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Vulval melanoma

This is a rare type of vulval cancer.

What is it?

Vulval melanoma develops from the cells in the skin that produce pigment, which gives the skin its colour. It often involves the inner lips (labia) of the vulva.

Diagram showing the anatomy of the vulva with Bartholinns glands

How it starts

Melanoma starts in cells called melanocytes. These are pigment producing cells found mostly in the skin.

Most melanomas develop in parts of the body exposed to the sun. But you can get them anywhere, including body organs, because there are melanocytes in these areas too.

It’s not clear why melanomas can form in parts of the body that are not exposed to the sun.

How common is it?

It is the second most common type of vulval cancer. About 9 out of every 100 vulval cancers (9%) are melanomas. It is important to remember that vulval cancers are rare. 

It is most often found in women older than 50 years. White women are at higher risk of vulval melanoma than black women.

Symptoms

Symptoms include:

  • itching
  • bleeding and pain
  • a change in colour (pigment) in any part of the vulva

Tests

To help diagnose vulval melanoma there are a few tests your specialist will want to do. These may include:

  • biopsy to remove the suspicious area
  • blood tests
  • MRI scan
  • CT scan
  • ultrasound scan of the lymph nodes

Staging

Staging is a way of describing the size of a cancer and how far it has grown. The Clark and Breslow staging system is used to stage vulval melanomas.

Treatment

The main treatments for vulval melanoma is surgery to remove the cancer. This is called a wide local excision. 

A wide local excision means that the surgeon removes the area containing the cancer, along with a border of healthy tissue around it. The border of healthy tissue is called the margin. The important thing is that the margin of healthy tissue does not contain cancer cells. This lowers the risk of the cancer coming back.

You may also need the lymph nodes from the groin removed. Your surgeon will explain in more detail if you need this.

Diagram showing a wide local excision of the vulva
Diagram showing a wide local excision of the vulva

Other treatments include:

  • radiotherapy
  • targeted cancer drugs and immunotherapy
  • chemotherapy

The treatment you have depends on:

  • where the melanoma is
  • the size of the tumour
  • whether it has spread
  • your general health

You may have treatment as part of a clinical trial where possible. You doctor will discuss this with you if there is a trial suitable for you.

Your treatment is planned by a multidisciplinary team (MDT). The team includes a number of different health professionals, including melanoma specialists, specialists in gynaecological cancers and specialist cancer nurses.

Follow up

You will have regular check ups once you finish your treatment. Your doctor will examine you and ask about your general health. This is your chance to ask questions and to tell your doctor if anything is worrying you.

How often you have check ups depends on your individual situation.

Research and clinical trials

There may be fewer clinical trials for rare types of cancer than for more common types.

It is hard to organise and run trials for rare cancers. Getting enough patients is critical to the success of a trial. The results won't be strong enough to prove that one type of treatment is better than another if the trial is too small. 

The International Rare Cancers Initiative (IRCI) aims to develop more research into new treatments for rare cancers. They are designing trials that involve several countries so that more people will be available to enter trials.

Talk to your doctor or nurse if you are interested in taking part in a trial. They may know of a trial that is running in your hospital or another specialist hospital.

Coping

Coping with a diagnosis of a rare cancer can be especially difficult, both practically and emotionally. Being well informed about your cancer and its treatment can make it easier to make decisions and cope with what happens.

Talking to other people

Talking to other people who have the same thing can also help.

Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.

The Melanoma Focus Helpline is a new confidential service for anyone in the UK who has a question about any aspect of melanoma.

The Rare Cancer Alliance offer support and information to people affected by rare cancers.

Last reviewed: 
23 Jul 2019
  • FIGO Cancer Report 2018
    L Rogers and M Cuello
    International Journal of Gynaecology and Obstetrics, 2018. Volume 143, Issue S2, Pages 4 to 13

  • Vulvar melanoma: relevant aspects in therapeutic management

    A Bittencourt Campaner and others

    The Brasilian Society of Dermatology, 2017. Volume 92, Issue 3, Pages 398 to 400

  • Guidelines for the Diagnosis and management of Vulval Carcinoma
    British Gynaecological Cancer Society and the Royal College of Obstetricians and Gynaecologists, May 2014

  • Textbook of uncommon cancers (5th edition) 
    D Raghavan and others, 2017
    John Wiley and sons

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