The vulva refers to the external female genitalia, encompassing the clitoris, labia majora (outer lips), and labia minora (inner lips). Vulvar cancer develops in the clitoris or labia.
In Australia, approximately 280 women are diagnosed with vulvar cancer annually. This cancer accounts for about 1% of all cancers in Australian women, typically affecting women between 55 and 75 years of age.
Vulvar cancer is a type of skin cancer, sharing similar cell types with skin cancers elsewhere on the body. Squamous cell carcinoma is the most prevalent, followed by melanoma, adenocarcinoma, and less commonly, verrucous carcinoma and sarcoma.
Due to the vulva’s rich network of blood and lymphatic vessels, cancer originating here can readily spread to adjacent areas like the vagina and bladder.
Early detection of vulvar cancer significantly increases the chances of a cure. Even in advanced stages, treatment remains possible, although the likelihood of long-term cure diminishes.
Causes of Vulvar Cancer
Pinpointing the exact cause of vulvar cancer in an individual woman is often challenging. However, established risk factors include:
- Age: The majority of vulvar cancer cases occur in women over 60.
- Human Papillomavirus (HPV) or Genital Warts: Prior infection increases risk.
- Nulliparity: Women who have never given birth may have a slightly elevated risk.
- Smoking: Smoking is a known risk factor for various cancers, including vulvar cancer.
- Pre-existing Vulvar Conditions: Conditions like vulvar intraepithelial neoplasia or lichen sclerosus, and chronic vulvar itching can increase risk.
- History of Gynecological Cancers: Previous vaginal or cervical cancer elevates vulvar cancer risk.
- Pelvic Radiotherapy: Prior radiation therapy to the pelvic region is a risk factor.
Recognizing Vulvar Cancer Symptoms
If you experience any concerning symptoms, consulting a nurse, doctor, or gynecologist is crucial. While symptoms are more likely to be unrelated to cancer, professional evaluation is essential.
Early vulvar cancer may not always present noticeable signs. Persistent vulvar itching, especially if unresponsive to thrush treatments, warrants medical attention as it could be a symptom of cancer.
Vulvar cancer symptoms may include:
- Vulvar Lumps or Bumps: Unusual growths on the vulva or surrounding area.
- Persistent Vulvar Itching, Burning, Pain, or Soreness: Discomfort in the vulvar region.
- Abnormal Vaginal Discharge: Unusual or foul-smelling bleeding, pus, or fluid.
- Mole Changes: Alterations in the shape or color of a vulvar mole.
- Skin Color Changes: Raised patches of red, white, or dark brown skin on the vulva. This is related to the question “Why Is My Vagina Dark,” as changes in vulvar skin pigmentation can be a symptom, although it is crucial to understand that vulvar darkness itself is often normal variation and not necessarily indicative of cancer. However, new dark patches, especially when accompanied by other symptoms, need medical review.
Seek medical advice if any of these symptoms are persistent, worsen, or are unusual for you.
Diagnosing Vulvar Cancer
If you suspect vulvar cancer, consult a healthcare professional. Inform them about your symptoms and any relevant medical history, including sexually transmitted infections or predisposing conditions.
Diagnostic procedures typically involve:
- Medical History and Family History Review: Questions about your health background and family medical history.
- Physical Examination: A general physical assessment.
- Pelvic Exam: A thorough examination of the vulva and pelvic area.
- Blood Tests: Routine bloodwork may be conducted.
- Colposcopy: Examination of the vulva using a magnifying instrument (colposcope).
Alt text: Colposcopy examination for vulvar health assessment, utilizing magnification for detailed vulvar inspection.
- Biopsy: Tissue samples from suspicious sores or lumps are taken under local or general anesthesia and sent for laboratory analysis to confirm cancer.
Vulvar Cancer Treatment Options
Treatment strategies are tailored to individual factors, including:
- Cancer Stage: The size and extent of cancer spread.
- Cancer Grade: The rate of cancer cell growth.
- Cancer Type: The specific type of vulvar cancer.
- Patient Factors: Age, overall health, and medical history.
- Patient Preferences: Lifestyle and personal wishes regarding treatment.
Doctors will discuss these factors to determine the most appropriate treatment plan.
Common Treatment Modalities
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Surgery: Surgical removal of the cancerous tissue, including a margin of healthy tissue to minimize recurrence. This may involve partial or complete vulvectomy (removal of the vulva). Lymph node removal from the groin (lymphadenectomy) may also be necessary. Surgery may also be performed to remove cancer that has spread to other areas.
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Radiotherapy: Using high-energy radiation to control or destroy cancer cells. External beam radiation therapy involves directing radiation beams to the vulvar area. Radiotherapy may be considered as a primary treatment option to potentially avoid clitoral or labial removal.
Alt text: External beam radiation therapy procedure, a non-invasive cancer treatment option targeting vulvar cancer cells with radiation beams.
- Chemotherapy: Utilizing medications to control or eliminate cancer cells. Chemotherapy is typically administered intravenously (IV drip) over several hours.
Questions to Ask Your Doctor
Open communication with your healthcare team is vital. Consider asking questions such as:
- What is the precise size and location of my cancer?
- Is there an increased risk of vulvar cancer for my daughter due to my diagnosis?
- How will vulvar cancer treatment affect future pregnancy plans?
- Is there a risk of cancer in children conceived after treatment?
- Will I be able to maintain sexual activity after treatment?
- What will the vulva look like after treatment?
- Will treatment affect urinary or bowel function?
- What are the potential side effects of the recommended treatment?
- Why is this specific treatment approach considered best for me?
- Will all treatments be conducted at this hospital?
- What is the recommended frequency of follow-up checkups?
- Will treatment induce menopause or disrupt menstruation?
- Can you provide written information about our discussion for future reference?
Disclaimer:
This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. The website and content providers do not assume any liability for the information provided. Always seek professional medical advice for diagnosis and treatment.
