Symptoms, Causes, Diagnosis, and Treatment
Vulvar cancer is a type of cancer that occurs on the outer surface of the female genitalia. The vulva is the area of skin that surrounds the urethra and vagina, including the clitoris and labia. Check out the full explanation of the symptoms, causes, and how to treat it below.
What is Vulvar Cancer?
Vulvar cancer is a type cancer which affect the external genital organs that protect the female reproductive system, are most likely to appear on the outer lips of the vagina. This type of cancer generally takes the form of a lump and often causes itching. Although it can occur at any age, this condition is most often diagnosed in the elderly.
Vulvar Cancer Symptoms
The first sign is usually a lump or ulceration, possibly with itching, irritation, or bleeding. Typical features of vulvar cancer include:
- Painful sexual intercourse.
- There is a burning pain.
- Change to dark color on case melanoma.
- Painful urination.
- Genital organs become more sensitive.
- Tissue growths such as warts.
- Thick skin.
- A scab appears.
It is important to know that different types of vulvar cancer may have different symptoms, and in some cases there may be no visible symptoms. Therefore, any changes that occur must be consulted with a doctor.
When is the Right Time to See a Doctor?
Immediately consult a doctor if you experience the above symptoms, especially if you have a high risk of developing vulvar cancer. The sooner it is detected, the more likely you are to recover.
If you have been diagnosed with vulvar cancer, are currently undergoing treatment, or have recovered from vulvar cancer, you should regularly check with your doctor to prevent the condition from recurring after you are declared cured.
Also Read: 9 Types of Vaginal Odor and How to Overcome It
Causes of Vulvar Cancer
Until now it is not clear what causes this cancer. However, in general, cancer begins when cells develop changes (mutations) in their DNA. Mutations tell cells to grow and divide rapidly.
The cell and its progeny continue to live when other normal cells would die. The accumulating cells form a tumor that may be cancerous, invading the surrounding tissue and spreading to other parts of the body.
While the exact cause of this cancer is unknown, certain factors appear to increase the risk, including:
- Age. Although it can occur at any age, the risk of this condition will increase with age. The average age at diagnosis is 65 years.
- Caught human papillomavirus (HPV). This is a sexually transmitted infection that increases the risk of several types of cancer, incl cervical cancer. For some people, the infection causes cell changes and increases the risk of cancer later in life.
- Smoke. These activities can increase the risk of this cancer.
- Have a weak immune system. People who are taking drugs to suppress the immune system, such as someone who has had an organ transplant and who has conditions that weaken the immune system, eg human immunodeficiency virus (HIV) have an increased risk.
- Have a history of pre-cancer of the vulva. Vulvar intraepithelial neoplasia is a precancerous condition that increases the risk of this cancer. Even so, the majority of cases will not develop into cancer, but a small percentage go on to become invasive vulvar cancer.
- Have a skin condition involving the vulva. lichen sclerosus, a chronic skin disorder that causes the skin of the vulva to become thin and itchy, increasing the risk of this cancer.
Other factors that put a person at risk of having this cancer are lupus, suffering from psoriasis, or undergoing radiotherapy for uterine cancer.
Also Read: Alert, these are the 9 most common types of cancer that affect women
Diagnosis of Vulvar Cancer
The doctor will carry out a gynecological evaluation, including an examination of the vulva. If there is an ulceration, lump, or mass that looks suspicious, the doctor may need to take a biopsy.
Examination may cover the perineal area, including the area around the clitoris and urethra. Apart from that, doctors can also examine the Bartholin glands.
Further checks that you may need to do include:
- Cystoscopy: The bladder is examined to determine if the cancer has spread to the area.
- Proctoscopy: The rectum is examined to check if the cancer has spread to the rectal wall.
- Imaging: This procedure can help doctors determine whether the cancer has spread. MRI or CT scans can be used. While X-rays can be used to determine whether the cancer has reached the lungs.
If the biopsy confirms vulvar cancer, the doctor will determine the stage with the help of imaging methods. Here’s how to determine the stage of cancer:
- Stage 0 or carcinoma in situ: Cancer is only on the surface of the skin.
