Vulvar Cancer

Vulvar cancer is a rare cancer that is the malignant tissue development on the exterior surface area of the female genitalia or the tissue of the vulva. A majority of vulvar cancer cases are squamous cell carcinomas that are noted to gradually progress over a time span of the years. A miniscule number of vulvar cancers start as melanoma and only in atypical cases, vulvar cancers are noted to develop on the sides of the vaginal aperture where the mucus-secreting glands are located.

Vulvar Cancer Causes:

The precise reason leading to each vulvar cancer type is still unclear.

• Women in the older age bracket diagnosed with vulvar cancers that are not linked to HPV infection might be correlated to a mutation or flaw in the P53 tumor suppressor gene that dons the crucial responsibility to safeguard cells from turning cancerous.
• Moreover, this form of cancer is observed in women that have a condition known as lichen sclerosus wherein the vulvar skin turns thin and scratchy.
• There are about 30-50% of vulvar cancers that are related to HPV infection that is sexually transmitted.
• On several occasions such women develop a pre-cancerous skin ailment known as vulvar intraepithelial neoplasia observed in several areas of the vulva prior to developing cancer.
• Smoking leads to exposure to harmful cancer producing chemicals that could raise the risk of vulvar cancer. Those women with a past of genital warts or HPV have a heightened risk of getting vulvar cancer if they indulged in smoking.
• Those with family or individual past of the grave form of skin cancer or of abnormal moles on any part of the body, then it raise the chances of vulvar melanoma.

Vulvar Cancer Symptoms:

The following symptoms are experienced in the vulvar region that includes:

• Persistent itchiness.
• Sensation of burning, pain, discomfort and tenderness.
• Non-menstrual bleeding.
• Variations in the colour and thickening observed on the skin.
• Bumps that have a lumpy, wart-similar nature or an ulcer or open boil.

Diagnosis & Tests:

To diagnose vulvar cancer, the doctor would initially carry out a physical exam inclusive of a pelvic examination. If any abnormalities are cited, the doctor would recommend additional testing like:

• Colposcopy, biopsy is done to ascertain diseased or precancerous area. Once the area is determined, a local anesthesia is given to carry out either excisional or punch biopsy for the removal of the dubious tissue.
• Staging tests are undertaken to establish the size, location and extent of spread of the cancer and also aids in deciding the idyllic treatment that would provide the best outcome. The doctor would carry out the following tests to collect this data that would include cystoscopy, pelvic exam under the influence of anesthesia, imaging tests like X-ray chest, scanning tests like X-ray, CT-scan, MRI scan, PET scan to aid in ascertaining whether the cancer has proliferated. The outcome of the staging tests help one detect the stage in which the cancer is like Stages 0, I, II, III, IVA, IVB that represent the extent of spread with the stage 0 being the preliminary stage and the IVB depicting the spread to distant locations like lungs or even the brain.

Vulvar Cancer Treatment:

• The treatments choices are dependent on the form and stage of the cancer and would incorporate surgery to remove the tumor, radiation therapy, chemotherapy or a grouping of both.
• The later forms of vulvar cancer need more of the tissue to be surgically excised. The surgery options include laser surgery, excision procedure, vulvectomy like skinning, simple and radical vulvectomy. Pelvic exenteration is done in the advanced stages that include the removal of any or all of the organs like lower colon, rectum, bladder, cervix, uterus, vagina, ovaries and close by lymph nodes.
• Vulvar intraepithelial neoplasia is the surgical removal of the pre-cancerous cells. Some studies have revealed that imiquimod or Aldara – an immunity altering medicine could decrease the size of the lesions and perhaps offer an adjunct treatment choice.
• Follow-up sessions at least twice annually with one’s gynaecologist after treatment is crucial as there are chances of recurrence.

Possible complications:

The cancer could metastasize or spread to the close by local lymph nodes or other major parts of the body. Death could also be a possible complication with a death statistics of approximate 880 women that died due to vulvar cancer in the United States in the year 2007 according to the National Cancer Institute webpage.

Prevention:

• Keeping away from risky sexual encounters that raises the chances of getting sexually transmitted diseases like HPV and HIV that raise one’s risk of vulvar cancer. Condoms may reduce the risk of getting HPV though they don’t totally safeguard against HPV.
• The HPV vaccination is beneficial in averting vulvar, cervical and vaginal cancers.
• Stopping smoking would lower the risk of vulvar cancer.
• Going in for regular gynaecological screening to detect any dubious precancerous condition that could lead to vulvar cancer. When diagnosed in the preliminary stages, it can be effectively treated.

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