Vulvar Cancer Treatment in Delhi

Vulvar cancer is a rare cancer that affects the outer surface of the female genitalia, including:

• Labia
• Opening of the vagina
• Clitoris
• Opening of urethra
• Mon Pubis
• Perineum 

It typically develops slowly over the years and is often preceded by precancerous changes in the vulvar skin called vulvar intraepithelial neoplasia (VIN). Early-stage vulvar cancer may not always present noticeable symptoms, making regular gynaecological check-ups essential for early detection.

While the exact vulvar cancer causes remain unclear, risk factors include persistent human papillomavirus (HPV) infection, chronic skin conditions, a weakened immune system, and age-related changes. Early diagnosis and prompt vulvar cancer treatment improve the chances of successful recovery and reduce complications.

Vulvar cancer is classified into four stages based on the size of the tumour, its spread to nearby tissues, and whether it has affected lymph nodes or other parts of the body. Accurate staging helps doctors develop a personalised vulvar cancer treatment plan and predict outcomes.

Stage 0 (Carcinoma in Situ)

• Abnormal cells are found only on the surface of the vulvar skin.
• This stage is considered pre-cancerous and highly treatable with early intervention.

Stage 1 Vulvar Cancer

• The tumour is confined to the vulva or perineum.
• It measures up to 2 cm (Stage 1A) or larger than 2 cm (Stage 1B).
• The cancer has not spread to lymph nodes or distant organs.
• Symptoms may include persistent itching, lumps, or skin changes.

Stage 2 Vulvar Cancer

• The tumour has spread to nearby structures, such as the lower urethra, lower vagina, or anus.
• Lymph nodes and distant organs are not affected at this stage.

Stage 3 Vulvar Cancer

• The cancer has spread to nearby lymph nodes.
• Tumours may affect the urethra, vagina, or anus.
• Common symptoms include pain, bleeding, or ulcers on the vulva.

Stage 4 Vulvar Cancer

• The cancer has spread to lymph nodes in the pelvis or other distant organs, such as the bladder, rectum, or lungs.
• This stage requires a combination of advanced treatments, including surgery, chemotherapy, and radiation therapy.

At Max Hospital, our specialists follow internationally recognised vulvar cancer management guidelines to ensure accurate staging and customised treatment plans.

Vulvar cancer often develops gradually, and early symptoms may be subtle. Recognising the signs early can lead to prompt diagnosis and treatment. Common vulvar cancer symptoms include:

Early-stage Vulvar Cancer Symptoms

• Persistent Itching or Burning: Long-term irritation that doesn’t improve with treatment.
• Skin Changes: The vulvar skin may appear red, white, or darkened, with patches that feel thickened or rough.
• Lumps or Growths: Small bumps, ulcers, or warty growths on the vulva that may be painless initially.

Advanced Vulvar Cancer Symptoms

• Pain or Tenderness: Discomfort in the vulvar region, especially during urination or sexual activity.
• Bleeding or Discharge: Unusual bleeding that is not related to menstruation.
• Non-Healing Sores: Open wounds or ulcers that do not heal over time.
• Swollen Lymph Nodes: Enlarged nodes in the groin area, indicating possible cancer spread.

Since symptoms may resemble other benign conditions such as infections or skin disorders, early medical evaluation is crucial.

Vulvar cancer develops when abnormal cells in the vulva grow uncontrollably, often due to genetic changes or long-term irritation. While the exact cause remains unclear, several factors may increase the risk of developing the disease. Key causes and risk factors include:

