The vulva, or external genital region of a woman's reproductive system, is where vulvar cancer develops. It can affect the labia, the mons pubis (the skin and tissue that covers the pubic bone), the clitoris, or the vaginal or urethral openings, among other parts of the vulva. In most situations, it affects the labia majora or minor's inner margins.
Squamous cell carcinomas account for the great majority of vulvar malignancies. Squamous cells, the most common form of skin cell, are where this cancer begins. Squamous cell carcinoma generally develops over a long period. Abnormal cells generally occur in the epithelium, the skin's surface layer, before it develops. Vulvar intraepithelial neoplasia is the medical term for this disease (VIN) Vulvar intraepithelial neoplasia.
Melanoma is another frequent kind of vulvar cancer. It most commonly affects the labia minora or clitoris. Bartholin's gland adenocarcinoma and non-mammary Paget's disease are uncommon types of vulvar cancer. Sarcomas make up a small percentage of vulvar malignancies. These tumours start in the connective tissue beneath the skin and spread from there.
Vulvar cancer is rare cancer in women, accounting for just a small fraction of all malignancies. The majority of women diagnosed with vulvar cancer are over the age of 50, with two-thirds being over the age of 70.
Younger women have recently been diagnosed with VIN Vulvar intraepithelial neoplasia. A woman may never acquire true vulvar cancer if this precancerous disease is detected and treated early.
Vulvar carcinoma is linked to several risk factors.
Vulvar cells that are aberrant and precancerous
Infection with the human papillomavirus (HPV)
Cigarette smoking
Having a disease that is caused by a lack of immunity (an organ transplant, for example)
Possessing vulvar dystrophy, a disease characterized by abnormal skin and white lumps
Precancerous vulva alterations
A history of cervical cancer or precancerous abnormalities on the cervix.
Symptoms
The following are some of the most common symptoms of vulvar cancer and Vulvar intraepithelial neoplasia.
Itching or burning on the vulva for a long time
A wart-like or rough surface on a red, pink, or white lump
A rough, white patch on the vulva
Urination that hurts or bleeds
Discharge that isn't connected to your menstruation
An ulcer on the skin that lasts more than a month.
A black or brown elevated spot, or a change in the size, form, or colour of an existing mole, are all signs of vulvar melanoma.
A lump near the vaginal entrance is a sign of Bartholin's gland cancer. You don't have cancer just because you lump. It may be a benign cyst. However, you should lump examined by a doctor to ensure that it is not malignant.
Paget's disease can be identified by a painful, red, scaly region on the vulva.
Some vulvar cancer signs and symptoms might be confused with noncancerous diseases including infection or trauma. In addition, several noncancerous diseases might be mistaken for vulvar cancer. If conservative therapy fails to resolve these issues, a biopsy will be required to determine whether they are malignant.
Diagnosis
A biopsy is generally used to diagnose vulvar cancer. During a biopsy, your doctor will extract a tiny piece of tissue from the abnormal area's centre to ensure that a representative sample is collected. Under a microscope, a specialist will analyze the tissue for malignant and precancerous cells.
A colposcope, which includes magnifying lenses, may be used by your doctor to choose the biopsy location. Your doctor will apply a vinegar solution to any suspicious-looking spots before the colposcopy. It turns atypical skin white for a short period. Through the colposcope, your doctor will be able to see these regions more clearly. The colposcope may also be used to examine your cervix and vagina.
Your doctor may collect numerous tissue samples if he or she notices abnormalities in different regions of the vulva. Small anomalous regions may be fully eliminated.
If cancer is discovered during the biopsy, your doctor may order further testing to see if the disease has spread beyond the vulva. He or she may, for example, inspect the inside of the bladder and rectum with a lighted tube. Under anaesthesia, he or she may do a more comprehensive pelvic exam. CT scans or MRIs may be required to determine whether cancer has spread to other areas.
A sentinel node biopsy may be recommended by your doctor to screen for malignancy in neighbouring lymph nodes. This is done at certain medical institutions by injecting a radioactive material into the lymph nodes, which absorbs it. If the radioactive material seems abnormal, it might indicate that cancer has spread to the lymph nodes.
These sentinel nodes may be removed to aid doctors in determining if cancer has progressed to surrounding pelvic organs or other regions of the body. The presence of malignancy in these lymph nodes will aid doctors in determining your treatment choices.
