How fast does vulvar cancer spread?

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Understanding the different types of vulvar cancer gives an indication of how fast they spread, as they spread at different rates.

People with vulvar cancer may have:

• Squamous cell carcinoma (SCC): This is the most prevalent type of vulvar cancer and is responsible for most cases. It originates in the thin, flat cells of the skin.
• Basal cell carcinoma (BCC): BCC is relatively uncommon, making up 8% of vulval cancers. It begins in the basal cells, which are in the lowest layer of the skin.
• Vulvar melanoma: Melanoma is a less common type of vulvar cancer that begins in the skin cells that produce melanin, which is the substance that gives skin its color.
• Extramammary Paget disease: This is a rare form of vulvar cancer that often starts in the sweat or oil glands and may extend to nearby tissues.

Many vulvar cancers, such as SCC, grow slowly and can take several years before they spread to other areas. However, melanoma is more aggressive and can spread rapidly without treatment.

The stage and grade of the cancer are also factors. For example, vulvar Paget disease lesions are often slow-growing for many years. However, once the cancer spreads through the middle layer of the skin, known as the dermis, it can spread quickly and aggressively through the lymphatic or blood system.

Once vulvar cancer is at an advanced stage and has spread to the lymph nodes, it typically spreads throughout the body quickly.

Doctors diagnose most cases of vulval cancer at an early stage. At this point, the cancer has not spread and is easier to treat.

When cancer cells grow and multiply, they first affect nearby tissues and blood vessels around and beneath the vulva.

Without treatment, vulvar cancer can advance to areas in the same region, such as the urethra, vagina, or anus. It may also spread to small lymph nodes close to the original tumor.

If cancerous cells spread to the lymph nodes, this can allow the cells to enter the lymphatic system and travel to distant parts of the body. This can also occur if cancer cells get into blood vessels.

It is not always possible for people to know exactly how much vulvar cancer has spread, but the symptoms and appearance of the disease may give some clues.

Early stages

There are four stages of vulvar cancer. In stage 1, the cancer is only present on the vulva and has not spread elsewhere. At this stage, people may experience localized symptoms such as:

• persistent itching or burning
• tenderness
• changes in skin color
• sores that bleed or do not heal
• lumps

In stage 2, the cancer has spread to nearby tissues, including the lower part of the urethra, vagina, or anus. This may result in pain when urinating or having sex.

It is important to note that doctors use a slightly different staging system for vulvar melanoma, with stage 2 involving a deeper tumor or ulceration. It may not necessarily have spread anywhere else.

People with any of these symptoms require medical attention as soon as possible.

Advanced stages

In stage 3, the cancer has spread to the upper part of the urethra, vagina, or anus or to nearby lymph nodes.

As vulvar cancer progresses, symptoms become more pronounced. Pain, ulceration, and bleeding may occur, signaling a more extensive spread.

In stage 4, the cancer has spread to the bone, lymph nodes in the groin, or distant sites outside the pelvis. This may cause a range of symptoms depending on where the cancer spreads.

Yes — without treatment, vulvar cancer can be life threatening. However, for early stage vulvar cancer, the survival rates are generally high.

For localized vulvar cancer of any type that has not spread anywhere else, the 5-year relative survival rate is 86%. This data comes from real cancer cases from between 2008 and 2014. The figures represent how likely it is that a person will live for at least 5 years after their diagnosis in comparison to those without cancer.

As the cancer progresses, the relative survival rates decrease. For cancer that has spread elsewhere in the same region, it is 53%. Once vulvar cancer affects distant sites, the 5-year relative survival rate is 19%.

However, it is important to note that this data is from a specific period of time and does not focus on any specific type of vulvar cancer. This means the outlook for cases of more aggressive cancer types will affect the figures.

Additionally, survival rates do not predict what will happen in each case. A person’s outlook will vary depending on their circumstances.

People need to contact a doctor promptly if they notice any potential symptoms of vulvar cancer. Early detection can significantly improve the prognosis and allow people to undergo treatment sooner.

It is also advisable for females to get regular gynecological check-ups and examine their own bodies for potential early signs of cancer.

People with a history of vulvar cancer or risk factors for the condition should discuss screening options with their doctor.

How fast vulvar cancer spreads depends on the type and stage of the cancer, as well as a person’s response to it. Most cases of vulvar cancer spread slowly, but some types, such as melanoma, can be aggressive.

When a doctor diagnoses vulvar cancer in the early stages, the outlook is generally favorable, with an 86% 5-year relative survival rate. Anyone who notices concerning symptoms should consult their doctor promptly for an evaluation.