Treatments for stages 1 and 2 vulvar cancer

The following are treatment options for stage 1 and stage 2 vulvar cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is the standard treatment for stage 1 and stage 2 vulvar cancer. The type of surgery you may have depends on:

• the depth, size and location of the tumour
• whether the tumour is linked to human papillomavirus (HPV) infection
• whether there is also vulvar intraepithelial neoplasia (VIN)

A wide local excision removes the vulvar tumour or other abnormal areas, along with 1 to 2 cm of healthy tissue around it (surgical margin). A wide local excision is used for VIN or very small vulvar tumours that haven’t grown deeper than 1 mm into the underlying tissue (stage 1A).

A partial radical vulvectomy removes part of the vulva and the deeper tissues under the tumour. It may or may not remove the clitoris. A partial radical vulvectomy is used for vulvar tumours that have grown deeper than 1 mm into the underlying tissue (stage 1B or stage 2).

You may also need one or both of the following types of lymph node surgery along with a partial radical vulvectomy.

A sentinel lymph node biopsy removes the sentinel lymph node to see if the cancer has spread there. If cancer is found in the sentinel node, a complete inguinofemoral lymph node dissection may be done.

An inguinofemoral lymph node dissection removes the lymph nodes from the same side of the groin as the cancer or both sides of the groin, depending on the location of the cancer.

Find out more about surgery for vulvar cancer.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation therapy is sometimes offered for stage 1B or stage 2 vulvar cancer.

External radiation therapy is sometimes used as a main treatment. It’s also used to destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant therapy).

Find out more about radiation therapy for vulvar cancer.

Radiation therapy and chemotherapy may be given during the same time period to treat vulvar cancer. This is called chemoradiation. You may be offered chemoradiation if you cannot have surgery due to health problems or the size or location of the tumour, or if cancer is found in the sentinel node.

Chemotherapy uses drugs to destroy cancer cells. The most common types of chemotherapy drugs used in chemoradiation include:

• cisplatin and paclitaxel
• carboplatin and paclitaxel

In some cases, cisplatin may be given on its own in chemoradiation. But it is less common.

Find out more about chemotherapy for vulvar cancer.

Talk to your doctor about clinical trials open to people with vulvar cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.