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Vulvar Cancer

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Introduction

The vulva is the external female genitalia. The vulva includes the area of skin that surrounds the urethra, vagina, clitoris, and labia. Vulvar cancer is the cancer of the outer surface of the female genitalia and usually does not affect the vagina, clitoris, or inner lip.

Vulvar Cancer forms a sore or a lump of the tissues in the vulva and is not a very aggressive cancer. However, it can be bothering and uncomfortable. The tumor usually does not grow very large and grows slowly.

Vulvar Cancer can be of various types, such as squamous cell carcinoma, adenocarcinoma, melanoma, sarcoma, or basal cell carcinoma. These involve different tissues in the vulva and relative to it.

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What are the Causes of Vulvar Cancer?

The exact cause of Vulvar Cancer is not known. The following are some risk factors thought to contribute to causing Vulvar Cancer:

  • ● Age of 70 years or above
  • ● History of vaginal or cervical cancer
  • ● Family history of melanoma
  • ● HPV infection
  • ● Presence of melanoma or moles
  • ● Smoking, associated with a history of HPV infection
  • ● Unusual pap smear test or a history of it
  • ● Existing precancerous lesion in the area
  • ● HIV or AIDS infection
  • ● Conditions like lichen sclerosus

What are the Symptoms of Vulvar Cancer?

Vulvar Cancer might not initially show any symptoms; however, it is only with the progression of the disease that one may notice the following:

  • ● Thickened skin on the vulvar region
  • ● Pain, burning sensation, or sores in that area
  • ● Persistent itching
  • ● Unusual bleeding or discharge from the vagina
  • ● Painful urination
  • ● A visible change in the color of the vulva
  • ● Unusual red, pink, or white bumps that grow on the vulva
  • ● An open sore
  • ● Change in the appearance of a mole

These are common signs that present with other medical conditions too. Therefore, visit your doctor before any interventions.

How is Vulvar Cancer Diagnosed?

Your doctor will initially take a detailed medical history to know if you have any concerning infections and habits to diagnose the condition. The doctor will conduct a pelvic examination, which includes examining the vagina, cervix, vulva, and rectum, and ovaries to look for any abnormalities.

If needed, your doctor will examine your vagina in detail using an instrument known as the colposcope. This procedure of detailed visual examination of the vulva, vagina, and cervix is known as vulvoscopy.

Sometimes, a biopsy may also be needed. Your doctor may need to take a sample of tissues from the vulvar growth. This tissue is sent to the pathology lab for microscopic examination.

If the biopsy confirms the growth as a cancerous growth, imaging such as X-rays, CT scans, PET scans, and MRIs are needed to see how far cancer has spread. Your doctor might recommend these investigations to decide on the treatment protocol.

How is Vulvar Cancer Treated?

Treatment of Vulvar Cancer varies based on the type of cancer that has occurred, the extent of spread, and your overall health. The four main types of treatments include:

Treatment of Vulvar Cancer varies based on the type of cancer that has occurred, the extent of spread, and your overall health. The four main types of treatments considered include:

  • Surgery: Surgery is a crucial part of the treatment, as it removes the mass of the tumor and cancer cells. This includes ultrasound-guided surgical aspiration, wide local excision, radical local excision, laser surgery, skinning vulvectomy, simple vulvectomy, partial or modified radical vulvectomy, radical vulvectomy, etc.

The doctor may perform pelvic exenteration in severe cases of Vulvar Cancer, in which the vulva, along with one or more organs, is removed.

  • Radiation therapy: The process of killing cancer cells with high-frequency x-ray beams. A specific region of cancer or the whole body receives the radiation. Recent advancement of radiological implant capsules is also used. This procedure is known as brachytherapy.
  • Chemotherapy: The doctor prescribes medications to stop the growth of the cancer cells or kill the cancer cells altogether. These drugs are usually given orally or through the IV route. Your doctor can also give you these drugs as topical cream or ointment to apply to the vulvar growth.
  • Immunotherapy: Also known as biological therapy. In this therapy, the platelets of another individual or your platelets are filtered from the cancer cells and administered to your body. Immunotherapy is usually the last resort but effective as it targets the cancer cells and has been proven effective in most patients.

What is the Results of Vulvar Cancer Treatment?

Successful surgery should give a good prognosis, given there are no complications. Any factors like infections, diabetes, etc., might cause a delay in healing, and this might cause discomfort, bleeding, and even yeast infection.

Mostly, Vulvar Cancer surgery has a good outcome; however, there are always chances of recurrence. If cancer metastasizes to distant organs, there are even higher chances of progressive disease, even after partial remission.

What are the Risk Associated with Vulvar Cancer Treatments?

Successful surgery should give a good prognosis, given there are no complications. Any factors like infections, diabetes, etc., might cause a delay in healing, and this might cause discomfort, bleeding, and even yeast infection.

Mostly, Vulvar Cancer surgery has a good outcome; however, there are always chances of recurrence. If cancer metastasizes to distant organs, there are even higher chances of progressive disease, even after partial remission.

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FAQ's

What are the Common Symptoms of Vulvar Cancer that one Should be Alert To?

Irregular periods, bleeding while or after sexual activity, bleeding after menopause, and persistent white or watery or foul discharge are some of the common alert signs of Vulvar Cancer.

Do I Need to See My Doctor Even After the Treatment of Cancer?

Yes, every 3 to 6 months for two years and then every 6 to 12 months for three to five years. Your doctor will tell you if further screening is necessary.

Does Vulvar Cancer Affect Sex Life?

Yes, due to Vulvar tumor or treatment, your body might feel differently during sexual activity. You might feel pain during sex or even may not have satisfaction.

Can HPV Cause Vulvar Cancer?

Yes, HPV infection can cause squamous cell carcinoma in the Vulvar region. It is a slow-growing, wart-type cancerous growth. This type mostly occurs in young women.

What is Bartholin Gland Cancer?

It is a form of Vulvar Cancer that starts in the Bartholin’s glands in the vulva. These are secretory glands; hence, they cause adenocarcinoma in this area.

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