Vulval cancer: ‘Awareness is very important’

Academic clinical lecturer at the University of Manchester and former Wellbeing of Women researcher, Dr Vanitha Sivalingam, tells us about a gynaecological cancer that more women need to know about

by Wellbeing of Women | 3rd Sep 2020

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What are the symptoms of vulval cancer?

A persistent itch, pain or tenderness in the vulva, raised or thickened skin patches, unexplained bleeding or blood stained discharge, a mole or pigmented spot that is new, or a change in the appearance of the skin – an ulcer or scab that’s not healing, for example.

What are you researching?

My project is looking at detecting vulval cancer early. It’s quite rare – it probably affects around 1,300 women in the UK each year – but there are factors that make women higher risk.

In my research, I am trying to find ways to encourage women who are high risk to self-examine to see if this can help early detection.

How should women self-examine?

In women who are at high risk, try and do it consistently, say once a month. Examine all the skin, make sure you part the labia to have a look inside as well as abnormalities can be very well hidden. This can be done by looking but also feeling.

Have a look in the area between the vulva and the anus – the area called the perineum – too. You can use a mirror, like a make-up mirror to help.

Are some women more likely to get vulval cancer than others?

It’s much more common in women over the age of 75, and women with certain health conditions – such as vulval intraepithelial neoplasia (VIN), lichen sclerosis and lichen planus – are at increased risk. In lichen sclerosis, this increased risk is about 5%.

Anyone with a weakened immune system, for example if they have HIV or are taking medications after an organ transplant, is more likely to develop vulval abnormalities too.

Is it just older women who get vulval cancer?

Younger women can be affected as well – there are cases of women in their 40s and 50s getting vulval cancer, so it's not a definite ‘never going to happen' event.

Are there any common misconceptions about vulval cancer?

Some women assume that if they’d had a cervical smear with a negative result, they don’t have any other gynaecological abnormalities. But you can still have vulval cancer and have a normal smear.

When you are having a smear, health professionals don’t always check everywhere for signs of vulval cancer, so it’s important to be aware of this.

What changes in vulval cancer care would you like to see?

Early detection. If the cancer is picked up early, We can perform curative surgery, which may just involve removing the cancer and a small amount of the surrounding skin. If vulval cancer is picked up late, women have to have very extensive surgery involving the vulva and the groins. In extreme cases, they can end up with a stoma, when your bowel is brought up through your abdomen. Sometimes, it’s too late for curative surgery and women are treated with chemotherapy and radiotherapy instead.

Though we know that women with lichen sclerosis, lichen planus or VIN are at higher risk of getting vulval cancer, there are no proven non-surgical treatments to stop them from developing it. Women with VIN have laser treatment or multiple small surgeries to remove areas which can potentially develop into cancer. These repeated treatments can have psychological and physical impacts on their lives.

Awareness is very important, and so is finding better ways of detecting vulval cancer early, so that we can perform surgery as early as possible.

Wellbeing of Women invests in research to find new ways of detecting, diagnosing and treating vulval cancer. Donate here.

Find out more about vulval cancer symptoms and treatment here.