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  • How is vulvar cancer diagnosed?

    Last reviewed October 2014

    Contents

    If you have symptoms of vulvar cancer your doctor will do a physical examination of your vulva, groin and pelvic area, and may also do a blood test to check your general health.                 

    You may have some of the following tests.

    Vulvoscopy

    During a vulvoscopy the doctor uses a microscope called a colposcope to examine your vulva.

    You will lie on your back on an examination table with your knees bent and legs apart. The doctor will apply some weak vinegar-like solution to your vulva which will make it easier to see abnormal cells. The doctor will use the colposcope and sometimes a handheld magnifying glass, to look at your vulva.

    Your doctor will usually take a small tissue sample (biopsy) during the vulvoscopy.

    Biopsy

    A biopsy is the best way to diagnose cancer of the vulva. The doctor will put a local anaesthetic into the suspicious area of your vulva to numb it and remove some of the abnormal skin. Your vulva may bleed a little but it is usually not a large wound. It may be sore afterwards; let your doctor know if it is too uncomfortable. Ask your doctor how to care for the area so that it doesn’t become infected.

    The tissue is sent to a laboratory where a pathologist examines the cells under a microscope. The pathologist will be able to confirm whether or not the cells are cancerous.

    Internal examination

    Although the vulva is the outer part of your genitals the doctor may also do an internal examination to look at the vagina, cervix, rectum and bladder.

    If you haven’t had one recently your doctor may do a Pap test.

    The doctor may use a colposcope to look inside your vagina.

    Cystoscopy and Proctoscopy 

    You may also have a cystoscopy using a thin flexible camera to examine your bladder and urethra, and a proctoscopy using a short tube with a light on it to look inside your rectum and anus.

    These will be done under a general anaesthetic.

    Examination under anaesthetic

    The doctor can give you a general anaesthetic so the vulva can be thoroughly examined without any pain.

    Further tests

    Sometimes further tests are needed to determine the size and position of the cancer, and whether it has spread. These may include:

    • a blood test—where a blood sample is taken to check the number of cells in your blood and to see how well your kidneys and liver are working
    • a chest x-ray—a painless x-ray of your lungs and heart
    • a CT scan—which is a computerised tomography scan. This scan takes three-dimensional x-rays of the inside of your body
    • an MRI scan— a magnetic resonance imaging scan uses magnetic waves to build up detailed cross-sectional pictures of the organs inside your body.

    Health professionals you might see

    Your GP will probably arrange the first tests to assess your symptoms. You will then be referred to a gynaecological oncologist. You will be cared for by a range of health professionals who specialise in different aspects on your treatment. This is called a multidisciplinary team.

    gynaecological oncologist

    a surgeon who specialises in treating gynaecological cancers, such as cancer of the vulvar

    radiation oncologist

    prescribes and coordinates the course of radiotherapy

    medical oncologist

    prescribes and coordinates the course of chemotherapy

    cancer care coordinator

    provides support throughout treatment and liaises with other health professionals

    nurses

    administer treatment and provide support and assistance through all stages of your treatment and recovery

    dietitian

    recommends the best eating plan to follow while you are in treatment and recovery

    social worker

    advises you on support services

    physiotherapist

    assists you with getting back to your usual activities

    counsellor, sex therapist, psychologist

    advises on how to cope with the physical and emotional changes that may occur after treatment. They can help you explore intimacy issues that may occur

    Information reviewed by: Prof Jonathan Carter, Head Gynaecologic Oncology, Chris O’Brien Lifehouse, Professor of Gynaecological Oncology, University of Sydney, and Head Gynaecologic Oncology, Royal Prince Alfred Hospital, NSW; Ellen Barlow, Gynaecological Oncology Clinical Nurse Consultant, Gynaecological Cancer Centre, The Royal Hospital for Women, NSW; Jason Bonifacio, Practice Manager/ Chief Radiation Therapist, St Vincent’s Clinic, Radiation Oncology Associates and Genesis Cancer Care, NSW; Wendy Cram, Consumer; Kim Hobbs, Social Worker, Gynaecology Oncology, Westmead Hospital, and Chair COSA Social Work Group, NSW; Lyndal Moore, Consumer; Pauline Tanner, Cancer Nurse Coordinator, Gynaecological Cancer, WA Cancer and Palliative Care Network, WA

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