Vaginal and vulvar melanoma: Diagnosis and staging
It is important to see your GP if you have symptoms or any ongoing unexplained symptoms that are worrying you. If your GP has any concerns or they are not sure what the problem is, they will refer you to a hospital specialist who will examine you and will arrange for you to have a biopsy. This is a small sample of the tissue that will be removed under local anaesthetic to look for cancer cells. It is then analysed by a pathologist (a specialist doctor who diagnoses diseases from tissue and cells in the body) to determine whether it is a melanoma or not. It typically takes a few weeks to receive the results of your biopsy and this can be a very anxious time. You may have other tests to help diagnose vulvo-vaginal melanoma and these tests can also be used to check whether your melanoma has spread to other parts of the body.
Determining your stage for vaginal and vulvar mucosal melanoma
After a diagnosis of vulvo-vaginal mucosal melanoma, your medical team will work out the ‘stage’. The stage is a way of describing the key features of your melanoma and is helpful in guiding the best treatment and follow-up for you. Your stage provides an indication of how advanced your melanoma is. Generally, the higher the stage, the more advanced it is.
Staging for vaginal melanoma is different to the standard type for melanoma (American Joint Committee on Cancer – AJCC TNM system). It is more common to use the staging below.
Stage 1= the melanoma is ‘localised’ which means it is in the vaginal area only and has not spread anywhere else
Stage 2= the melanoma has spread to nearby lymph nodes
Stage 3 = the melanoma has spread to another part of your body (metastasised)
Vulvar melanoma is commonly staged like skin melanoma using the TNM system. This is based on how big the tumour is (T), whether it has spread to nearby lymph nodes (N), and if there is spread to other organs (M – metastasis).
> Find more detail about TNM staging for Vulvar mucosal melanoma here