The short answer: vulvar cancer (cancer of the outer genital skin, yoni ke bahari hisse ka cancer) is uncommon, and most itching or skin changes in older women have a harmless cause. But itching that does not settle with creams, a white or red patch, a lump, or a sore that does not heal should be examined, and a small biopsy under local anaesthesia gives a clear answer. Found early, vulvar cancer is highly treatable.
Diagnosis is often delayed because older women feel shy about genital symptoms, or treat private part me khujli (प्राइवेट पार्ट में खुजली) with creams for months. This article is for patients, families and primary care doctors who may be the first to notice the signs. For full treatment details, see our guide to vulvar cancer care.
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Who gets vulvar cancer
Two distinct patterns:
- Older women (60s–80s): often linked to lichen sclerosus (a long-term itchy skin condition that causes white, thin patches) and to a pre-cancer called differentiated VIN. Not caused by HPV.
- Younger women (30s–50s): linked to HPV infection (HPV 16, 18), often preceded by VIN (vulvar intraepithelial neoplasia: abnormal pre-cancer cells in the skin).
Signs to watch for
- Persistent itching that does not respond to creams
- Persistent white, red, or pigmented patches on the vulva
- A lump, nodule, or wart-like lesion
- Ulceration or bleeding
- Pain or burning sensation
- Changes in skin texture (thickening, atrophy)
The single biggest barrier to early diagnosis is patient embarrassment. The single biggest aid is family encouragement to mention symptoms to a doctor.
Diagnosis pathway
- Examination of the vulva by a gynaecologist or gynaecological oncologist
- Vulvoscopy: looking at the skin closely with a magnifying instrument
- Punch biopsy of the suspicious area: a tiny skin sample taken in the clinic under local anaesthesia, in about 5 minutes; you go home the same day
- If the biopsy confirms cancer: an MRI of the pelvis, and often a CT scan, to see how deep it has grown and whether the lymph nodes look involved
- Examination of the lymph nodes in the groin (inguinal lymph nodes)
- Sentinel lymph node biopsy (removing only the first 1–2 groin nodes the cancer would reach) is increasingly used to avoid full groin dissection and lowers the risk of long-term leg swelling
Take any earlier skin or gynaecology notes and biopsy reports with you; see preparing for a specialist appointment. You can book an appointment in Ahmedabad or ask for a video consultation first; the examination itself is done in person.
Treatment overview
- Small early lesions: wide local excision with inguinal sentinel lymph node biopsy
- Larger or multiple lesions: a bigger operation (radical vulvectomy), with removal of the groin lymph nodes (inguinofemoral lymphadenectomy) if the sentinel nodes contain cancer or sentinel biopsy is not suitable
- Locally advanced disease: chemoradiation (radiotherapy, or sikai, given with chemotherapy)
- Reconstructive surgery may be needed for larger resections
Outcomes
Stage 1 disease has 5-year survival above 80%. Stage 2 around 60%. The largest determinant of outcome is whether inguinal lymph nodes are involved. Early diagnosis dramatically improves prognosis.
See also lichen sclerosus and VIN and vulvar itching evaluation.
FAQs
My mother has lichen sclerosus. Does she need monitoring?
Yes — lichen sclerosus carries a small but real risk of vulvar cancer over years. Annual gynaecology review is appropriate.
Is vulvar cancer painful?
Early-stage often painless. Pain develops with larger tumours or ulceration.
Can it be confused with infection?
Yes — recurrent yeast infections, chronic dermatitis, and lichen simplex can mimic early cancer. Lesions that do not respond to standard treatment within 4–6 weeks should be biopsied.
Will surgery affect sexual function?
Smaller excisions typically allow normal function. Larger resections may need reconstructive surgery. Discussion about outcomes is essential pre-operatively.
Can the HPV vaccine prevent vulvar cancer?
Yes — HPV-related vulvar cancers (younger women) are preventable through vaccination. Lichen-sclerosus-related cancers (older women) are not HPV-driven.
Is itching in the private parts after menopause a sign of cancer?
Usually not. After menopause, thin, dry skin from low hormone levels, thrush and skin conditions such as lichen sclerosus are much more common causes. Have it checked if it lasts more than a few weeks despite treatment, stays in one spot, or comes with a patch, lump or sore.
Reviewed by Dr. Nishtha Tripathi Patel, MBBS, DGO, DNB, Fellowship Gynaecological Oncology, ESGO-certified. To book: WhatsApp +91 76988 00333.