This map explains vulval cancer step by step: what it is, the types, the tests, the stages, the treatment and its side effects.
Tap any topic on the map to read about it. Topics with an arrow open more topics.
Tap a type on the map.
About 90 out of 100 vulval cancers. This map is mainly about this type.
Tap a test on the map to see why it is done.
Please wait for all the reports. Why we wait
A small piece of the abnormal area is taken under local anaesthesia. It confirms the cancer and how deep it has grown.
The doctor checks the size and position of the tumour, the groins, and whether the urethra, vagina or anus are involved. Sometimes this is done under anaesthesia.
MRI pelvis shows the depth of the tumour. CT or PET-CT checks the groin and pelvic lymph nodes and other organs.
For small tumours, a dye or tracer is injected near the tumour during surgery to find the first groin lymph node (sentinel node). If it is clear, a larger groin operation can be avoided.
Before starting chemotherapy, immunotherapy or targeted therapy, these tests check that you are fit for treatment, and give a starting point to compare with later.
| Test | Why it is done |
|---|---|
| CBC (complete blood count) | Haemoglobin, white cells and platelets. Treatment can lower them. |
| RFT (kidney function) | Many medicines are cleared by the kidneys; the dose may need to change. |
| LFT (liver function) | Many medicines are processed by the liver. |
| Viral markers: HBsAg, anti-HCV, HIV | Hepatitis B can flare up during treatment. If positive, a tablet is given to prevent this. |
| Blood sugar (and HbA1c if diabetic) | Steroids given with chemotherapy can raise blood sugar. |
| ECG and 2D Echo | Check the heart rhythm and pumping before treatment, as some medicines affect the heart. |
Before immunotherapy, also:
| Test | Why it is done |
|---|---|
| Serum TSH (thyroid) | Immunotherapy can affect the thyroid gland. |
| Serum cortisol (morning sample) | Immunotherapy can affect the adrenal and pituitary glands. |
Sometimes needed, depending on your treatment:
Your doctor will choose the tests that apply to you. Some of them are repeated during treatment.
Tap your stage on the map.
Limited to the vulva (or the skin between the vulva and anus). No lymph nodes involved. The aim is cure.
Spread to the lower part of the urethra, vagina or anus. No lymph nodes involved. The aim is cure.
Spread to the upper urethra or vagina, the lining of the bladder or rectum, or to the groin lymph nodes. The aim is still cure for many.
Lymph nodes that are fixed or broken through the skin, spread to the pelvic bone, or to distant organs.
Treatment is planned by the gynae-oncology surgeon, radiation oncologist and medical oncologist. Tap your stage on the map.
Side effects: surgery · radiotherapy
Side effects: chemoradiotherapy · surgery
Side effects: chemotherapy · immunotherapy
Tap a treatment on the map.
Fever, a red, hot or painful leg or groin, wound bleeding or breaking open, inability to pass urine, or fever of 38°C or more during chemotherapy need urgent care.
This information is general. Your own treatment plan may be different. Please discuss it with your doctor.
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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