Vulvar cancer happens when the cells lining the vulvar region start dividing abnormally and form a tumour.
The vulva is the term given to female external genitalia. The vulva is the collective term for the labia majora and labia minora (inner and outer lips of the vagina), pudendal cleft, mons pubis, Bartholin glands, the clitoris and the vaginal and urethral openings.
Vulvar cancer is one of the rare cancers that can occur among women of any age group. However, it is found to be more common among older women.
One of the first symptoms of vulvar cancer is a lump or sore in the vulvar region.
Vulvar cancers are usually slow-growing and start as vulvar intraepithelial neoplasia, i.e., the precancerous condition of vulvar cancer, wherein the healthy cells in the lining of the vulva start showing asymmetrical changes.
Based on the type that they originate from, vaginal cancers are classified into the following types:
In the initial stages, patients with vulvar cancer may not have any symptoms. However, as the disease progresses, the symptoms may start becoming apparent:
The exact cause of vulvar cancer remains unknown. However, researchers have identified a few risk factors that can increase one’s risk of developing vulvar cancer:
There are various tests recommended by the doctor for the detection and diagnosis of vulvar cancer.
a. Physical Examination and Medical History Assessment: If an individual is suspected to have vulvar cancer, the doctor recommends a physical exam, wherein the vulvar and the pelvic regions are examined for the signs of the disease. The doctor may also study the medical history of the patient in order to have a better understanding of the underlying medical conditions, previous medical treatments, allergies, etc.
b. Colposcopy: A colposcopy is a specialised tool used to examine the areas of the vulva, vagina and cervix. This lighted instrument magnifies and helps the doctor thoroughly examine these areas and find out if there are any abnormalities.
c. Biopsy: If vulvar cancer is suspected, the doctor may recommend a biopsy for a definitive diagnosis. During this procedure, a small portion of tissue from the suspicious area on the vulva is collected and examined under a microscope for the presence of cancer cells.
d. Imaging Tests: Further, the doctor may also recommend imaging tests, such as CT scan, MRI scan and other tests like cystoscopy and proctoscopy to check if cancer has spread to nearby organs. These imaging tests may be recommended throughout the cancer treatment as these also help in disease staging, treatment planning and therapy monitoring.
Treatment planning for vulvar cancer is made based on multiple factors such as the stage of the disease, exact location of the tumour, the tumour size, the patient’s age, her overall health condition and preferences.
The main treatment options available for vulvar cancer include surgery, radiation therapy, chemotherapy, targeted therapy and immunotherapy.
a. Surgery: Surgery is the main line of treatment for vulvar cancers. The primary goal of surgery is to remove the cancer cells whilst keeping the patient’s sexual function intact. There are multiple surgical options available for vulvar cancer; the doctor may recommend one of the following based on the stage of the disease:
b. Laser Surgery: Laser surgery involves the usage of focussed laser beams to destroy cancer cells. Laser surgery is largely used to treat vulvar intraepithelial neoplasia and pre-invasive vulvar cancer.
c. Radiation Therapy: For vulvar cancer, radiation therapy may be administered in combination with other treatment modalities, namely chemotherapy and surgery – this is important to enhance the overall effectiveness of the treatment. Radiation therapy uses high-energy radiation beams, which could be X-rays or proton beams, in order to destroy the cancer cells.
Usually, for vulvar cancers, radiation therapy is delivered externally.
d. Chemotherapy: Chemotherapy is a treatment method that uses strong anticancer drugs to kill cancer cells in the body. Chemotherapy may be administered orally or intravenously. It helps in preventing or slowing down the cancer cells from dividing and spreading to other organs. Chemotherapy may be administered along with radiation therapy before surgery in order to shrink the tumour. It is also one of the common treatments recommended for vulvar cancers that have spread to the nearby lymph nodes.
Yes, if detected early, vulvar cancers can be treated successfully in most cases. There are multiple treatment options available today that can support the successful management of vulvar cancers.
For vulvar cancers to be detected in the early stages, it is important for women to be mindful of the changes happening in the vulvar region. No symptom should be ignored as this can lead to delayed diagnosis and poor clinical outcomes.
Studies have found that those who have received treatment for cervical cancer are at a higher risk of getting vulvar cancer, along with many other cancers. That said, it is important to note that not all patients with cervical cancer develop vulvar cancer.
If you have received cervical cancer treatment in the past, you can talk to your doctor to understand the best practices that you can follow in order to reduce your vulvar cancer risk.
Yes, unfortunately, vulvar cancers can come back in a few cases. However, they can be treated successfully, if they are detected early.
After the treatments, patients must strictly keep up their follow-up appointments, which will help doctors in catching the recurrences in the early stages and treat them appropriately.
This depends on the severity or the stage of the disease. Those with early-stage vulvar cancers can still have children after the treatment in most cases.
In other cases, the doctor may recommend fertility preservation methods through which patients can have children after the treatment.
One cannot prevent vulvar cancer entirely as there is no known cause for this condition. However, there are a few measures that you can follow in order to bring down your risk of developing vulvar cancers: