What Happens If Vulval Cancer Comes Back?

Below summaries the main points for all treatments in accordance to British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023. Please read the guidelines attached for further details.

British guidelines for vulva cancers Download

A summary of key recommendations from the British Guidelines

Suggested One: Additional Surgery

Suggested Two: Radiotherapy

Comparison with the different radiotherapeutic techniques

What is Stereotactic Body Radiation Therapy? – SLUCare Radiation Oncology

Option Three: Chemotherapy

Neoadjuvant chemotherapy (before surgery) is followed by personalised or tailored therapy.

What To Do If A Patient Has Both?

Radiotherapy or Chemotherapy is recommended. However, there is also IMMUNOTHERAPY...

Let’s find out more…

Palliative radiotherapy

Palliative Chemotherapy

When is this performed?

Quick Reminder

Paclitaxel is a microtubule stabiliser that promotes tubulin protein dimers and prevents depolymerisation. This inhibits cell division (mitosis), which is required for growth and repair.

Cisplatin and Carboplatin are platinum-based drug and alkylate the DNA.
Mitomycin C is a non-platinum-based drug and can alkylate the DNA.

Capecitabine is a prodrug for 5-FU and converts to 5-FU to inhibit RNA synthesis by inhibiting the enzyme thymidylate synthase needed for folate metabolism.

Combined chemotherapy is given at three-week intervals up to a maximum of six cycles, with interval assessment after three cycles to assess the response.

Immunotherapy and Metastatic disease?

A Phase II trial of cisplatin-sensitized radiation therapy with pembrolizumab for vulvar cancer By Dr. Oladapo Yeku

Insights into immune checkpoint inhibitors for vulvar cancer By. Dr. Oladapo Yeku

Some patients…

Have a patient with distant metastatic disease needing surgery?

Vulvar Cancer Staging FIGO 2021 By The Oncology Resident

References

Addley, S., Sadeghi, N., Smyth, S.L., Johnson, C., Damato, S. and Majd, H.S. (2023). Bartholin’s gland carcinoma—the diagnostic and management challenges of a rare malignancy—a case report and review of current literature. Translational Cancer Research, [online] 12(1). doi:10.21037/tcr-22-612.

American Cancer Society (2026) Anal Cancer. Available at: https://www.cancer.org/cancer/types/anal-cancer.html (Accessed: 2^nd October 2026)

British Association of Dermatologists (2026) Imiquimod cream. Available at: https://www.bad.org.uk/pils/imiquimod-cream (Accessed: 30^th September 2026)

Cancer Research UK (2028) Chemotherapy for vulval cancer. Available at: https://www.cancerresearchuk.org/about-cancer/vulval-cancer/treatment/chemotherapy (Accessed: 30^th September 2026)

Cleveland Clinic (2026) Volumetric Modulated Arc Therapy (VMAT). Available at: https://my.clevelandclinic.org/health/treatments/17626-volumetric-modulated-arc-therapy-vmat (Accessed: 30^th September 2026)

Hoppe-Seyler, K., Bossler, F., Braun, J.A., Herrmann, A.L. and Hoppe-Seyler, F. (2018). The HPV E6/E7 Oncogenes: Key Factors for Viral Carcinogenesis and Therapeutic Targets. Trends in Microbiology, [online] 26(2), pp.158–168. doi:10.1016/j.tim.2017.07.007.

Iowa Head and Neck Protocols (2017) Adenoid Cystic Carcinoma. Available at: https://iowaprotocols.medicine.uiowa.edu/protocols/adenoid-cystic-carcinoma (Accessed: 4^th October 2026)

Kochhar, R., Plumb, A.A., Carrington, B.M. and Saunders, M. (2012). Imaging of Anal Carcinoma. American Journal of Roentgenology, 199(3), pp.W335-W344. doi:10.2214/ajr.11.8027.

Lobna Ouldamer, Z. Chraibi, Flavie Arbion, Barillot, I. and Body, G. (2013). Bartholin’s gland carcinoma: Epidemiology and therapeutic management. 22(2), pp.117–122. doi:10.1016/j.suronc.2013.02.004.

Morrison, J., Baldwin, P., Hanna, L., Andreou, A., Buckley, L., Durrant, L., Edey, K., Faruqi, A., Fotopoulou, C., Ganesan, R., Hillaby, K. and Taylor, A. (2024). British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023. PubMed, 292, pp.210–238. Doi: 10.1016/j.ejogrb.2023.11.013.

National Cancer Institute (2026) Vulvar Cancer Treatment (PDQ®)–Health Professional Version. Available at: https://www.cancer.gov/types/vulvar/hp/vulvar-treatment-pdq (Accessed: 17^th August 2026)

Royal College of Obstetricians and Gynaecologists (2014) Guidelines for the Diagnosis and Management of Vulval Carcinoma. Available at: https://www.rcog.org.uk/media/dqwnw2a1/vulvalcancerguideline.pdf (Accessed: 1^st October 2026)

The Eve Appeal (2026) Vulval cancer Available at; https://eveappeal.org.uk/information-and-advice/gynaecological-cancers/vulval-cancer/ (Accessed: 7^th August 2026)