When vulvar cancer is discovered, it is "staged." The stages, which range from stage I to stage IV, show how far cancer has progressed. Stage 0 Vulvar intraepithelial neoplasia. (VIN). It indicates that aberrant cells are localized to a single location on the vulva's outer surface. These atypical cells have the potential to develop into malignant tumours.
Vulvar cancer progresses at a faster rate as you move through the stages. Stage IV cancer has progressed to other organs or lymph nodes on both sides of the pelvis in women with stage IV disease.
Expected Timeframe
Until vulvar cancer is treated, it will continue to spread.
Prevention
You may take action to lower your chances of developing vulvar cancer. You can also make efforts to detect and treat precancerous problems before they become cancerous.
Infection with the human papillomavirus (HPV) is identified in up to 50% of all vulvar malignancies. HPV infections usually spread through sexual contact. HPV types 16, 18, and 33 are the most prevalent cancer-causing viruses. To reduce your HPV risk,
Obtain an HPV vaccination
Condoms made of latex should be used (the female condom protects a broader area of the lower genital tract and vulva than the male condom)
Limit the number of sex partners you have.
Precancerous abnormalities can be detected and treated early to help avoid invasive squamous cell vulvar carcinoma. If you get an annual pelvic exam, you can discover precancerous and cancerous problems early. All vulvar rashes, moles, and lumps should be properly examined.
When you get a Pap test and a pelvic exam, the vulva is generally checked. Doctors generally suggest that women begin getting Pap tests when they reach the age of 21. The number of Pap tests you should get is determined by your age and your risk of cervical cancer.
Some vulvar melanomas can be prevented by removing odd-looking moles from the vulva. Many malignancies, including vulvar cancer, can be reduced by quitting smoking and avoiding tobacco usage. Precancerous alterations in the vulva may also be prevented by taking these actions.
Related article: 7 ways to prevent cancer.
Treatment
The type of vulvar cancer, its stage, and its location all influence how it is treated. Treatment options will be influenced by your age, overall health, and the necessity of preserving sexual function.
The most frequent treatment for vulvar cancer is surgery. The sort of surgery you undergo will be determined by the amount of tissue that has to be removed:
Laser surgery.The layer of aberrant cells is burned away during laser surgery. VIN Vulvar intraepithelial neoplasia is treated with laser surgery, but invasive cancer is not.
Excision (sometimes known as broad local excision) is a surgical procedure that eliminates the tumour as well as some normal tissue around it.
Vulvectomy is the surgical removal of part or all of the vulva as well as the surrounding tissue. Only the vulva is removed in a basic vulvectomy. Part of the vulva and the surrounding tissue is removed during a partial radical vulvectomy. The whole vulva, as well as the tissue beneath it, including the clitoris, is removed during a total vulvectomy. How much of the vulva is removed has an impact on sexual function.
The most invasive procedure is pelvic exenteration. It involves vulvectomy, lymphadenectomy, and removal of one or more of the following structures: vagina, rectum, lower intestine, bladder, uterus, and cervix.
The surgeon will aim to remove as many cancer cells as feasible while preserving sexual function.
Following surgery, radiation with or without chemotherapy may be indicated. The most difficult task is to choose a therapy that increases the odds of eliminating the malignancy while keeping sexual function, which can be lost with severe surgery.
Vulvar cancer can be related to malignancies elsewhere in the body in rare cases. This might need more testing, treatment, and monitoring.
When should you see a professional?
It's critical to check your vulva and the region around it frequently. If you have any concerns, talk to your doctor.
A rash that doesn't seem to be going away
Itching or chronic discomfort that won't go away
Growths, lumps, or ulcers that aren't typical
Any alterations in the vulva's skin.
Itching, stomach discomfort, and fever can all be signs of infection rather than malignancy. If you experience stomach pain and a fever, you should visit your doctor.
Patients with vulvar cancer should consult a gynecologic oncology expert.
Prognosis
The odds of a cure are good if precancerous alterations in the vulva and vulvar cancer are discovered early. VIN is virtually completely reversible. Patients with vulvar cancer that hasn't progressed to the lymph nodes almost often live for at least five years. The prognosis for vulvar cancer that has spread to the lymph nodes is determined by the number of lymph nodes affected.