• Human Papillomavirus (HPV) Infection: A leading risk factor, particularly for squamous cell carcinoma of the vulva. Persistent HPV infection can cause cellular changes, increasing cancer risk.
• Lichen Sclerosus: A chronic skin condition that makes vulvar tissue thin, itchy, and more vulnerable to cancerous changes.
• Vulvar Squamous Intraepithelial Lesions (VIN): Precancerous lesions that may develop into vulvar cancer over time if left untreated.
• Abnormal Cervical Screening Results: Changes in the cervix detected through Pap smears may indicate a higher likelihood of developing vulvar cancer.
• History of Cervical or Vaginal Cancer: Women who have had cervical or vaginal cancer face an increased risk due to shared risk factors like HPV exposure.
• Tobacco Smoking: Smoking weakens the immune system, making it harder to fight HPV infections and other carcinogenic changes.
• HIV Infection: HIV lowers the immune system’s ability to clear HPV infections, which may contribute to vulvar cancer development.
• Organ Transplant: Patients who have undergone an organ transplant often take immunosuppressant medications, increasing vulnerability to infections and cancer.
• Age: Vulvar cancer is more common in women over 60, though younger women can also be affected, especially if they have HPV.
• Chronic Inflammatory Conditions: Long-term inflammation or irritation of the vulvar skin can lead to precancerous or cancerous changes.
• Radiation Exposure: Prior radiation therapy to the pelvic area can increase the risk of vulvar cancer later in life.
• Melanoma and Moles: A personal or family history of melanoma or unusual moles may contribute to vulvar melanoma, a rare type of vulvar cancer.
• Immunodeficiency: A weakened immune system, whether due to medications or underlying conditions, may reduce the body’s ability to fight off cancerous changes.

While some risk factors, such as age and genetic predisposition, cannot be controlled, others—such as HPV infection, smoking, and inflammatory conditions—can be managed through preventative care and early screenings.

Early detection of vulvar cancer improves treatment success. If you or a loved one experiences persistent itching, pain, lumps, or skin changes in the vulvar area, consult a doctor for evaluation. Symptoms such as unexplained bleeding, sores that don’t heal, or discomfort during urination or intercourse should not be ignored.

Women at higher risk, including those with HPV infection, HIV, chronic vulvar conditions, a history of cervical abnormalities, or past radiation therapy, should schedule regular screenings. If diagnosed, seeking a second opinion can help explore the best treatment options.

Max Hospitals offers advanced diagnosis and treatment for various types of vulvar cancer, ensuring personalised care for every patient.

• Vulvar Squamous Cell Carcinoma: The most common type, originating in the thin, flat cells lining the vulva. Often linked to HPV infection.
• Vulvar Melanoma: A rare but aggressive cancer that develops in the pigment-producing cells of the vulva.
• Vulvar Sarcoma: A rare cancer that arises from the connective tissues, including muscles and fat, in the vulvar region.
• Bartholin Gland Adenocarcinoma: Affects the Bartholin glands, responsible for vaginal lubrication.
• Vulvar Basal Cell Carcinoma: A slow-growing cancer that originates in the basal (tall) cells of the vulvar skin.
• Paget Disease of the Vulva: A rare condition presenting as red, scaly lesions on the vulva, often linked to underlying carcinoma.
• Verrucous Carcinoma: A slow-growing but locally invasive type of squamous cell cancer resembling large genital wart-like growths.

At Max Hospital, we use cutting-edge diagnostic methods to detect vulvar cancer early and determine its stage. A precise diagnosis allows for effective treatment planning and better outcomes. Key diagnostic tests include:

• Pelvic Exam: A thorough physical check-up to identify lumps, lesions, or abnormalities in the vulvar region.
• Pap Smear: A screening test that involves collecting cells from the cervix to check for HPV infection or precancerous changes.
• Colposcopy: A procedure where a special instrument called a colposcope (a magnifying device) is used to examine the vulva, cervix, and vaginal walls for abnormal tissue or lesions.
• Biopsy: Confirms cancer by analysing a tissue sample under a microscope.
• Cervical Screening Test: Identifies early cellular changes that could indicate a risk of vulvar cancer.

Tests to Determine Cancer Spread:

• Scope Exams: Cystoscopy and proctoscopy help check if cancer has spread to the bladder or rectum.
• Cystoscopy: A thin, flexible tube with a camera is inserted into the urethra, allowing doctors to inspect the bladder lining for abnormalities.
• Proctoscopy: A small, illuminated scope is inserted into the rectum to examine for cancer spread.
• Blood Test: Assesses abnormalities that may signal cancer progression.
• Imaging Tests: MRI, CT, and PET scans provide detailed visuals of the tumour and nearby lymph nodes.
• Sentinel Node Biopsy: A dye is injected near the tumour, and the first lymph node that absorbs it is removed and analysed. If cancer is found, further treatment may be needed.

At Max Hospital, a multidisciplinary team of oncologists, surgeons, and specialists offers advanced and personalised treatments for vulvar cancer. The choice of treatment depends on the stage, type, and spread of cancer, ensuring the best possible outcomes for patients.

1. Surgery

Surgical procedures are the primary treatment for vulvar cancer, aiming to remove the tumour while preserving as much healthy tissue as possible.

