Understanding Vulvar Cancer Survival Rates

When facing a diagnosis of vulvar cancer, one of the most pressing questions for patients and their families revolves around the prognosis and survival rates. These statistics can provide a general idea of the outlook for someone with this condition. It's important to remember that survival rates are averages based on large groups of people and cannot predict what will happen in any individual case. Many factors, including the stage of the cancer, a person's overall health, and how well the cancer responds to treatment, can influence the outcome.

This guide breaks down what survival rates mean, the statistics for different stages of vulvar cancer, and the various factors that can affect an individual's prognosis.

What is a 5-Year Relative Survival Rate?

Before diving into the specific numbers, it's crucial to understand the terminology used by organizations like the American Cancer Society and the National Cancer Institute. The most common statistic you will encounter is the 5-year relative survival rate. This figure doesn't just tell you what percentage of people live for at least five years after their diagnosis; it's a more specific comparison.

The 5-year relative survival rate compares people with the same type and stage of vulvar cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage is 87%, it means that people diagnosed with that cancer are, on average, 87% as likely as people who don’t have that cancer to live for at least five years after their diagnosis. This method helps to account for deaths from other causes and provides a clearer picture of the cancer's impact on survival.

Vulvar Cancer Survival Rates by Stage

The stage of the cancer at the time of diagnosis is the most significant factor in determining the survival rate. Staging describes how large the cancer is and how far it has spread. The Surveillance, Epidemiology, and End Results (SEER) database, maintained by the National Cancer Institute, groups cancers into three main stages for reporting survival statistics:

• Localized: The cancer is confined to the vulva.
• Regional: The cancer has spread to nearby lymph nodes or structures.
• Distant: The cancer has spread to distant parts of the body, such as the lungs or liver.

The most recent SEER data (based on women diagnosed between 2013 and 2019) provides the following 5-year relative survival rates for vulvar cancer:

Localized Vulvar Cancer

When vulvar cancer is diagnosed at a localized stage, it means the tumor has not spread beyond the vulva itself. This is the earliest stage, and fortunately, the majority of vulvar cancers are found at this point. Early detection is key, as treatment is most effective when the cancer is contained.

The 5-year relative survival rate for localized vulvar cancer is approximately 87%. This high survival rate underscores the importance of seeking medical attention for any persistent symptoms, such as itching, pain, a lump, or skin changes in the vulvar area. When caught early, the prognosis is generally very positive.

Regional Vulvar Cancer

A regional stage diagnosis means the cancer has grown beyond the vulva and has spread to nearby lymph nodes, most commonly the inguinal lymph nodes in the groin area. It may have also spread to adjacent tissues like the lower vagina, urethra, or anus. Determining the extent of lymph node involvement is a critical part of staging and planning treatment.

The 5-year relative survival rate for regional vulvar cancer is about 49%. The drop in the survival rate from the localized stage highlights how the spread of cancer to the lymphatic system complicates treatment and affects the overall prognosis. Treatment at this stage is often more aggressive, potentially involving surgery to remove lymph nodes, followed by radiation therapy and sometimes chemotherapy.

Distant Vulvar Cancer

Distant, or metastatic, vulvar cancer is the most advanced stage. In this case, the cancer has traveled through the bloodstream or lymphatic system to form tumors in distant parts of the body. Common sites for metastasis include the lungs, liver, bones, or distant lymph nodes.

The 5-year relative survival rate for distant vulvar cancer is approximately 18%. At this advanced stage, the cancer is much more difficult to treat. The focus of treatment often shifts from curing the cancer to controlling its growth, managing symptoms, and improving the patient's quality of life. Systemic treatments like chemotherapy or targeted therapy are typically the primary approaches.

Factors That Influence Vulvar Cancer Survival Rates

While staging is the most critical predictor, several other factors can influence an individual's prognosis. These elements help doctors create a more personalized treatment plan and provide a more nuanced outlook than statistics alone can offer.

