Squamous cell vulvar cancer is the most common type of vulvar cancer. It’s often diagnosed in the early stages when it’s found only in the vulva. The main treatment for this cancer is surgery.

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Vulvar cancer is cancer that develops on the outer part of the female genitals. It’s a rather uncommon cancer, with 6,900 new diagnoses expected in the United States in 2024.

Squamous cell vulvar cancer is the most common type of vulvar cancer. It is often diagnosed in early stages when it hasn’t yet spread to nearby or distant tissues.

Keep reading to learn more about early stage squamous cell vulvar cancer. We’ll cover topics such as symptoms, causes and risk factors, and diagnosis and treatment.

Vulvar cancer develops in the outer portion of the female genitals. This includes tissues such as the opening of the vagina, the labia majora and minora, and the clitoris.

Squamous cell vulvar cancer is the most common type of vulvar cancer, making up 90% of all diagnoses. Squamous cells are flat cells found in your skin, along your respiratory and digestive tract, and in hollow organs such as your uterus and bladder.

Early stage cancer has not yet spread from its initial site to other areas of your body. In the case of vulvar cancer, this means the cancer is only in your vulva, and there are no suspicious lymph nodes.

Most vulvar cancers — about 59% — are diagnosed when they’re in the early stages.

One of the main symptoms of early stage squamous cell vulvar cancer is a lesion on your vulva. Lesions are most often found on the skin of the labia but can less commonly affect the clitoris or Bartholin glands.

Vulvar cancer lesions can look like bumps or lumps and may sometimes look like warts. They can also look like ulcers. Lesions may be skin-colored but can also appear white, pink, red, or pigmented.

While some people with early stage squamous cell vulvar cancer don’t have additional symptoms, you might experience:

Squamous cell vulvar cancer happens when squamous cells in your vulva begin to grow uncontrollably and invade surrounding tissue. This happens because of DNA changes that you might have inherited or acquired during your lifetime.

The risk factors for squamous cell vulvar cancer include:

To diagnose early stage squamous cell vulvar cancer, a doctor will start by getting your medical history and doing a physical exam, which will include a pelvic exam. They may perform a Pap smear, an HPV test, or both. They may also order blood tests to get a better idea of your overall health.

The gold standard for diagnosing vulvar cancer is performing a biopsy of the affected area. This involves taking a tissue sample, which healthcare professionals can analyze in a lab to see whether cancer cells are present.

If cancer cells are found, your doctor will order additional tests to determine whether the cancer has spread outside of your vulva. These may include:

Early stage squamous cell vulvar cancers are typically treated with surgery to remove the cancer. Healthcare professionals may refer to this as excision. The extent of the surgery depends on how large the cancer is.

If your cancer is small, a surgeon will remove the lesion and an area of healthy surrounding tissue. This is called a wide local excision.

For larger cancers, a surgeon may perform a radical local excision. This involves removing the cancer and a larger area of healthy surrounding tissue.

If the cancer is large and has spread more deeply into the tissues of your vulva, a surgeon may recommend a vulvectomy. A modified radical vulvectomy involves removing most of your vulva, while a radical vulvectomy involves removing your entire vulva.

When performing a radical local excision or vulvectomy to remove larger cancers, a surgeon will also often remove some of the lymph nodes in your groin.

If you cannot or choose not to have surgery, early stage squamous cell vulvar cancer can also be treated with radiation therapy.

The outlook for early stage squamous cell vulvar cancer can depend on factors such as:

  • the extent of the cancer in your vulva
  • how the cancer responds to treatment
  • your age and overall health

When squamous cell vulvar cancer is found in early stages, the outlook is typically quite good. According to the National Cancer Institute, the 5-year relative survival rate for vulvar cancers that are localized (located only in the vulva) is 86.3%

Five-year relative survival rates reflect how likely it is that a person with a certain type and stage of cancer will be alive 5 years after their diagnosis, as compared with someone without cancer.

It’s important to note that these statistics don’t account for recent advances in treatment or individual factors such as age and overall health.

Recurrence

It’s possible for squamous cell vulvar cancer to come back (recur) after treatment. About 37% of people have a recurrence within 5 years, and most recurrences happen within 2 years of initial treatment.

Because of the risk of recurrence, your doctor will want to continue to follow up with you after your initial treatment. You’ll likely see them every 3 to 6 months for the first 2 years and then every 6 to 12 months until 5 years have passed.

What does stage 1 vulvar cancer look like?

Stage 1 vulvar cancer can look like a lump or bump, a wart, or an ulcer on your vulva. It can vary in color from skin-colored to red, pink, white, or pigmented.

What are the warning signs of vulvar cancer?

A typical warning sign of vulvar cancer is the appearance of lumps or lesions on your vulva that do not go away or that continue to get larger. These may be accompanied by itching, pain, abnormal discharge, or bleeding.

How fast does squamous cell vulvar cancer spread?

Vulvar cancer doesn’t typically spread quickly. In a 2016 study involving 391 people with squamous cell vulvar cancer, only 20 people (5.1%) went on to develop metastatic disease.

Within this small group, the median time from diagnosis to first metastasis (spread) was 13.4 months.

Squamous cell vulvar cancer is the most common type of vulvar cancer. In most cases, this cancer is diagnosed in the early stages when it affects only the vulva.

The main treatment for early stage squamous cell vulvar cancer is surgery to remove the cancer and some healthy surrounding tissue. The extent of the surgery depends on how large the cancer is.

The outlook for early stage vulvar cancer is typically positive. Be sure to consult a doctor if you notice an unusual lump or lesion on your vulva that doesn’t go away, gets larger, or comes with symptoms such as itching, pain, or bleeding.