.com
Morrison J, Baldwin P, Buckley L, et al. Gynaecological Cancer Society (BGCS) vulval cancer guidelines: recommendations for practice. 2020. Available from https://www.bgcs.org.uk/wp-content/uploads/2021/07/BGCS-vulval-guidelines-v22.pdf [accessed November 2020].
Rogers LJ, and Cuello MA. Cancer of the vulva. Int J Gynaecol Obstet, 2018; 143, S2, 4-13. Available from https://doi.org/10.1002/ijgo.12609 [accessed November 2020].
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