Surgery can be individualized, but in more advanced cases, chemotherapy and radiation can be utilized, sometimes as definitive management, and sometimes that’s a method to shrink down the cancer and operate in a more manageable manner. Many times radical vulvectomy with the removal of sentinel lymph nodes is utilized to manage vulvar cancer. Radical vulvectomy entails the removal of the underlying fatty tissue along with getting adequate margins around the cancer. Sentinel lymph nodes removal is a surgical advancement whereby only one or two lymph nodes are removed that take up the dye injected to light up the first lymph nodes where the cancer would go if it were to spread. This minimizes the complications that result from the removal of more lymph nodes. Sometimes reconstructive surgeries such as flap creation are needed as well.