Vulvar cancer tends to be slow growing, progressing over several years. But some less common types can spread to other parts of your body faster.

The current 5-year relative survival rate, which is the amount of people expected to survive the effects of cancer, is almost 70%.

Vulvar cancer is often diagnosed at an early stage, usually making the chance of survival higher.

Most vulvar cancers are squamous cell carcinoma (SCC).

Other types, such as melanoma, tend to grow and spread at a quicker rate, moving to nearby places such as the vagina and anus as well as distant parts of your body via the lymph nodes.

How fast any cancer spreads depends on quite a few factors.

With vulvar cancer, the type is particularly important. Most grow slowly and can take years to spread to other body parts. But more aggressive types, which tend to be melanomas, may spread much quicker if not treated.

The stage and grade of the cancer when it’s first diagnosed can also have a big impact.

Vulvar cancer that has reached an advanced stage and has traveled to your lymph nodes will likely spread across the body much faster. This tends to be rare with SCC vulvar cancer, and early stage cancer of this type is curable.

Similarly, higher grade cancers tend to grow and spread faster than lower grade ones.

There’s treatment to consider, too. If treatment is started quickly, that gives the cancer less of a chance to grow and spread.

But if treatment is delayed or if less effective treatment methods are opted for, growth rates may increase, and the cancer may spread to other body parts.

The majority (60%) of vulvar cancer diagnoses happen during the localized stage. This means the cancer still remains inside the vulva and hasn’t spread to other parts of your body.

Localized vulvar cancer is split into two stages: stages 1A and 1B.

Stage 1A means the cancer is 2 centimeter (cm) or less in size and has grown up to 1 millimeter (mm) into your skin and tissues that sit underneath the vulva.

Stage 1B means the cancer is more than 2 cm in size or has grown more than 1 mm into your tissues and skin beneath.

The lowest cancer grade is known as grade 1. The grade of a person’s cancer isn’t necessarily related to the stage. Cancerous cells with fewer abnormalities may be slower to spread, resulting in a lower grade.

If vulvar cancer is diagnosed at the localized stage, it’s potentially curable.

According to the SEER database, the current 5-year relative survival rate for localized cases is almost 86%.

Other studies have found the survival rate for stage 1 vulvar cancer is between 93–100%.

Of course, this depends on getting effective and efficient treatment, which is typically some form of surgery.

Vulvar cancer can come back with time. One study published in 2021 found 1 out of 5 people with vulvar cancer experienced a recurrence within 5 years.

Regional vulvar cancer is more advanced than the localized stage, with a 5-year relative survival rate of 47.5%.

It typically includes stages 2 and 3.

If you receive a diagnosis of stage 2 vulvar cancer, this means the cancer has spread to nearby tissues such as the anus, the lower vaginal area, or the lower part of your urethra.

Stage 3 vulvar cancer is split into three sub-stages:

  • Stage 3A: The cancer has spread to upper parts of your urethra or vagina, the rectal lining, or the bladder lining. It may also have spread to lymph nodes that are smaller than 5 mm.
  • Stage 3B: The cancer has moved to lymph nodes that are at least 5 mm in size or larger.
  • Stage 3C: The cancer has spread to lymph nodes and outside of the lymph node capsule.

Again, the grade of the cancer may be separate from the stage. If grade 2 is detected, for example, the cancer cells are more likely to spread.

Once cancer has entered your lymph nodes, it’s likely that it will spread to other parts of your body, and this may happen relatively quickly.

But regional cancer is still treatable via surgery and potentially radiotherapy or chemotherapy.

Regular follow-up appointments may also be needed to confirm the cancer hasn’t come back.

Distant vulvar cancer is the most advanced type, with a 5-year relative survival rate of 23%. It’s classed as either stage 4A or 4B.

For stage 4A, the cancer has spread to nearby lymph nodes or the pelvic bone or both. The lymph nodes are hard and not moveable.

For stage 4B, the cancer has moved to more distant parts of your body, such as your lungs. It may continue to spread if left untreated.

The most advanced cancer grade is grade 3. These cells can grow quickly and are even more likely to spread than grade 2 cells.

Research has found that the average amount of time for SCC vulvar cancer to become this advanced is just over 13 months.

Vulvar cancer becoming distant is rare, especially when it’s being treated.

Just like the other cancer stages, surgery, chemotherapy, and radiotherapy may be needed. Sometimes, treatment will focus on maintaining a person’s quality of life if the cancer is incurable.

If cancer is found in your lymph nodes, these may also need to be removed surgically. One study found that many recurrences occur in the lymph nodes around the groin.

For advanced cases, a pelvic exenteration may be necessary. This is where the vulva, bladder, uterus, and part of the bowel are removed.

To see whether vulvar cancer has spread and where it may have spread to, your healthcare team will perform one or more tests.

They may give you an anesthetic and undergo a pelvic exam to take a better look at the vulva and signs of spread.

Other options include an MRI scan, which uses a combination of magnets and radiowaves to produce detailed images, or a CT scan, which involves X-rays. MRI scans can give clearer images than a CT scan for some parts of your body.

Finally, a PET scan may be necessary. This may be used if a doctor is trying to pinpoint where the cancer has spread to. A substance, which is usually a type of sugar, is injected into your arm and the scanner detects the low level radiation produced by the substance.

Sometimes, a PET and CT scan may be combined. Known as PET-CT scans, they can be more accurate than a PET or CT scan alone because they result in more detailed information.

The more common types of vulvar cancer can take a few years to spread to other parts of your body. So, symptoms may not change until the cancer is more advanced.

Some symptoms to watch out for include:

  • persistent sores or warts on the vulva
  • growths or skin changes on the vulva
  • a rash on the vulva
  • persistent pain or discomfort in the vulva, including itchiness

While some types can grow quicker than others, the most common form of vulvar cancer — SCC —tends to grow and progress slowly over the course of the next few years.

That means vulvar cancer can be curable, particularly if diagnosed at an early stage.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.