This article explores what vulvar melanoma is, its symptoms, and how doctors can diagnose and treat this type of skin cancer.
Vulvar melanoma develops on the outer part of the vagina, known as the vulva. This tissue surrounds the urethra, vagina, clitoris and labia.
While most people associate melanoma with areas of skin that are frequently exposed to the sun, this type of skin cancer can develop anywhere on the body, including the vulva.
Because it can be difficult to examine this area regularly, vulvar melanoma often progresses by the time doctors diagnose it, making treatment more difficult.
Contact your doctor immediately for any symptoms or changes you notice in or around your vulva.
How common is vulvar melanoma?
Vulvar melanoma is rare, accounting for 6% of all diagnosed vulvar cancers, according to the American Cancer Society (ACS). The ACS also notes that vulvar cancer itself is rare, accounting for less than 1% of all cancers in women.
White women are three times more likely to develop vulvar melanoma than other ethnic groups, according to a Preview 2021. The same research notes, however, that black women experience more deaths from the disease.
It is not clear whether these differences have genetic causes or whether social and economic factors, such as discrimination and inequalities in access to care, also play a role.
Learn more about other types of vulvar cancer, symptoms and risk factors.
Vulvar melanoma can develop on any area of the vulva, including the clitoris, labia, and outer skin.
The The most common the site of vulvar melanoma is the labia majora, followed by the labia minora.
Symptoms of vulvar melanoma include:
- pigmentation or a dark patch on the vulva
- a raised area or bump on the vulva
- pain and pain in the vulva
- a mole that changes shape or color
- pain on urination or burning
- itching in the vulva or genital area
- vaginal pain during penetration or after
- discharge or bleeding between periods
Since some of these symptoms can also occur with many other conditions, it’s important to let your doctor know about any changes you notice in your vulva. This can allow you to get an accurate diagnosis and start treatment quickly.
Learn eight health questions you should ask your OB-GYN.
What are the causes and risk factors of vulvar melanoma?
Like other melanomas, vulvar melanoma develops due to changes in cells called melanocytes, which produce melanin. A research paper 2021 explains how experts are studying the biological and genetic components of vulvar melanoma to better understand how it occurs.
The risk factors for vulvar melanoma are less clear than those for cutaneous melanoma or melanoma of the outer skin.
The Preview 2021 describes some risk factors for vulvar melanoma based on previous studies. These include:
- Age: Vulvar melanoma is more common in women aged 60 and older, with 68 as the average age at diagnosis. However, the disease can occur at any age, including childhood.
- Female sex assigned at birth: Women are often twice as likely as men to develop all types of mucosal melanoma.
- Personal or family history of melanoma: If you or a close relative has had cutaneous melanoma, you may have a higher risk of developing vulvar melanoma.
- Ethnicity: White individuals have three times more vulvar melanoma than those of African descent, but black women are more likely to die from it. It is unclear whether these disparities are due to genetics or whether social and economic factors, such as racial discrimination and reduced access to care, also play a role.
- Sclero-atrophic lichen: This condition causes areas of discoloration on the skin, especially in the genital or anal area. It is a known risk factor for squamous cell carcinoma and can also link to vulvar melanoma.
- Ultraviolet (UV) radiation: While UV light exposure is a primary factor in skin melanoma, it has a less direct association with melanomas that occur in areas that are usually hidden from sunlight. However, recent research cited in a study 2021 have shown some links between UV exposure and genetic mutations that can cause mucosal melanomas, such as vulvar melanoma.
Talk to your doctor about your individual risk factors for vulvar melanoma and the steps you can take to manage your risk.
Learn about other types of melanoma, including symptoms and risk factors.
How do doctors diagnose vulvar melanoma?
To diagnose vulvar melanoma, your gynecologist or other healthcare professional will perform a physical exam of your vagina and vulva. They will likely also ask you questions about your personal and family medical history.
If your doctor identifies an area that could be vulvar melanoma, they will likely order tests to diagnose or evaluate vulvar melanoma. These may include:
- Dermoscopy: This procedure uses a lighted magnifying glass called a dermascope that allows doctors to look closely at possible lesions.
- Biopsy: In this procedure, doctors remove a small amount of tissue for laboratory analysis to determine if cancer cells are present. It also allows doctors to measure the depth of the melanoma to gauge how far the cancer has spread.
- Imaging tests: If your doctor is worried about the cancer spreading, they may order tests such as MRIs or CT scans to check other areas of the body for cancer.
Treatment for vulvar melanoma depends on many factors, including the size and stage of the cancer. Your individual medical history and personal preferences will also play a role.
The typical treatment because vulvar melanoma is a partial vulvectomy, which is the removal of the tumor and a margin of healthy tissue around it. Doctors may also remove nearby lymph nodes to reduce the risk of cancer spreading.
Depending on how far the vulvar melanoma has spread, additional treatments may include:
Your doctor will discuss all of your vulvar melanoma treatment options, including potential benefits and risks, in the context of your individual diagnosis.
Early detection is essential for successful treatment of vulvar melanoma. However, because changes in the vulva can be hard to notice, the cancer often progresses by the time doctors diagnose it, making treatment more difficult.
The overall 5-year survival rate for vulvar melanoma is 47%, according to the research paper 2021. This is about half of the overall 5-year survival rate of 92% for cutaneous melanoma.
The survival rate refers to the number of people who are still alive for a specific length of time after a particular diagnosis.
For example: A 5-year survival rate of 50% of people means that half of people are still alive 5 years after their diagnosis.
It is important to remember that these numbers are estimates and are based on previous medical studies. Talk with your doctor about the outlook for your specific condition.
Vulvar melanoma is a rare but aggressive type of mucosal melanoma. It is more common in white women over the age of 60.
Symptoms include a dark area on the vulva that may be raised, vulvar pain or pain, itching, and pain on urination. Early detection is essential for effective treatment, so contact your gynecologist or other medical professional immediately if you notice any changes in your vulva.