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Vulvar Cancer

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Vulvar cancer is one of the rarest gynecologic cancers in the U.S. The American Cancer Society estimates that 6,000 women are diagnosed with vulvar cancer yearly. Regardless of its rarity, if it happens to you, you’ve come to the right place.

The vulva, the outside of a woman’s genitalia, includes the outer lip-like structures, the smaller inner labia and the perineum, the space between the vagina and anus, and the anus itself. Vulvar cancer most often affects the labia majora or labia minora.

Squamous cell carcinoma: Eighty percent of vulvar cancers are squamous cell carcinomas, usually found on the vaginal lips.

Adenocarcinoma: About eight percent of vulvar cancers are adenocarcinomas usually found on the sides of the vaginal opening.

Other types of vulvar cancer, which account for less than 10 percent of vulvar cancers, include:

  • Melanoma: Usually found on light-exposed areas of the body, melanomas of the pigment cells account for six of every 100 vulvar cancers.
  • Extra-mammary Paget Disease (EMPD): This type accounts for less than two percent of all vulvar cancers.
  • Sarcomas: Less than two of every 100 vulvar cancers are sarcomas. Unlike other cancers of the vulva, vulvar sarcomas can occur in females at any age, including childhood.
  • Basal cell carcinomas: Basal cell, the most common type of skin cancer, is often found on sun-exposed areas of the skin, rarely on the vulva.

Why Choose Sylvester Comprehensive Cancer Center?


More experienced physicians to care for you. Sylvester treats more than 5,000 patients with cancer each year. Your dedicated team of physicians at Sylvester have a huge depth and breadth of experience treating your unique cancer.

Multidisciplinary care teams provide nationally recognized expertise. Your physician experts talk to each other, face-to-face, on a regular basis and plan the right care for you and your specific cancer. And you can expect that caliber of care in years to come. Sylvester also has the only gynecologic oncology fellowship in South Florida training the next generation of doctors.

A dedicated dysplasia clinic. Pre-invasive ano-genital disease (also known as dysplasia) is common and can affect the cervix, vagina, vulva, and anus. If you have dysplasia, when appropriately treated, cancer of these sites may be prevented.

Fertility preservation experts. You don’t have to choose between future fertility and cancer treatment. Specialists at the University of Miami Fertility Center in the Department of Obstetrics and Gynecology offer fertility counseling for male and female cancer patients to help you explore your options and make decisions regarding fertility preservation before you undergo treatments such as chemotherapy or radiation therapy.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Treatments

  • Surgery

    Most women will have surgery for their vulvar cancer, either by itself or in conjunction with other therapies. Depending on how advanced your cancer is at treatment, your doctor will determine if external-beam radiation therapy or low-dose chemotherapy along with radiation therapy will make your treatment work better.

    The goal of surgery is to remove the cancer from your vulva and keep as much surrounding normal tissue as possible. Over the years, oncologists have been able to develop less radical surgical techniques while maintaining the potential cure rates of the surgery.

    • Laser Surgery: Specialists use a laser beam instead of a scalpel to make cuts in tissue or to remove the surface lesion or tumor.
    • Wide Local Excision: Many surgeries for vulvar cancer can just remove the cancer and a clear margin of normal tissue around it.
    • Radical Local Excision: In cases where the cancer is more extensive, the surgical procedure to remove the cancer may need a large amount of normal tissue around it, as well as nearby lymph nodes in the groin.
    • Vulvectomy: This surgical procedure removes part or the entire vulva.

    Even if the doctor removes all the visible cancer at the time of the surgery, some patients may need follow-up chemotherapy or radiation therapy to kill any cancer cells that are left.

  • Sentinel Node Biopsy

    The cancer is most likely to spread from the tumor to the sentinel lymph node. A dye is injected near the tumor and flows through the lymph ducts to the lymph nodes. Because the dyes make the sentinel nodes glow under special goggles, sentinel node detection has risen to 95 percent or greater. Researchers at Sylvester are leading international trials to validate the role of sentinel node biopsy in vulvar cancer.

  • Chemotherapy

    Chemotherapy is a combination of cancer-fighting drugs that can be administered intravenously to kill remaining cancer cells in the body. A novel treatment offered at Sylvester can also prevent taking more lymph nodes even if the sentinel node is suspicious. Before surgery, an ultrasound scan of the groin can highlight probable lymph node involvement, indicated by node enlargement. Giving chemotherapy before surgery (neoadjuvant) can convert a previously positive lymph node to negative when biopsied, avoiding taking out more lymph nodes.

  • Topical Chemotherapy

    Chemotherapy may be applied topically to the vulva in a cream or lotion.

  • Immunotherapy

    This type of treatment uses your immune system to fight his or her cancer. Specialists use substances made by your body or made in a laboratory to enhance, direct, or rebuild the body's natural defenses against cancer. Imiquimod is an immunotherapy that may be used to treat vulvar lesions and is applied to the skin in a cream.


Tests 


Every new patient exam at Sylvester starts with a detailed history. That may be followed by the following exams or tests:

  • Physical Examination, Including a Pelvic Examination 

    A Pap test may be done as part of the pelvic examination to check for any signs of cancer or pre-cancer, infection or inflammation.

  • Colposcopy

    A special magnifying device called a colposcope is used to look at your vulva, vagina, and cervix. During a colposcopy, the doctor will treat your skin with a diluted solution of the main ingredient in vinegar, acetic acid. It causes irregular or suspicious areas to turn white which makes them easier to see. If the doctor detects abnormal tissue, he or she may test it for cancer cells.

  • Human Papillomavirus (HPV) Test 

    HPV is a group of viruses that often cause warts on your genital areas. Certain types of the virus can cause vulvar cells to become precancerous. Your doctor may do this test at the same time as a Pap test.

  • Biopsy

    Taking a sample of suspicious tissue and testing it is the only way to tell for sure if you have vulvar cancer. The results will tell your care team if you need additional surgery or need to have additional lymph nodes sampled.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care