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
- inner and outer vaginal lips (labia minora and labia majora)
- vaginal opening and its glands
- mons pubis (the tissue that covers the public bone)
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.
|4A||The cancer is in the vulva or the |
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.
|4B||The cancer has spread to distant lymph nodes or organs like the lungs or bone. The cancer may or may not have spread to nearby organs or lymph nodes.|
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.
Treatment for stage 4 vulvar cancer depends on whether it’s stage 4A or 4B.
Stage 4A treatment
In stage 4A, treatment can
- surgery (radical vulvectomy or pelvic exenteration)
- surgery and
- radiation or chemotherapy and radiation, then surgery
- radiation, with or without chemotherapy
Your treatment team will discuss your options with you, and depending on your overall health and the specifics of your cancer and where it has spread, your options may vary. T
reatment may not be able to cure the cancer at this stage, but it can help ease symptoms, reduce tumor size, and improve quality of life.
Stage 4B treatment
According to the
Treatment guidelines from the National Comprehensive Cancer Network (NCCN) for stage 4B vulvar cancer recommend External Beam Radiation Therapy (EBRT) to relieve symptoms and control the cancer’s further spread.
Doctors may also use systemic therapies or Best Supportive Care (BSC) to manage cancer-related symptoms. Per the NCCN, the preferred first-line systemic therapies for stage 4B vulvar cancer include:
Other recommended medications by the NCCN for stage 4B vulvar cancer include:
Survival rates vary based on the stage of vulvar cancer and the amount of spread. For stage 4 vulvar cancer, the 5-year relative survival rate is
A relative survival rate is an estimate of how long someone with a specific condition may live after their diagnosis compared with someone without the condition. For example, a 5-year relative survival rate of 22.9% means that someone with that condition is 29.9% as likely to live for 5 years as someone without the condition.
Here are the
- Localized (only in the vulva): 86.2%
- Regional (spread only to lymph nodes in the vulvar area): 48.4%
- Distant (spread to other areas of the body): 22.9%
- Overall (combined survival rate): 70.3%
It’s important to remember that statistics are a good estimate, but each person is different, and these are not absolutes.
Factors influencing survival rates
Lymph node involvement has been found to
The stage at which a person is diagnosed with vulvar cancer also affects survival rates. Being diagnosed at a later stage is associated with a lower rate of survival.
Vulvar cancer is a slow-growing cancer that begins in the vulvar tissues. Like other cancers, it’s broken down into stages, which provide an idea of how far the cancer has spread and help to guide treatment.
Stage 4 vulvar cancer is the most advanced stage, and may involve vulvar cancer that has spread to other areas of the body.
There are multiple treatments available for stage 4 vulvar cancer, including surgery, chemotherapy, and radiation. Your treatment team will discuss with you the most appropriate treatment for your specific medical situation.