Diagnosis and Staging

The two most common tests used to diagnose, or confirm the presence of vulvar cancer are a physical exam and a biopsy (tissue sample). Further tests may be used to determine if the cancer has spread and to what extent it has spread. This is called staging, and is essential so that our oncologists can plan the most effective treatment possible. Staging tests may include: a pelvic exam, CT scan (CAT scan), MRI (magnetic resonance imaging) or x-rays.

• Pelvic Exam. A physical exam of the vulva, vagina, cervix, uterus, fallopian tubes, ovaries and rectum for signs of disease.
• CT Scan (CAT Scan). Also known as a computed tomography scan, this high-tech computer linked x-ray machine takes a series of detailed “slices” through the body, offering thorough images of the affected tissue.
• MRI (Magnetic Resonance Imaging). A procedure that uses a high-powered magnet and a computer to make a series of detailed images of the body. These pictures pinpoint diseased tissue.
• X-Ray. A type of energy beam that can go through the body and onto film, making a picture of areas inside the body. To stage vulvar cancer, x-rays may be taken of the organs and bones inside the chest, and the pelvic bones to detect any spread of the disease.

Stages range from 0 to IVB depending on factors such as size and location:

• Stage 0 (carcinoma in situ). Cancer is found only on the surface of the skin.
• Stage IA. Cancer has spread 1 millimeter or less into the tissue of the vulva or perineum (muscle tissue between the vagina and rectum).
• Stage IB. Cancer has spread more than 1 millimeter into the tissue of the vulva or perineum.
• Stage II. A cancer mass larger than 2 centimeters is found in the vulva or the vulva and perineum.
• Stage III. Cancer of any size has spread to nearby lymph nodes or nearby tissue.
• Stage IVA. Cancer has spread to nearby lymph nodes, beyond nearby tissues to the upper part of the urethra, bladder, and rectum, or has attached to the pelvic bone and may have spread to distant lymph nodes.
• Stage IVB. Cancer has spread to distant parts of the body.

To schedule a pelvic exam, or more advanced diagnostic services from our Gynecologic Cancer Clinic simply ask your primary care physician for a referral or make a self-referral by calling 1-877-LACKS-MI.