Vulval melanoma
Vulval melanoma is a rare type of vulval cancer. It develops from the cells in the skin that produce pigment. These cells give the skin its colour.
How it starts
Melanoma starts in cells called melanocytes. These are pigment producing cells found mostly in the skin.
Most melanomas develop in parts of the body exposed to the sun. But you can get them anywhere, including organs. This is because there are melanocytes in these areas too.
It’s not clear why melanomas can form in parts of the body that are not exposed to the sun.
Vulval melanoma can start anywhere on the vulva. The most common place for it to start is the inner lips (labia) and clitoris.
How common is it?
Vulval melanoma is the second most common type of vulval cancer. Less than 10 in every 100 vulval cancers (less than 10%) are melanomas.
It is most often found in women who no longer have periods (post menopause). White women are at higher risk of vulval melanoma than Black women.
Symptoms of vulval melanoma
The symptoms of vulval melanoma include:
- changes in the colour of the vulva
- itching
- bleeding
- a lump
- an open sore visible on the skin
Tests for vulval melanoma
You usually have a number of tests to find out if the symptoms you have could be due to vulval melanoma. If you have vulval melanoma you then need more tests to find out how far it has grown.
The tests you might have include:
- a vulval examination
- taking a sample of tissue called a biopsy
- blood tests
- scans to look at your pelvis and the rest of your body. This includes a CT and MRI scan
Staging
The tests you have helps your doctor find out if you have vulval cancer and how far it has grown. This is the stage of the cancer.
There are different ways to stage vulval melanoma. In the UK, doctors usually use the Clark and Breslow staging system.
We describe the Clark and Breslow staging system in the melanoma section.
Treatment
A team of doctors and other professionals recommend the best treatment and care for you. They are called a multidisciplinary team (MDT). The team includes melanoma specialists, specialists in gynaecological cancers and specialist cancer nurses.
The treatment you have depends on:
- where the melanoma is
- the size of the tumour
- whether it has spread
- your general health
The main treatment for vulval melanoma is surgery. You usually have a type of surgery called a wide local excision.
Surgery
A wide local excision means that the surgeon removes the area containing the cancer and a border of healthy tissue around it. The border of healthy tissue is called the margin.
After the operation, a 
looks at the tissue removed. They check the margins for cancer cells. They say that you have clear margins if there are no cancer cells at this border. This lowers the risk of the cancer coming back.
You may need more surgery if there are cancer cells at the margin. You may also need the from the groin removed. Your surgeon will explain in more detail if you need this.
Other treatments
Other treatments you might have include:
- radiotherapy
- targeted cancer drugs and immunotherapy
- chemotherapy
You may also have treatment as part of a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments. Your doctor will discuss this with you if there is a trial suitable for you.
Follow up
You have regular check ups once you finish your treatment. Your doctor will examine you and ask about your general health. This is your chance to ask questions and to tell your doctor if anything is worrying you.
You usually have a check up every 3 months. After 3 years, you may have a check up every 6 months.
Coping
Coping with a diagnosis of a rare cancer can be especially difficult, both practically and emotionally. Being well informed about your cancer and its treatment can make it easier to make decisions and cope with what happens.
Talking to other people
Talking to other people who have the same thing can also help.
Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.
