Diagnosis

Cancer of the vulva can be detected early through regular pelvic checkups. The earlier a cancer is found, the better the chance for conservative therapy and a cure. Typically a gynecologist will diagnose and treat problems of the vulva. The physician will examine the vulvar tissue with a magnifying device (colposcope) and take a biopsy of any suspicious-looking tissue. If cancer is found, referral to a gynecologic oncologist is important. At Mayo Clinic, experienced gynecologic oncologists consider each patient's personal and medical needs before recommending a treatment plan.
Other noncanerous gynecologic conditions can exhibit similar symptoms to vulvar cancer. Evaluation by a phyisician is critical when the following symptoms appear:
Constant itching of the vulva
Changes in color of the vulva or in the way the vulva looks
White, rough-feeling areas of the vulva
Bleeding or discharge not related to periods
Severe burning, itching or pain in the vulva
Any thickening ulcer or lump not previously present
Once cancer of the vulva has been diagnosed, more tests will be done to determine whether it has spread to other parts of the body. This process is called staging, and it helps doctors determine the best treatment modalities. The stages of vulvar cancer include:
Stage 0 -- Precancerous cells, vulvar intraepithelial neoplasia (VIN), are present; VIN often forms slowly.
Stage I -- The cancer is 2 cm (about 1 inch) or less and found only in the vulva or perineum (the tissue between the vagina and the anus). The stage is further classified as Stage IA or IB depending on how deeply the cancer has invaded underlying connective tissue.
Stage II -- The cancer is greater than 2 cm but is still found only in the vulva or perineum. No cancer has been found in the lymph nodes.
Stage III -- The cancer has spread to the adjacent urethra (the opening from the bladder) or to nearby lymph nodes on one side of the vulva or groin.
Stage IV -- Cancer has spread to other organs. The stage is classified as stage IVA or IVB depending on which part(s) of the body the cancer has invaded.