Vulvar cancer is an uncommon type of cancer. In its early stages, it has a relatively good prognosis. However, stage 4 vulvar cancer has spread beyond the vulva, which means it is harder to treat.
The 5-year relative survival rate for vulvar cancer is
However, the survival rate for stage 4 is lower. Stage 4A means the cancer has spread to nearby structures such as the urethra, and stage 4B means the cancer has spread to distant structures in the body. The survival rate for stage 4B is lower than for 4A.
Read on to learn more about stage 4 vulvar cancer, including the symptoms, survival rates, and treatments.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Stage 4 vulvar cancer is cancer that started in the vulva but has spread to other areas. Stage 4 is the most advanced stage of cancer.
The most common type of cancer that may affect the vulva is squamous cell carcinoma, a type of skin cancer. Other types of skin cancer, including melanoma, can also occur in the vulva.
It is possible to survive stage 4 vulvar cancer. Some people may go into remission after treatment, meaning they have no perceptible signs of cancer. This does not guarantee that the cancer will not return, but it can extend a person’s life.
For other people, treatment may not work or may lead to remission for only a short period.
There is no standard or average life expectancy for someone with stage 4 vulvar cancer. Instead, doctors measure cancer survival based on a 5-year relative survival rate. This rate represents the likelihood that a person with a cancer diagnosis will still be alive after 5 years, as compared with the general population.
According to data from the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer with regional spread had a 5-year relative survival rate of
For vulvar cancer with distant spread, the 5-year relative survival rate for the same time period was 19%. This includes stage 4B.
However, these data come from several years ago and may not reflect recent improvements in diagnosis and treatment.
Also, these statistics do not account for some of the factors that influence the prognosis, such as:
- overall health
- responsiveness to treatment
Whether vulvar cancer has spread to any lymph nodes is
Survival rates are higher when vulvar cancer has not reached the lymph nodes. The type of cancer a person has also affects the outlook. For example:
- Melanoma: This type of cancer has a lower overall survival rate than other types of vulvar cancer, especially in the advanced stages.
- Sarcoma: This type of cancer rarely affects the vulva, but it is possible. It tends to grow slowly and rarely affects lymph nodes, but a subtype known as epithelioid sarcoma has the
lowestsurvival rate of all vulvar cancers.
- Basal cell carcinoma: This type has a high risk of recurrence. However, it is rare, and despite the risk of recurrence, the prognosis is often good.
- Human papillomavirus (HPV)-related cancer: HPV is a sexually transmitted infection that raises the risk of certain cancers. HPV-related vulvar cancer
can respondwell to treatment.
The symptoms of advanced vulvar cancer can
- sores on the vulva that do not go away or that come back
- unusual growths of any color on the vulva
- a rash or warts on the vulva
- changes in the skin of the vulva
- pain, bleeding, or itching in the vulva that does not go away on its own or keeps coming back
People can also develop these symptoms inside the vagina in cases of vaginal cancer.
The symptoms of vulvar cancer can be similar to those of other diseases. It is important to consult a doctor for a diagnosis.
Diagnosis of vulvar cancer
If the doctor suspects cancer, they will recommend a biopsy. This involves taking a small sample of tissue to send to a laboratory for testing.
If cancer is present, a doctor may recommend additional tests to determine how far it has spread, if at all. This may include surgery to remove the cancer or to check the lymph nodes for signs of cancer.
Treatment for stage 4 vulvar cancer
It is not usually possible to remove all cancer at stage 4, but a doctor may still recommend surgery to remove as much cancer as possible.
After surgery, or if surgery is not possible, a doctor may recommend a combination of:
- targeted therapies
- medication to manage side effects such as nausea
Cancer can be physically, emotionally, and financially difficult, both during and after treatment.
Surviving vulvar cancer can feel exciting but also scary. Additionally, a person may experience complications from treatment or need to adjust to changes in their body.
People can get support from:
American Cancer Society, which offers a helpline and programs to help with transportation, accommodations, and cancer survival
- the Foundation for Women’s Cancer, which has a Seek a Specialist tool, educational resources, and information on financial aid
- cancer treatment centers, many of which offer support groups
Online support groups may be an option for people who cannot attend in person.
Stage 4 vulvar cancer is cancer that began in the vulva and then spread elsewhere. It may affect nearby areas, such as the urethra, or may have spread farther.
The likelihood of long-term survival for people with this diagnosis is
The prognosis is better with early detection, so people who have any symptoms that could indicate vulvar cancer should contact a doctor.