The vulva is the external female genital system adjacent to the vagina. It is located under the triangle of hair that covers the midline pubic bone. Vulva cancer usually starts as a small, hard knot on the skin that turns into a raised ulcer. The ulcer may ooze or bleed and can spread to other parts of the body if left untreated. Treatment of vulva cancer may begin with a biopsy or removing a small portion of the lump for further examination. If the growth is malignant, the doctor may choose to do a vulvecotomy (vul-vek-toe-me), which entails removal of the growth and the surrounding skin or removal of the glands in the groin and the skin in between. If detected early, there is a high rate of recovery. If you have any questions concerning vulva cancer, please contact your healthcare provider.