The vulva is the visible part of the female genitals, including the clitoris, the vaginal lips, the opening to the vagina, and the surrounding skin and tissue. Most vulvar cancers are squamous cell carcinoma. This type of cancer starts in squamous cells (thin, flat skin cells) and is normally found on the vaginal lips. A small number of vulvar cancers are adenocarcinomas (cancers that start in cells that make mucus and other fluids). This kind of cancer is usually discovered on the sides of the vaginal opening. Vulvar cancer normally develops slowly over many years. Unusual cells can develop on the surface of the vulvar skin for a long time. This condition is called vulvar intraepithelial neoplasia (VIN). Because VIN can become vulvar cancer, it is important to get treatment.
What Are The Symptoms Of Vulvar Cancer?
Women with vulvar cancer may undergo the following symptoms Sometimes, women with vulvar cancer do not have any of these changes.
These are normal symptoms in women who have improved vulvar cancer.
- A lump on the vulvar area
- A patch of skin that is uniquely textured or colored than the rest of the vulvar area
- Itching, pain, soreness, or burning in the vulvar place
- Burning urination
- Bleeding that is not menstrual blood
This symptom is for vulvar melanoma specifically
Wart-like growths that are similar to genital warts
Physical testing, including a pelvic exam, is the initial step in diagnosing vulvar cancer. In addition to a physical test, the following tests may be used to diagnose vulvar cancer:
Biopsy: A biopsy is the elimination of a small amount of tissue for review under a microscope. Other tests can recommend that cancer is present, but only a biopsy can make a definite diagnosis. The sample extracted during the biopsy is examined by a pathologist. A pathologist is a doctor who practices in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The type of biopsy completed will depend on the place of the suspicious tissue. If the biopsy shows invasive vulvar cancer, the specialist will refer the woman to a gynecologic oncologist, who specializes in treating this type of cancer.
Chest X-ray: An x-ray is a method to create a picture of the structures inside of the body using a small amount of radiation.
Magnetic resonance imaging (MRI): An MRI uses magnetic fields, not x-rays, to create accurate images of the body. MRI can also be applied to estimate the tumor’s size.
Endoscopy: An endoscopy enables the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The woman may be sedated as the pipe is injected through the urethra into the bladder, called cystoscopy, or through the anus into the rectum, called proctoscopy or colonoscopy. Sedation is giving a pill to become more comfortable, relaxed, or sleepy.
What Are The Treatment Options For Vulvar Cancer?
The main therapy for vulvar cancer is surgery. Radiation treatment and chemotherapy may be used if cancer cannot be fully eliminated with surgery, if cancer has a high risk for recurrence, and/or if the lymph nodes are involved with cancer.
If the tumor has developed to the point that initial surgical removal is not possible, sometimes the patient’s therapy plan starts with x-rays therapy, often with simultaneous low-dose chemotherapy given weekly during the radiation treatments. Surgical elimination of the vulvar lesion is sometimes considered if the whole tumor does not go away after these treatments.
Women with vulvar cancer may have concerns about if and how these medications may affect their intimate function and fertility (ability to have children). These topics are important and should be discussed with the health care team before treatment starts.
Surgery is the extraction of the tumor and some surrounding healthy tissue during an operation. A gynaecologic oncologist is a doctor who specializes in treating gynaecologic cancer using operation. Due to the place and sensitivity of vulvar tissue, the type of operation is carefully considered. Operational options for invasive vulvar cancer include the elimination of part or all of the vulva, depending on the size and extent of the primary tumor. This is called a vulvectomy.
Different vulvectomy ways to treat invasive vulvar cancer include:
Radical local excision of the vulva: This surgery is performed to eliminate the tumor and a large amount of tissue around it, called a margin. It is used for most basic tumors that are less than 4 (cm) in diameter and are either stage I or stage II disease.
Modified radical vulvectomy: This term defines an operational method in which less than the full vulva is eliminated. For example, in a radical hemivulvectomy, only one side of the vulva is eliminated.
Radical vulvectomy: A radical vulvectomy is the elimination of part or all of the vulva, along with the underlying deep tissue. This is a very unique operation because most vulvectomies are modified in some way, and very large tumors are usually treated with chemoradiation, as described below.Laser operation is the advantage of a focused beam of light that vaporizes a premalignant skin lesion. It cannot be used to treat an invasive tumor.
Lymphadenectomy: this is a operational method to eliminate lymph nodes in the groin in order to check for cancer.