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Tests and diagnosis
By Mayo Clinic staff
Diagnosing vulvar cancer
Tests and procedures used to diagnose vulvar cancer include:
- Examining your vulva. Your doctor may conduct a physical exam of your vulva to look for abnormalities.
- Using a special lens to examine your vulva. During a colposcopy exam, your doctor uses a device that works like a magnifying glass to closely inspect your vulva for abnormal areas.
- Removing a sample of tissue for testing (biopsy). To determine whether an area of suspicious skin on your vulva is cancer, your doctor may recommend removing a sample of skin for testing. During a biopsy procedure, the area is numbed with a local anesthetic and a scalpel or other special cutting tool is used to remove all or part of the suspicious area. Depending on how much skin is removed, you may need stitches.
Determining the extent of the cancer
Once your diagnosis is confirmed, your doctor works to determine the size and extent (stage) of your cancer. Staging tests can include:
- Examining your pelvic area for cancer spread. Your doctor may do a more thorough examination of your pelvis for signs that the cancer has spread.
- Imaging tests. Images of your chest or abdomen may show whether the cancer has spread to those areas. Imaging tests may include X-ray, computerized tomography (CT) and magnetic resonance imaging (MRI).
Vulvar cancer stages
Your vulvar cancer is assigned a Roman numeral that denotes its stage. Stages of vulvar cancer include:
- Stage I describes a small tumor that is confined to the vulva or the area of skin between your vaginal opening and anus (perineum). This cancer hasn't spread to your lymph nodes or other areas of your body.
- Stage II tumors are those that have grown to include nearby structures, such as the lower portions of the urethra, vagina and anus.
- Stage III cancer has spread to lymph nodes.
- Stage IVA signifies a cancer that has spread more extensively to the lymph nodes, or that has spread to the upper portions of the urethra or vagina, or that has spread to the bladder, rectum or pelvic bone.
- Stage IVB is a cancer that has spread (metastasized) to distant parts of your body.
References
- Jhingran A, et al. Cancers of the cervix, vulva and vagina. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2007:1766.
- Frumovitz M, et al. Neoplastic diseases of the vulva: Lichen sclerosus, intraepithelial neoplasia, Paget's disease, carcinoma. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/202781245-2/0/1524/0.html. Accessed June 2, 2010.
- Crosbie EJ, et al. The management of vulvar cancer. Cancer Treatment Reviews. 2009;35:533.
- Whitcomb BP. Gynecologic malignancies. Surgical Clinics of North America. 2008;88:301.
- Elkas JC, et al. Vulvar cancer: Staging, treatment and prognosis. http://www.uptodate.com/home/index.html. Accessed June 7, 2010.
- Gagne HM. Colposcopy of the vagina and vulva. Obstetric and Gynecologic Clinics of North America. 2008;35:659.
- Helm CW. Radical vulvectomy. http://www.uptodate.com/home/index.html. Accessed June 7, 2010.
- Barton DPJ. The prevention and management of treatment related morbidity in vulvar cancer. Best Practice & Research Clinical Obstetrics Gynaecology. 2003;17:683.
- Disorders of the vulva. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp088.cfm. Accessed June 9, 2010.
- Human papillomavirus infection. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp073.cfm. Accessed June 9, 2010.
- Vulva. In: Edge SB, et al. AJCC Cancer Staging Manual. 7th ed. New York, N.Y.: Springer; 2010:379.
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