• Type of Vulvar Cancer: The vast majority (about 90%) of vulvar cancers are squamous cell carcinomas, and the survival rates discussed above are largely based on this type. Other rarer types, like vulvar melanoma, adenocarcinoma, or sarcoma, have different characteristics and may have different prognoses. Vulvar melanoma, for instance, tends to be more aggressive.
• Patient's Age and Overall Health: A patient's general health status plays a significant role. Younger, healthier individuals may be better able to tolerate aggressive treatments like extensive surgery, radiation, and chemotherapy. Co-existing medical conditions can complicate treatment and affect recovery and survival.
• Tumor Size and Depth of Invasion: Even within the localized stage, the size of the tumor and how deeply it has grown into the underlying tissue can impact the prognosis. Smaller, more superficial tumors generally have a better outlook.
• Lymph Node Involvement: For regional stage cancer, the number of lymph nodes affected is a key prognostic factor. The prognosis is generally better if cancer is found in only one or two small nodes compared to multiple or larger nodes.
• Response to Treatment: How an individual's cancer responds to the initial treatment is also crucial. A complete response, where all signs of the cancer disappear, is associated with a much better long-term outcome than a partial response or no response.

Frequently Asked Questions About Vulvar Cancer Prognosis

After learning about survival rates, many people have follow-up questions about the diagnosis, treatment, and long-term outlook for vulvar cancer. Here are answers to some common queries.

How is Vulvar Cancer Diagnosed and Staged?

The diagnostic process typically begins with a physical exam, where a doctor inspects the vulvar area for any abnormalities. If a suspicious area is found, the next step is a biopsy. During a biopsy, a small sample of tissue is removed from the abnormal area and sent to a lab to be examined by a pathologist. This is the only way to definitively confirm a cancer diagnosis.

If cancer is confirmed, further tests are needed to determine the stage. This may include imaging tests like a CT scan, MRI, or PET scan to see if the cancer has spread to lymph nodes or other parts of the body. A gynecologic oncologist may also perform an examination under anesthesia to get a better sense of the tumor's size and location. The results of all these tests are combined to assign a stage, which guides the treatment plan.

What are the Common Treatment Options for Vulvar Cancer?

Treatment for vulvar cancer depends heavily on the stage of the disease and the patient's overall health. Surgery is the most common treatment, especially for early-stage cancers. The goal of surgery is to remove the tumor and a margin of healthy tissue around it. Depending on the extent of the cancer, this could range from a wide local excision to a more extensive procedure called a vulvectomy. Surgery to remove nearby lymph nodes (lymph node dissection) is also often performed to check for spread.

Radiation therapy, which uses high-energy rays to kill cancer cells, may be used after surgery to destroy any remaining cancer cells, or as the main treatment if surgery is not an option. It is also often used to treat lymph nodes in the groin. Chemotherapy, which uses drugs to kill cancer cells, can be given in combination with radiation (chemoradiation) to make the radiation more effective, or it can be used to treat advanced cancer that has spread to distant organs.

Can Vulvar Cancer Recur?

Yes, like many cancers, vulvar cancer can recur (come back) after treatment. The risk of recurrence depends on the original stage of the cancer and other prognostic factors. Recurrence can be local (in the vulva or nearby area), regional (in the pelvic lymph nodes), or distant (in other parts of the body). This is why follow-up care after treatment is so important.

Regular check-ups allow doctors to monitor for any signs of recurrence so it can be treated as early as possible. Follow-up appointments typically include physical exams and may sometimes involve imaging tests. If a recurrence is detected, treatment options will depend on where the cancer has returned and what treatments were used previously.

Conclusion

Understanding the survival rates for vulvar cancer can provide valuable context, but it's essential to interpret these numbers correctly. The statistics are a guide, not a definitive prediction. The most crucial takeaway is the significant difference in survival rates between early-stage and late-stage cancer, which highlights the life-saving importance of early diagnosis. Advances in surgical techniques, radiation therapy, and systemic treatments continue to improve outcomes. Anyone with concerns or symptoms should speak with a healthcare provider to get an accurate diagnosis and a personalized understanding of their prognosis and treatment options.

For More Information

To learn more from trusted sources, please visit:

• American Cancer Society - Survival Rates for Vulvar Cancer
• National Cancer Institute - Vulvar Cancer