Medical Oncologist
CION Cancer Clinics
Follow-up after vulvar cancer surgery | CION Cancer Clinics
After a vulvectomy you are seen every few months in the first couple of years, then less often, for several years in all. Your surgeon sets the exact gaps from your pathology report and treatment. Visits are built around examining the vulva, the groins and the legs rather than scans. This page explains what happens at each visit, what you can check yourself, and what should never wait for the next appointment. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- How often will I be seen after a vulvectomy?
- What actually happens at a follow-up visit
- What the doctor is checking for, and what you can check yourself
- Words on the follow-up letter, in plain language
- Making follow-up work from a district town
- Four things women tell us, and what is actually true
- Common questions about follow-up after vulvectomy
The short answer
How often will I be seen after a vulvectomy?
Every few months in the first couple of years, then less often, for several years in all. Your surgeon sets the exact gaps, and they depend on the stage of the cancer, whether the groin nodes were involved, and whether you had radiotherapy afterwards. There is no single schedule, so do not compare yours with another woman's.
Why the visits are closest together at the start
If vulvar cancer comes back, it most often does so in the first years, and most often in the vulva itself or the groin. Both are places a doctor can examine directly, without a scan. That is why follow-up for this cancer is built around examination rather than imaging, and why the early visits are frequent.
Why it goes on for so long
The vulvar skin that remains carries the same background risk it had before. Lichen sclerosus, a long-standing skin condition, and pre-cancerous changes called VIN can produce a new cancer years later. Follow-up checks for that as much as for the original cancer returning.
What follow-up cannot tell you
A normal visit means nothing was found that day. It is not a promise about the next visit, and a long run of normal visits is not a reason to stop coming. Being called back sooner than usual does not mean the doctor has seen something serious. Ask why.
In the room
What actually happens at a follow-up visit
Questions first
Any new lump, itch, pain, bleeding or discharge. How you are passing urine. Whether a leg feels heavy. How you are sleeping and eating, and how things are at home. Bring a written list so nothing is forgotten.
Examination of the vulva
You lie on the couch, as for a smear test, and the doctor looks at and gently feels the scar and the surrounding skin. A nurse or a relative can be in the room if you wish.
The groins and the legs
The doctor feels both groins for any lump and checks the legs for swelling. If nodes were removed, the legs may be measured and compared with the last visit.
Scans only when needed
There is no routine scan at each visit. A CT or PET-CT is arranged if something is felt, if you have a new symptom, or as a one-off check after treatment. A visit without a scan is normal, not neglect.
Not sure whether this applies to you?
Ask an oncologistUnder the surface
What the doctor is checking for, and what you can check yourself
You see the area far more often than your doctor does. Knowing what matters turns you into the first line of follow-up.
The cancer returning at the vulva
A new lump, a sore that does not heal, a thickened or raised patch, or a change in skin colour near the scar. Itching that does not settle counts too.
Check monthly with a mirror
- The scar line and both sides of it
- The skin between vulva and anus
- The inner thighs
A lump in the groin
A firm swelling in one groin that was not there before, even if it does not hurt. This is the second most common place for the cancer to return, and the one most often put down to a strain.
Leg swelling
Heaviness, tightness or visible swelling in one or both legs. This is usually lymphoedema from the node surgery, not the cancer, but it needs to be seen early to be controlled well.
How you are living
Pain, trouble passing urine, difficulty sitting, sex, low mood. These are part of follow-up, not a distraction from it. Raise them yourself if nobody asks.
!
Do not save these for the next appointment
A new lump or ulcer on the vulva, bleeding that is not a period, a firm swelling in a groin, or a leg that becomes hot, red and painful all need a call within days, not months. Ring the number on your discharge sheet or the helpline and say you are on follow-up after vulvar cancer surgery. You will be seen sooner. Waiting to "see if it goes" is the most common reason a recurrence is found late.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
On your letter
Words on the follow-up letter, in plain language
- Surveillance
- Regular checking with no active treatment. It is the normal state after successful surgery, not a sign that something is being watched.
- Recurrence
- The cancer coming back, either in the same place (local) or elsewhere (distant). "No evidence of recurrence" means nothing was found at that visit.
- VIN
- Vulvar intraepithelial neoplasia: changed cells in the surface skin that are not cancer but can become it. It is treated or watched closely.
- Lichen sclerosus
- A long-term skin condition of the vulva that causes itching and white, thin skin. It raises the chance of a new cancer and is usually managed with a steroid cream your doctor prescribes.
- Margin
- The rim of healthy tissue around what was removed. A close margin may mean closer follow-up, not necessarily more treatment.
- HPV-related
- Caused by human papillomavirus, a common virus. Some vulvar cancers are; others, especially in older women, are not.