• Wide Local Excision: Removes the cancerous lesion and some surrounding healthy tissue.
• Radical Vulvectomy:  Removes the entire vulva, used for advanced-stage cancer.
• Lymph Node Dissection: Removes lymph nodes in the groin to check for and prevent cancer spread.
• Pelvic Exenteration: A complex surgery performed in cases where cancer has spread to nearby organs, such as the bladder or rectum. It involves the removal of the vagina, cervix, ovaries, bladder, colon, rectum, and nearby lymph nodes. 

2. Radiation Therapy

Radiation therapy uses high-energy beams to target and destroy cancer cells. External beam radiation therapy is common in vulvar cancer treatment. It may be used:

• Before surgery to shrink tumours and make them easier to remove.
• After surgery to eliminate the remaining cancer cells.
• As a primary treatment for patients who are not candidates for surgery.

3. Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells or stop them from growing. It may be given in the form of an injection in a vein or tablets, and sometimes as topical cream for the vulva. Chemotherapy is commonly used in:

• Advanced or recurrent vulvar cancer to slow disease progression.
• Combination with radiation therapy for better treatment outcomes.
• For relieving symptoms of the cancer as a palliative treatment.

4. Targeted Therapy

For some types of vulvar cancer, targeted therapy may be recommended. These treatments focus on specific cancer cell mutations and block their growth. They are often used in patients with advanced-stage cancer or cancers resistant to standard treatments.

5. Immunotherapy

Immunotherapy helps the body's immune system identify and attack cancer cells. It is especially beneficial for HPV-related vulvar cancers and cases where cancer has spread beyond the vulva.

Post-treatment, patients are advised to have tests to monitor their condition and check whether the cancer has returned. 

Max Hospitals offers personalised treatment plans, supportive care, and post-treatment monitoring to help patients recover and maintain their quality of life. Our team also provides counselling and rehabilitation support to manage the emotional and physical challenges of vulvar cancer treatment. For expert consultation and world-class care, book an appointment with our vulvar cancer specialists at Max Hospitals today.

Can vulvar cancer be cured?

Yes, vulvar cancer is highly treatable, especially when diagnosed early, with surgery, radiation, or other targeted treatments.

What is the first sign of vulvar cancer?

The first sign is often persistent itching, burning, or a lump or sore on the vulva that does not heal.

Do vulvar cancer symptoms come and go?

Some symptoms, such as itching or discomfort, may fluctuate, but sores or lumps usually persist and worsen over time.

Is vulvar cancer rare?

Yes, vulvar cancer is a rare type of gynaecologic cancer, accounting for only a small percentage of female reproductive cancers.

Does vulvar cancer spread fast?

Vulvar cancer usually grows slowly, but if left untreated, it can spread to nearby tissues, lymph nodes, or distant organs.

Who is at risk for vulvar cancer?

Risk factors include HPV infection, smoking, weakened immune system, older age, and a history of precancerous vulvar conditions.

How do I reduce my risk of developing vulvar cancer?

You can lower your risk by getting the HPV vaccine, avoiding tobacco, practising safe sex, and attending regular gynaecological check-ups.

What are the signs of vulvar cancer?

Signs include persistent itching, pain, unusual lumps, open sores, bleeding, or changes in skin colour or texture on the vulva.

Are there any dietary restrictions for vulvar cancer patients?

There are no strict dietary restrictions, but a balanced, nutrient-rich diet can help support overall health during treatment.

What are the signs that vulvar cancer is getting worse?

Worsening pain, increased ulceration, bleeding, enlarged lymph nodes, or spread to nearby organs may indicate cancer progression.

What are the chances of getting vulvar cancer?

Vulvar cancer is not a common type of cancer, but its risk increases with age, HPV infection, smoking, or a history of vulvar or cervical abnormalities.

Where does vulvar cancer usually start?

It typically starts in the outer vaginal lips (labia majora or labia minora) but can also develop in the clitoris or vaginal opening.

Can I have children after a vulvar cancer diagnosis?

Yes, it is possible to have children after a vulvar cancer diagnosis, depending on the stage and treatment. Fertility-preserving options can be discussed with your doctor before starting treatment.

Reviewed By Dr. Kanika Gupta, Principal Director – Surgical Oncology (Gynae & Robotic Surgery) on 19 Mar 2025.