Stage 4 vulval cancer is advanced cancer. 

Stage 4A

In stage 4A the cancer has either:

• spread into the lining of the upper part of the vagina, the lining of the upper part of the urethra, the lining of the bladder or the lining of the anus
• attached on to the pelvic bone
• spread into nearby lymph nodes and the lymph node is either fixed, meaning it cannot move around, or it has formed an open sore called an ulcer

Stage 4B

In stage 4B, the cancer can spread to one or both of the following:

• to the lymph nodes in your pelvis
• to other parts of your body further away from the vulva

An example of this is the cancer spreading to the lungs.