VIN and vulval cancer

• Many conditions cause vulval itch, or pruritus. Changes in the vulval skin may be noticeable, but this does not necessarily indicate cancer.

• One cause of vulval itching is lichen sclerosis. This is a distressing condition that affects mainly elderly women. Although harmless in itself, women with lichen sclerosis have an increased risk of developing vulval cancer.

• Vulval intraepithelial neoplasia (VIN for short) is a pre-cancerous condition, and is associated with infection with a virus called the wart virus. VIN is not a cancer but it means that the cells are abnormal and have the potential to become cancerous.

• It is often not possible to distinguish between a non- cancerous condition and early cancer by appearance alone. VIN and vulval cancer may cause no symptoms, and VIN may appear normal to the naked eye.

• Vulval cancer spreads directly into the tissues next to the vulva, including the vagina, urethra, bladder and anus. Early spread or metastasis occurs though the lymph fluid channels into the lymph glands in the groin, and then to the lymph glands in the pelvis. Less commonly, metastasis occurs through the bloodstream, causing tumours to grow in distant sites such as the lungs and brain.