Vaginal Cancer Stages: Understanding Their Classification and Measurement Methods
Vulvar cancer is a rare form of cancer that starts in the vulva, a woman's external genital area. The American Cancer Society estimates that there will be approximately 6,180 new cases of vulvar cancer in the United States in 2023.
Doctors use the International Federation of Gynecology and Obstetrics (FIGO) system to stage vulvar cancer. This system is based on the cancer's location, size, and spread. The FIGO system was developed by the International Federation of Gynecology and Obstetrics (FIGO) to provide a standardised approach for the staging of vulvar cancer.
Vulvar cancer stages range from stage 1 to stage 4, with each stage representing a progression in the cancer's growth and spread.
- Stage 1A TNM classification indicates the vulvar tumor spreads no more than 1 millimeter into the underlying tissue and is no more than 2 centimeters in size, with no lymph node involvement or metastasis. Treatment options for stage 1A vulvar cancer include wide local excision, radical local excision, modified radical vulvectomy, removal of sentinel lymph nodes, radiation therapy, and radiation therapy with surgery following.
- Stage 1B TNM classification indicates the tumor is larger than 2 cm or has grown more than 1 mm into the underlying tissue, with no lymph node involvement or metastasis. Treatment options for stage 1B vulvar cancer are similar to those for stage 1A.
- Stage 2 vulvar cancer means the cancer grew in size or invaded more tissue. Treatment options for stage 2 vulvar cancer are the same as those available for stage 1 vulvar cancer.
- Stage 3 vulvar cancer includes three substages: 3A, 3B, and 3C. For stage 3 vulvar cancer, a doctor may recommend a modified radical vulvectomy or radical vulvectomy with removal of lymph nodes in the groin and upper thigh, radiation therapy along with surgery, or radiation therapy or chemotherapy alone with surgery following.
- Stage 4A vulvar cancer can also involve T3, where the cancer has spread beyond nearby tissues to the pelvis, rectum, bladder, or upper part of the vagina or urethra, with any level of lymph node involvement (N any) and no distant metastasis (M0). Stage 4A vulvar cancer can be either T1 or T2, with the tumor located in the vulva or growing into the vagina, anus, or lower urethra. It also includes N3, where the cancer has spread to nearby lymph nodes and either became stuck to the tissue beneath or caused the formation of an ulcer in the lymph node(s), with no distant metastasis (M0).
- Stage 4B vulvar cancer includes any T, any N, and M1, where the cancer has spread to distant tissue or organs, such as bones or lungs.
Cancer grade indicates how the cancer cells look under a microscope. A low grade (Grade 1) means the cancer appears most like normal cells, while a high grade (Grade 3) means the cells look very abnormal. The higher the cancer grade, the more aggressive the cancer tends to be. Grade 1 vulvar cancer cells tend to spread less and grow slower than higher-grade cells. Grade 2 cells look less normal and have a higher chance of spreading compared with cells in grade 1. Grade 3 cells tend to be fast-growing and more likely to spread.
Not everyone will experience symptoms in the early stages of vulvar cancer. Those who do may notice one or more of the following: pain and tenderness, itching in the area that does not stop, changes in skin in the area, ulcer, lump, or wart-like bumps, or unusual bleeding.
It's important to remember that while this article provides an overview of vulvar cancer stages, grades, and treatment options, each individual's situation is unique. If you or someone you know is experiencing symptoms or has concerns, it's crucial to consult with a healthcare professional for accurate and personalised information.
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