Medical Centric

VULVAR CANCER

Cancer, Women's Health / By

VULVAR CANCER

Vulvar cancer is a type of cancer arising from the vulva, the outer surface of the female genitals.

  • The vulva is the area of the skin that surrounds the urethra and vagina, including the clitoris and the labia.
  • The disease accounts for only 0.6% of cancer diagnosis and is commonly diagnosed in older adults.
  • The most common sites are the outer lips of the vagina, other parts of the vulva may be affected especially as cancer enlarges.
  • The American Cancer Society in 2014 estimated about 4,850 cases of vulvar cancer resulting in 1,030 deaths.
  • Cancer that originates in the vulva is called primary vulvar cancer, if it spreads from another body part, it is called secondary vulvar cancer.
  • There are several types of vulvar cancer. Some common types are:
  • Squamous cell carcinoma arising from the thin, flat cells that line the surface of the vulva. Approximately 90% of vulvar cancer is squamous cell carcinoma.
  • Vulvar melanoma arising from the pigment-producing cells found in the skin of the vulva. It accounts for around 5% of vulvar cancer.

CAUSES

It is not clear what causes vulvar cancer but certain risk factor has been associated with the condition, this may include:

  • Increased age
  • Exposure to HPV
  • Vulvar intraepithelial neoplasia (VIN)
  • Smoking
  • HIV infection
  • Lichen sclerosus, a skin condition that causes the vulvar skin to become tiny and itchy.
  • Smoking

SYMPTOMS

  • Pain and tenderness in the vulvar area
  • Itching in the vulvar area
  • Pain with urination
  • Abnormal bleeding
  • Wart-like sores or a lump on the vulva
  • A discolored patch of skin

DIAGNOSIS AND TREATMENT

The doctor will review your medical history and ask questions about your lifestyle

The doctor will perform a physical exam and do a careful examination of the vulva to look for abnormalities.

The doctor will carry out a colposcopy. In this procedure, a magnifying instrument called a colposcope is used to examine the vulva for abnormal areas.

A biopsy will be carried out to determine whether an area of suspicious skin on the vulva is cancer, this is done by removing a small tissue from the vulva to be tested in the lab

The stages of the cancer are determined based on how far cancer has spread. This will help the doctor to determine the best treatment option. Imaging tests such as x-rays, CT scan, and MRI can be used to determine your cancer stage.

Stage 1, the cancer is confined to the vulva or area of skin between the vaginal opening and anus

Stage 2, cancer has grown to nearby structures including the lower part of the urethra, vagina, and anus

Stage 3, cancer has spread to lymph nodes

Stage 4, cancer has spread more extensively to the lymph nodes, or the upper part of the vagina, or the bladder, rectum, or pelvic bone.

TREATMENT

The stages, type, your general health, and preference will determine the treatment option

Treatment option may include surgery to cut out cancer and a small area of tissue that surrounds it, or surgery to remove part of the vulva (vulvectomy), or to remove lymph nodes if cancer has spread there

Radiation therapy that uses powerful, energy beams such as X-rays to kill the cancer cell

Chemotherapy that involves using medication injected intravenously or taken orally to kill the cancer cell.

After a successful vulvar cancer treatment, follow up treatment may be done periodically to look for cancer recurrence. Doctors generally recommend exam two to four times each year for the first two years after vulvar cancer treatment.