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Staging means finding out how far vulvar cancer has spread in your body. Physicians group vulvar cancer into stages I (1) through IV (4). Stage I is the least advanced, and stage IV is the most advanced. If there are abnormal cells on your vulva that are not cancer but might turn into cancer, it might be called stage 0, precancer, vulvar intraepithelial neoplasia (VIN), vulvar squamous intraepithelial lesions (SIL) or vulvar carcinoma in situ.
When your Fred Hutch Cancer Center team designs your treatment plan, they will take into account the stage of your cancer along with many other factors. The stage is an important part of choosing which treatments are right for you.
The stage depends on:
- The size of the tumor
- If it has spread to lymph nodes
- If it has spread to other places in the pelvis, like the bladder, urethra, vagina, rectum or anus
- If it is attached to bone
- If it has spread outside the pelvis
Vulvar Cancer Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Referrals are required for new patients. Please request your primary care provider or specialist fax all relevant medical information to the fax number listed below.
Phone: 206.598.8300
Fax: 206.598.3590
Stages of Vulvar Cancer
For melanoma of the vulva, your care team will use the staging system for melanoma of the skin.
For other types of vulvar cancer, here’s what each stage means in more detail:
Stage I (1)
Cancer is only in the vulva or the skin between the vagina and rectum (perineum) or both. It hasn’t spread to lymph nodes.
- Stage IA (1A): The tumor is 2 centimeters across or smaller. It has spread 1 millimeter or less into the vulva.
- Stage IB (1B): The tumor is more than 2 centimeters across, or it has spread deeper than 1 millimeter into the vulva.
Stage II (2)
The tumor has not spread to the lymph nodes but has spread to one of these places:
- The lower third of the urethra (tube from the bladder to the outside of the body)
- The lower third of the vagina
- The lower third of the anus
Stage III (3)
The tumor has spread to the upper two-thirds of the urethra, upper two-thirds of the vagina, inner lining of the bladder, inner lining of the rectum or any lymph nodes.
- Stage IIIA (3A): Cancer is in lymph nodes in the groin, not larger than 5 millimeters.
- Stage IIIB (3B): Cancer is in lymph nodes in the groin, larger than 5 millimeters.
- Stage IIIC (3C): Cancer is in lymph nodes in the groin and has grown through the outer covering of the lymph nodes.
Stage IV (4)
Cancer has spread to the pelvic bone or nearby lymph nodes and is not movable (it’s stuck to tissue underneath) or has caused ulcers (breaks in the surface) of lymph nodes, or cancer has spread to a distant part of the body.
- Stage IVA (4A): Cancer is attached to the pelvic bone or has spread to nearby lymph nodes that are not movable or have become ulcerated.
- Stage IVB (4B): Cancer has spread to parts of the body outside the pelvis, like the lungs or bone.
How to Know Your Vulvar Cancer Stage
After you are diagnosed with vulvar cancer, you will have imaging scans and other tests, like biopsies, to tell if and where the cancer has spread. In a biopsy, a pathologist checks samples of tissue under a microscope to see if they contain cancer cells.
For vulvar cancer, staging is typically done at the time of surgery. This means you and your care team will probably need to wait until after surgery to make some of your treatment decisions.
Vulvar Cancer Survival Rates
In cancer care, “survival rate” usually means the percentage of people expected to survive their cancer for at least five years from the time it was diagnosed. Data experts estimate this rate based on information about large groups of people with the same type of cancer. The rate doesn’t include the risk of dying during that five years for some other reason. For vulvar cancer, the relative five-year survival rate overall in the U.S. is about 70%, according to data from the National Cancer Institute.
But the chance of surviving cancer for five years or more can be quite different from person to person. One important reason is the stage of the disease at the time of diagnosis. Patients may have different treatments and respond to treatments in different ways.
This means it’s impossible to predict the likely lifespan of any one person based on survival rates. If you would like to know more about the outlook for your disease, talk with your Fred Hutch care team. They can tell you more based on your unique situation.
At Fred Hutch, we will tailor your treatment plan to you. In general, people who have the same stage of vulvar cancer often have the same or similar treatments. Common treatments by stage may include:
- Stage I (1): Surgery to remove the tumor. Sometimes surgeons need to remove nearby lymph nodes. Some people have radiation therapy after surgery or instead of surgery.
- Stage II (2): Surgery to remove the tumor. Sometimes surgeons need to remove nearby lymph nodes. Some people have radiation therapy after surgery or instead of surgery, sometimes along with chemotherapy.
- Stage III (3): Surgery to remove the tumor along with nearby lymph nodes. Some people have radiation therapy (or chemotherapy plus radiation therapy) before surgery, or they have radiation therapy after surgery, or they have only radiation therapy.
- Stage IV (4): Surgery to remove the tumor and sometimes other pelvic organs where the cancer has spread. Some people have radiation therapy (or chemotherapy plus radiation therapy) before surgery, or they have radiation therapy after surgery. Some people don’t have surgery; instead, they have radiation therapy, chemotherapy or both.
Learn more about vulvar cancer treatment.