Vulvar Cancer

Overview

Vulvar cancer is a type of cancer that develops on the outer surface area of the female genitalia, specifically the area of skin that surrounds the urethra and vagina, including the clitoris and labia. It can present as a lump or sore on the vulva that causes itching. While it can occur at any age, vulvar cancer is most commonly diagnosed in older adults. Treatment usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. Early diagnosis can lead to less extensive surgery being required.

Understanding the disease

Symptoms

The symptoms of vulvar cancer may include itching that doesn't go away, pain and tenderness, bleeding that isn't from menstruation, skin changes such as color changes or thickening, and a lump, wart-like bumps, or an open sore (ulcer).

Risk Factors

Risk factors for developing vulvar cancer include increasing age, exposure to human papillomavirus (HPV), smoking, having a weakened immune system, a history of precancerous conditions of the vulva (vulvar intraepithelial neoplasia), and having a skin condition involving the vulva (lichen sclerosus).

Development

Vulvar cancer develops when cells in the vulva undergo changes (mutations) in their DNA, leading to abnormal growth and division. The most common types of vulvar cancer include vulvar squamous cell carcinoma and vulvar melanoma. Vulvar squamous cell carcinoma begins in the thin, flat cells that line the surface of the vulva, while vulvar melanoma starts in the pigment-producing cells found in the skin of the vulva. The exact cause of vulvar cancer is not known, but factors such as increasing age, exposure to human papillomavirus (HPV), smoking, and having a weakened immune system may increase the risk of developing the disease.

Assessment and Diagnosis

Triage

If you suspect vulvar cancer, you should see a doctor as soon as possible. Vulvar cancer symptoms may include itching that doesn't go away, pain and tenderness, bleeding that isn't from menstruation, skin changes, and a lump, wartlike bumps, or an open sore. It's essential to receive a proper diagnosis and treatment, which can involve surgery to remove the cancer and a small amount of surrounding healthy tissue. Early detection of vulvar cancer can lead to a better prognosis and the need for less extensive surgery.

Diagnosis

To diagnose vulvar cancer, your doctor will likely conduct a physical exam of your vulva to look for abnormalities. Additionally, your doctor may use a special magnifying device to examine your vulva, and may remove a sample of tissue for testing (biopsy) to determine if an area of suspicious skin on your vulva is cancerous. Other tests may be used to determine the extent of the cancer, such as examination of your pelvic area, imaging tests like X-rays, CT scans, MRI, or PET, or procedures using tiny cameras to see inside your body.

Management and Treatment

Complications

Potential complications of vulvar cancer may include:

1. Lymphedema: Swelling caused by the accumulation of lymph fluid in the tissues due to the removal of or damage to lymph nodes during treatment.
2. Urinary incontinence: Loss of bladder control, which can occur as a side effect of surgery or radiation therapy.
3. Sexual dysfunction: Changes in sexual function, such as pain during intercourse or reduced libido, can result from surgery, radiation therapy, or chemotherapy.
4. Emotional and psychological impact: A diagnosis of vulvar cancer can be emotionally challenging, leading to anxiety, depression, or stress.
5. Recurrence: Vulvar cancer can recur after treatment, either in the same location or in a different area. Regular follow-up appointments with your doctor can help detect any recurrence early.
6. Treatment-related complications: Surgery, radiation therapy, and chemotherapy can cause various side effects, such as skin irritation, fatigue, nausea, or hair loss. It is important to discuss potential complications with your healthcare provider to better understand the risks and benefits of different treatment options.

Prevention

Vulvar cancer can be prevented to some extent by reducing the risk factors. Some ways to reduce the risk of vulvar cancer include:

1. Reducing the risk of sexually transmitted infections (STIs), such as HPV. This can be done by consistently using condoms during sexual activity and encouraging partners to get vaccinated against HPV.
2. Getting the HPV vaccine, especially for children and young adults who have not yet been exposed to the virus.
3. Practicing safe sex and being aware of one's sexual health.
4. Maintaining a healthy lifestyle, such as quitting smoking and avoiding excessive alcohol consumption. However, it's important to note that some risk factors, such as age, genetics, and a weakened immune system, are beyond personal control. Therefore, regular check-ups and screenings are crucial for early detection and prompt treatment of vulvar cancer. Remember, it's always best to consult with a healthcare professional for personalized advice and recommendations based on individual risk factors.

Home Remedies

There are no specific home remedies for vulvar cancer as it is a serious medical condition that requires professional treatment. If you suspect you may have vulvar cancer, it is important to consult with a healthcare professional for proper diagnosis and treatment. Some general self-care tips for vulvar discomfort include keeping the area clean and dry, avoiding tight-fitting clothing, and using gentle, fragrance-free soaps and moisturizers. Additionally, practicing good sexual hygiene and reducing your risk of sexually transmitted infections can contribute to overall vulvar health.

Treatment

The primary treatment for vulvar cancer usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. In some cases, the entire vulva may need to be removed. The earlier vulvar cancer is diagnosed, the less extensive surgery is required. Other treatments may include medications to kill cancer cells, such as chemotherapy and targeted therapy, or radiation therapy using powerful energy beams. Sometimes, a combination of radiation and low-dose chemotherapy may be used.

Preparing for medical consultation

To prepare for an appointment for vulvar cancer, you should:

1. Write down any symptoms you're experiencing, including those that may seem unrelated to vulvar cancer.
2. Note any major stresses or recent life changes.
3. Make a list of all medications, vitamins, or supplements you're taking.
4. Bring a family member or friend along to help remember important information and discuss the doctor's advice.
5. Prepare a list of questions to ask your doctor, such as the types of tests you'll need, possible causes of symptoms, the type and stage of vulvar cancer, surgical options, success rates, side effects, and any impact on your sexuality. Remember that your appointment time is limited, so prioritize your questions from most important to least important in case time runs out.