Being straight with you
Making follow-up work from a district town
The women who fall out of follow-up are rarely the ones who feel unwell. They are the ones for whom the journey is long, the bus fare adds up, and a normal visit feels like a wasted day. If that is you, say so. There are usually ways to make it work.
Ask what can be done nearer home
Some visits can be shared with a gynaecologist closer to you, with the findings sent to your surgeon. A video call can replace the questions part of a visit, though not the examination. Ask which of these your team will accept.
Bring the right things
Your last discharge summary and pathology report, the list of your current medicines, a written note of any change you have noticed and when it started, and the person who helps you at home. Take a photograph on your phone of any skin change when you first see it, so the doctor can compare.
What this page cannot tell you
It cannot tell you your own schedule, or how long your follow-up will last. Those are set from your pathology report and your treatment, and they change if anything is found. Missing a visit because you feel well is the one decision that reliably makes things worse.
If you have missed visits and are embarrassed to come back, just come. The examination is what matters, not the gap.Commonly believed
Four things women tell us, and what is actually true
"I feel fine, so I can skip this one."
A recurrence at the vulva or groin often causes no pain at first and can be small enough to miss yourself. Feeling well is the normal state for most women whose cancer comes back early. The visit exists to find what you cannot feel.
"A scan every visit would be safer."
For this cancer, careful examination finds most recurrences earlier than a scan would, and scans carry their own costs, radiation and false alarms. Scans are used when there is something to look at.
"Once a few years have passed, it is over."
The chance of the original cancer returning does fall with time. The chance of a new cancer in the remaining vulvar skin does not disappear, especially with lichen sclerosus or VIN. That is why visits become less frequent rather than stopping altogether.
"Pain at the scar means it is back."
Scar tissue, nerve regrowth and skin that has been stretched all cause aches and stinging for a long time after surgery. Pain on its own is far more often healing than recurrence. Mention it and let the doctor look.
Questions we are asked
Common questions about follow-up after vulvectomy
How many years does follow-up go on for?
Usually several years at least, and many teams keep seeing women for a decade or more because the remaining skin can develop a new cancer. Visits become less frequent as time passes. If you are discharged, ask who to contact if something changes.
Will I have a scan at every visit?
No. Follow-up for vulvar cancer is built on examination, because the places it most often returns to can be seen and felt. A CT or PET-CT is arranged if the doctor feels something, if you report a new symptom, or occasionally as a planned one-off check.
Do I still need smear tests?
If you still have a cervix, yes, on the usual schedule, because the same virus can affect the cervix and the vulva. If you have had a hysterectomy, ask your team whether a vault check is needed. Tell whoever does the smear about your surgery so they examine the vulva too.
Can my local gynaecologist do some of the visits?
Often, yes, if your surgeon agrees and the findings are sent back each time. This works well for women far from Hyderabad. The visits that follow a change, or that fall at key points in the plan, are usually kept with the surgical team.
I found something between visits. Do I wait?
No. Call the number on your discharge sheet or the helpline and describe what you have found. You will be given an earlier appointment. A new lump, sore or groin swelling is exactly what follow-up is for.
What happens if the cancer does come back?
It depends on where and how much. A small recurrence at the vulva is often removed with a further operation. Groin recurrences may be treated with surgery, radiotherapy or both. The team explains the options at that point. This page cannot tell you the likelihood for your own case; your surgeon can.
Will I be examined by a male doctor?
You can ask for a female doctor or for a female nurse to be present, and you can bring a relative into the room. Say so when you book or when you arrive. The examination is short, and nobody will think less of you for asking.
Are follow-up visits covered by Aarogyasri?
Consultations after a covered operation are generally part of the package for a period; scans and further treatment are approved separately. Aarogyasri, CGHS, ECHS and EHS are accepted at CION. Call the helpline with your card details and we will tell you what your follow-up will cost, if anything.
Meet the Specialists
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Dr. C. Raghavendra Reddy
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
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Sources
- Cancer Research UK — Vulval cancer
- NHS — Vulval cancer
- Macmillan Cancer Support — Vulval cancer
- National Cancer Institute — Vulvar cancer treatment
- American Cancer Society — Vulvar cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Leg lymphoedema after vulvar cancer surgeryThe leg check at every visit, and what to watch for at homeThe pathology report after surgeryThe report your follow-up schedule is built fromComplications and red flagsWhat needs a same-day call rather than the next visitGroin node surgery for vulvar cancerWhy the groins are examined every timeVulvectomyThe full guide to the operation and recovery
Talk to us
Missed a visit, or found something between visits?
Tell us when your operation was and what you have noticed. A surgical oncologist will tell you whether it needs an earlier appointment and arrange one. One helpline serves every CION centre.