What to Know About Stage 4 Vulvar Cancer
The four stages of vulvar cancer correspond with how far the cancer has spread. Stage 4 vulvar cancer is the most advanced stage. It means the cancer has spread to the upper part of the urethra, vagina, or other parts of the body.
Vulvar cancer is a rare cancer that starts in the vulvar tissues. The American Cancer Society estimates that 6,470 vulvar cancers will be diagnosed in the United States in 2023, and about 1,670 people will die of this cancer.
- inner and outer vaginal lips (labia minora and labia majora)
- clitoris
- vaginal opening and its glands
- mons pubis (the tissue that covers the public bone)
Most commonly , vulvar cancer is found in the outer vaginal lips. It’s usually a slow-growing cancer, starting with abnormal cells called vulvar intraepithelial neoplasia (VIN). Over time, VIN can become vulvar cancer, so early diagnosis and treatment is important.
In this article, we look at how doctors classify stage 4 vulvar cancer, along with treatment and survival rates.
Cancer staging determines how far the cancer has spread, and helps guide treatment decisions and prognosis.
Stage 4 vulvar cancer is the most advanced stage of vulvar cancer. There’s no stage 5. Doctors stage vulvar cancer through surgery, imaging scans, and other tests.
In stage four vulvar cancer , the cancer has spread to the upper part of the vagina or the upper urethra, or to another area of the body. There are two substages of stage four vulvar cancer: stage 4A and 4B.
| Stage | Description |
| 4A | The cancer is in the vulva or the perineum or both, and may be growing into the anus, lower vagina, or lower urethra. The cancer may have spread to nearby lymph nodes and has attached to the underlying tissue or caused an ulcer or ulcers to form on one or more lymph nodes. The cancer has not yet spread to distant sites. |
The cancer has spread to the bladder, rectum, pelvic bone, or upper part of the urethra or vagina. It may or may not have spread to nearby lymph nodes. It has not yet spread to distant sites.
Vulvar cancer is usually a slow-growing cancer that often starts on the outer vaginal lips. If not diagnosed and treated, it can spread to other tissues on the vulva, and then to areas like the vagina, anus, urethra, lymph nodes, and other parts of the body.
Because it’s typically a slow-growing cancer, regular pelvic exams can help with early identification and treatment of abnormal tissues, and reduce the risk of spread.