Treatments for stage 4 vulvar cancer

The following are treatment options for stage 4 vulvar cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.


You may be offered surgery for stage 4 vulvar cancer. The types of surgery are:

  • a complete radical vulvectomy
  • a pelvic exenteration
  • the removal of the lymph nodes from the same side of the groin as the cancer or both sides of the groin (inguinal lymph node dissection), depending on the location of the cancer
  • removing blockages of the bowel or bladder

Radiation therapy

You may be offered radiation therapy for stage 4 vulvar cancer. External beam radiation therapy may be used:

  • as the main treatment in women who cannot have surgery because of other health problems
  • before surgery, with chemotherapy, to shrink a tumour and make it easier to completely remove
  • after surgery, with chemotherapy, to reduce the risk of the tumour coming back (recurring)
  • to shrink the tumour and relieve symptoms


You may be offered chemotherapy with radiation therapy for stage 4 vulvar cancer. The types of chemotherapy drugs used in different combinations are cisplatin, paclitaxel, fluorouracil (5-fluorouracil or 5-FU, Efudex), mitomycin, bleomycin and vinorelbine.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

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.

Expert review and references

  • Klopp AH, Eifel PJ, Berek JS, Konstantinopoulos PA . Cancer of the cervix, vagina and vulva. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 72:1013-1047.
  • American Cancer Society. Chemotherapy for Vulvar Cancer. 2018:
  • Levine DA, Dizon DS, Yashar CM, Barakat RR, Berchuch A, Markman M, Randall ME. Handbook for Principles and Practice of Gynecologic Oncology. 2nd ed. Philadelphia, PA: Wolters Kluwer; 2015.
  • National Cancer Institute. Vulvar Cancer Treatment (PDQ®) Health Professional Version. 2017: