Overview
Vulvar cancer is a rare cancer that affects the external female genitalia, including the labia majora, labia minora, clitoris, and perineum. It primarily affects older women, though HPV-related cases are rising among younger women.
The most common types include:
- Squamous cell carcinoma (90% of cases)
- Melanoma (second most common)
- Basal cell carcinoma, adenocarcinoma, sarcomas (rare)
Symptoms
- Persistent vulvar itching or burning
- Lump, ulcer, or thickened patch on the vulva
- Pain or tenderness
- Bleeding or discharge not related to menstruation
- Pain during urination or intercourse
Causes & Risk Factors
- Persistent HPV infection
- Lichen sclerosus (chronic vulvar skin disorder)
- Smoking
- Immunosuppression
- Age >60
- History of cervical or vaginal neoplasia
Diagnosis
- Visual inspection during pelvic exam
- Vulvar biopsy
- Colposcopy (to evaluate entire lower genital tract)
- Imaging (MRI, CT, PET-CT) if staging is needed
Treatment Options
- Surgical excision (wide local excision, vulvectomy)
- Sentinel lymph node biopsy
- Radiation therapy (pre- or post-op for high-risk cases)
- Chemoradiation (for advanced or unresectable tumors)
- Topical therapy or laser (for precancerous VIN lesions)
Prognosis
- Early-stage vulvar cancer has a good prognosis
- 5-year survival rate:
- Localized: ~85%
- Regional spread: ~54%
- Distant spread: ~16%
Living with this Cancer Type
- Sexual health and body image counseling
- Skin care and wound healing post-surgery
- Managing lymphedema (if lymph nodes removed)
- Ongoing pelvic exams for recurrence monitoring
Prevention & Screening
- HPV vaccination
- Routine pelvic exams
- Avoid smoking
- Manage chronic vulvar skin conditions
FAQs
Q: Is vulvar cancer the same as vaginal cancer?
A: No. Vulvar cancer affects the outer genital area, while vaginal cancer involves the internal canal.
Q: Can it be prevented?
A: HPV vaccination and managing skin disorders like lichen sclerosus can reduce risk.
Q: Will surgery affect sexual function?
A: It depends on extent; counseling and rehabilitation can help recovery.
Resources
- Foundation for Women’s Cancer
- National Vulvar Cancer Awareness Alliance
- ClinicalTrials.gov
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