Vulvar Cancer – What It Is, Causes, Symptoms and Treatment

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The Vulvar Cancer or intraepithelial neoplasia is a disease little known, however, must be known to avoid the arisings of new cases. In addition, most women with Vulvar Cancer have no symptoms. When a woman with Vulvar Cancer has a symptom, it is most often as itchy that does not improve.

An area with vulvar cancer may look different than normal vulva skin. It is often thicker and longer than the normal skin around it. However, an area of Vulvar Cancer may also have different colors (red, pink or darker) of the surrounding skin.

Because these changes are often caused by other clinical conditions, some women do not realize that they may have a  serious illness. Some try to treat the problem on their own. Sometimes, even doctors do not diagnose the disease at first.

What is Vulvar Cancer:

The vulvar cancer is a malignant tumor that affects the outside of the female reproductive tract. The vulva is formed by the larger lips, smaller lips, clitoris and vaginal introitus. In the vulva is located the opening of the urethra, a channel that conducts urine from the bladder to the external environment.

The Vulvar cancer is a rare malignancy, accounting for 0.5% of all cancers in women and 5% of gynecological tumors. Approximately 90% of vulvar cancers are squamous cell carcinomas. The remaining cases include adenocarcinomas, melanomas, sarcomas and basal cell carcinomas.

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Vulvar Cancer Symptoms:

Some of the symptoms of Vulvar Cancer may be:

Long term itching on the vulva. This is a non-specific complaint that can be considered under various circumstances and is not usually a diagnostic symptom of vulvar cancer.

Some women may develop a mass, swelling, or bulge over the vulva. This is usually on or near the lips.

There may be pain and discomfort in the vulva especially during urination or during sex.

There are enlarged, reddish or even blackened patches of the skin .

There may bleed or discharge stained blood from the vulva or vagina. This is usually unrelated to menstrual periods.

There may be a mole or wart on the vulva that has recently changed in shape, size or color.

Some women may develop lesions with ulcers on the vulva. This is an open sore that persists for more than a month.

If the lesion is advanced and spreading it can affect the lymph nodes closest to the groin.

These lymph nodes may look swollen and elastic.

Causes of Vulvar Cancer:

Its causes are unknown, but a genetic predisposition is visible and 40% are associated with carcinogenic HPV types (16,18 or 31). It often begins as a vulvar intraepithelial neoplasm (VIN) which in 80% is associated with HPV.

Treatment For Vulvar Cancer:

Depending on the degree and type of cancer, all or part of the vulva is surgically removed (a procedure called vulvectomy). The surrounding lymph nodes are usually also removed. But sometimes doctors may perform a sentinel lymph node dissection (removal of the first lymph node that would be affected by Vulvar Cancer  – What is a sentinel lymph node?). This lymph node is examined for cancer. If there is no cancer , no other lymph nodes need to be removed. For early stage cancers, this treatment is usually sufficient.

For more advanced cancers, radiotherapy, often with chemotherapy (with cisplatin or fluoruracil), may be used prior to vulvectomy. Such treatment can reduce very large cancers, facilitating their removal. Sometimes the clitoris and other organs of the pelvis should be removed.

For very advanced cancers, treatment may include surgery to remove all pelvic organs (pelvic exenteration – advanced stages (advanced stage III to early stage IV)), radiotherapy and / or chemotherapy.

After removal of Vulvar Cancer , surgery to reconstruct the vulva and other affected areas (eg, the vagina) may be performed. Such surgery can improve function and appearance.

Doctors work closely with the woman to develop a treatment plan that best suits her and takes into account her age, sexual lifestyle and any other medical problems. Usually sexual intercourse is possible after vulvectomy.

Because basal cell carcinoma of the vulva usually does not spread (metastasize) to distant sites, surgery usually involves the removal of cancer only . The entire vulva is removed only if the vulvar cancer is extensive.

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