October 23, 2025 Author : João Casanova (obstetrics-gynecology) Vulvar cancer is one of the rarest gynecological cancers. It represents 3%-5% of gynecological cancer cases. It mainly affects postmenopausal women over the age of 60. It is often serious because it is diagnosed in advanced stages. It is closely related to the human papillomavirus (HPV) infection. What it is, causes, and risk factors for vulvar cancer Vulvar cancer develops in the external female genital region , which includes the labia majora and minora, the clitoris, and the entrance to the vagina, when an uncontrolled growth of cells began. There are several types of vulvar cancer , depending on the cells that give rise to it. The most common is called squamous cell carcinoma and accounts for 90% of cases. The causes of vulvar cancer are not fully understood, but it is known that there is an association with HPV infection . Age is a significant risk factor. Vulvar cancer primarily affects postmenopausal women and those over 60; However, it can also occur in younger women, mainly related to HPV infection. Factors that increase the risk of vulvar cancer include a personal history of: HPV infection, which is sexually transmitted; Other sexually transmitted infections; Chronic skin diseases of the genital area, such as lichen sclerosus; Premalignant lesions in the vulvar region; Other gynecological cancers. Smoking and a family history of vulvar cancer and other gynecological cancers are also significant risk factors. Symptoms and diagnosis As with any cancer, the earlier vulvar cancer is diagnosed, the greater the chance of a cure . Treatments will be less invasive and simpler, and their effectiveness will be greater, which has important implications for well-being and quality of life, including for women sexuality and self-esteem. The symptoms of vulvar cancer depend on its location and stage of the disease. Most often, in early stages, vulvar cancer causes local symptoms such as : Persistent itching; Burning, pain, or increased sensitivity; Sores that do not heal; Abnormal discharge; Abnormal bleeding; Pain during sexual intercourse; Changes in the color and texture of the genital area; A lump or mass that can be identified by palpation. Since these symptoms are not specific to vulvar cancer and can be related to many other problems, some of which resolve on their own and are not serious, they are often confused and underestimated by women. This explains why vulvar cancer is often diagnosed only in the late stages of the disease. The diagnosis of vulvar cancer is based on: The history reported by the patient; A detailed gynecological examination; Laboratory evaluation of suspicious lesions that may be present to determine whether cancer cells are present; The results of blood tests and imaging tests deemed necessary in each case. Treatment and prevention of vulvar cancer Treatment for vulvar cancer depends on: Type of tumor and its location; Stage of the disease; Each woman's particularities and desires. It almost always involves surgery and radiation therapy . Chemotherapy is closely related to the stage of the disease, especially whether it is localized or not. Immunotherapy and other treatment modalities are newer options and, like the other, their application is evaluated on a case-by-case basis. Preventing vulvar cancer primarily involves reducing the risk factors : HPV vaccination is one of the most important measures. Vaccination of girls has been part of the Portuguese National Vaccination Program (PNV) since 2008, but pediatricians recommended it long before that date. Currently, vaccination of boys born after 2009 is included in the PNV. For those born before this date, the vaccine can be recommended up to age 26. Avoid sexually transmitted infections by using condoms during sexual intercourse; Maintain a proper intimate hygiene; Do not smoke; Maintain regular gynecological follow up and seek medical attention if any doubts or suspicious signs arise. In summary, vulvar cancer: Can be a serious disease when is diagnosed in advanced stages; It is curable when detected early; There are preventive measures to be taken. In addition, knowing the signs and symptoms that may be related to vulvar cancer, being alert, maintaining regular medical follow up, and seeking medical advice if any concerns arise are the best things every woman can do to protect herself. Meet the obstetrics-gynecology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