- Stage I: Cancer is limited to the vulva or perineum and is a maximum of 2 centimeters.
- Stage II: Same as stage 1, but the tumor is at least 2 centimeters.
- Stage III: The cancer has reached nearby tissues, such as the anus or vagina, and may have reached lymph nodes.
- Stage IV: The cancer has reached the lymph nodes on either side of the groin and may have reached the intestine, bladder, or urethra.
Sometimes, a woman may not seek medical attention because of embarrassment, but early diagnosis is useful to prevent the spread of cancer.
Types of Vulvar Cancer
The type of cells where this cancer begins helps doctors plan the most effective treatment. Here are the two most common types include:
- Vulvar squamous cell carcinoma (vulvar squamous cell carcinoma). This cancer starts from the thin, flat cells that line the surface of the vulva. Most of these cancers are squamous cell carcinomas.
- Vulvar melanoma. This cancer begins in the pigment-producing cells found in the skin of the vulva.
Also Read: Vulvodynia: Symptoms, Causes, Treatment, and Complications
Vulvar Cancer Treatment
Types of treatment that are usually used for this condition are surgery, chemotherapy, radiation therapy, and biologic therapy. Here’s a full explanation:
This is the main way to treat vulvar cancer. Surgery aims to remove the cancer while allowing normal sexual function. If the diagnosis occurs in the early stages of cancer, limited surgery is required.
In later stages and if the cancer has spread to nearby organs such as the urethra, vagina, or rectum, surgery will be more extensive.
Types of surgery include:
- Laser surgery: This method uses a laser beam as a blade to remove the lesion.
- Excision: The surgeon tries to remove all of the cancer and some of the healthy tissue around it.
- Skinning vulvectomy: The surgeon removes the top layer of skin, where the cancer is. Skin grafts from other parts of the body can be used to replace lost body parts.
- Radical vulvectomy: The surgeon removes the entire vulva, including the clitoris, vaginal lips, vaginal opening, and usually nearby lymph nodes.
This method can shrink deep lesions or tumors before surgery to make them easier to remove. Radiation therapy can also treat lymph nodes.
This technique is often used with radiotherapy as part of palliative care. Chemotherapy can also be used on the skin as a creamhowever, the method will depend on how far the cancer has spread.
This operation can be done depending on how much tissue is removed. Reconstructive plastic surgery can involve skin flaps and skin grafts can sometimes be performed.
This is a type of immunotherapy that uses synthetic or natural substances to help the body defend itself against cancer. The drug imiquimod can be applied as a cream to treat the condition.
Also Read: Recognizing the Difference between Chemotherapy and Radiotherapy
Vulvar Cancer Complications
This condition can cause complications in the form of the spread of cancer cells to other organs. For information, vulvar cancer that has been successfully removed from the patient’s body can still attack again. Therefore, patients need periodic checks so that the progress of the disease can be known with certainty.
Generally, checkups that doctors recommend are every 3 or 6 months in the first 2 years and every 6 or 12 months in the next 3 -5 years. The doctor may also suggest that the patient undergo cancer screening.
Prevention of Vulvar Cancer
The following are some actions that can reduce the risk of developing this cancer, including:
- Practicing safe sex.
- Routinely perform Pap smear examinations.
- Get the HPV vaccination.
- Do not smoke.
Because there is no standard screening for this condition, you must carry out the examination as directed by your doctor and be aware of changes that occur in your body.
- Anonymous. Vulvar cancer. https://www.mayoclinic.org/diseases-conditions/vulvar-cancer/symptoms-causes/syc-20368051. (Accessed March 3, 2023).
- Anonymous. Vulva Cancer. https://www.hopkinsmedicine.org/health/conditions-and-diseases/vulvar-cancer. (Accessed March 3, 2023)
- Anonymous. 2022. Vulvar Cancer Treatment (PDQ®)–Patient Version. https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq. (Accessed March 3, 2023)
- Felman, Adam. 2018. Vulvar cancer: Types, symptoms, and more. https://www.medicalnewstoday.com/articles/173108. (Accessed March 3, 2023).
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