Vulvar cancer is a rare type of cancer that occurs on the outer surface of the external genitals, which includes the labia, clitoris, and the opening of the vagina. The most common type of vulvar cancer is squamous cell carcinoma, a kind of cancer when the cancer cells are in the skin.
WHAT IS VULVAR CANCER?
Symptoms of vulvar cancer can vary but often include:
- Persistent itching or burning in the vulvar area.
- Changes in skin colour or texture, such as red or white patches.
- Lumps or growths that may resemble warts.
- Bleeding or discharge that is unusual.
- Any ulceration of vulva
It is important to note that while these are recognised risk factors, the exact causes of vulvar cancer are not fully understood, and not all women with these risk factors will develop the disease. The key risk factors for vulvar cancer include:
- Human Papillomavirus (HPV) Infection: HPV infection is a major risk factor for vulvar cancer, with most cases of vulvar squamous cell carcinoma resulting from HPV.
- Chronic Inflammation or Autoimmune Processes: Chronic inflammation or autoimmune conditions of the vulva can increase the risk of vulvar cancer.
- Smoking: Smoking is a recognised risk factor for the development of vulvar cancer.
- Prior Pelvic Radiation: Previous pelvic radiation therapy can also increase the risk of vulvar cancer.
- Immunodeficiency: Conditions that weaken the immune system, such as HIV/AIDS, can contribute to the development of vulvar cancer.
- Vulvar Intraepithelial Neoplasia (VIN): Having precancerous changes in the vulvar skin, known as VIN, can increase the risk of vulvar cancer.
- Skin conditions like lichen sclerosus and lichen planus.
Symptoms
Symptoms of vulvar cancer can vary but often include:
- Persistent itching or burning in the vulvar area.
- Changes in skin colour or texture, such as red or white patches.
- Lumps or growths that may resemble warts.
- Bleeding or discharge that is unusual.
- Any ulceration of vulva
Risk Factors
It is important to note that while these are recognised risk factors, the exact causes of vulvar cancer are not fully understood, and not all women with these risk factors will develop the disease. The key risk factors for vulvar cancer include:
- Human Papillomavirus (HPV) Infection: HPV infection is a major risk factor for vulvar cancer, with most cases of vulvar squamous cell carcinoma resulting from HPV.
- Chronic Inflammation or Autoimmune Processes: Chronic inflammation or autoimmune conditions of the vulva can increase the risk of vulvar cancer.
- Smoking: Smoking is a recognised risk factor for the development of vulvar cancer.
- Prior Pelvic Radiation: Previous pelvic radiation therapy can also increase the risk of vulvar cancer.
- Immunodeficiency: Conditions that weaken the immune system, such as HIV/AIDS, can contribute to the development of vulvar cancer.
- Vulvar Intraepithelial Neoplasia (VIN): Having precancerous changes in the vulvar skin, known as VIN, can increase the risk of vulvar cancer.
- Skin conditions like lichen sclerosus and lichen planus.
Diagnosis
The key steps in diagnosing vulvar cancer include:
Physical Examination
The doctor will perform a thorough physical examination of the vulva to look for any abnormal growths, lesions, or changes in the skin.
Biopsy
If any suspicious areas are found during the physical exam, the doctor will likely recommend a biopsy. This involves removing a small sample of the affected tissue and sending it to a pathologist for analysis to determine if cancer is present.
Magnetic Resonance Imaging (MRI)
A process that creates highly detailed images of various body parts using radio waves, a magnet, and a computer.
Computed Tomography (CT) Scan
A diagnostic technique that produces a number of highly detailed pictures of inside body parts from various viewpoints.
Positron emission tomography (PET) scan
A process used to identify cancerous tumour cells within the body.
Treatment
The main treatment options for vulvar cancer include:
Surgery
The vulva is operated on to remove the lesion. Depending on the location and size of the lesion, it may involve a basic, wide local excision or the removal of an expanded region of the vulva.
Radiotherapy
Using high-energy radiation beams to target the tumor.
Chemotherapy
Involves the use of drug to either kill or inhibit the growth of cancer cells.
Prevention
By addressing these key risk factors and taking preventive measures, women can help lower their chances of developing vulvar cancer. Some key preventive measures that can help reduce the risk of vulvar cancer:
- Seek medical attention if abnormal lesion noted at vulva.
- HPV Vaccination: Getting the HPV vaccine can help prevent infection with the human papillomavirus (HPV), which is a major risk factor for vulvar cancer.
- Regular pelvic exams allow for timely treatment.
- Maintain a Healthy Immune System: Avoiding conditions that weaken the immune system, such as HIV/AIDS, can help lower the risk of vulvar cancer.
Prognosis
Younger women tend to have a better prognosis compared to older women. Patients with no lymph node involvement have a significantly better prognosis than those with positive lymph nodes. A patient’s overall health, as well as how well the cancer responds to treatment, can also impact the prognosis.
It is important to note that the prognosis is not absolute and can vary greatly for individual patients. Regular monitoring, early detection, and prompt, appropriate treatment are crucial for improving outcomes for vulvar cancer patients.
