Vulvar Cancer
Vulvar cancer is a rare cancer of the external female genital organs, including the labia, clitoris, and vaginal opening. It is also referred to as vulvar melanoma, melanoma of the inner or outer labia, genital melanoma, or labia skin cancer. Vulvar cancer symptoms include sores, lumps, changes to skin tone of the vulva, itching, and even bleeding of the external genitals. Mostly caused by human papillomavirus (HPV) infection and conditions like lichen sclerosus, vulvar cancer is treated similarly to other gynecologic cancers, with a customized treatment plan including surgery to remove the cancerous tissue, chemotherapy, radiation therapy, immunotherapy, and targeted medicines. Like other cancers, vulvar cancer outcomes are best when caught in early stages, which is thankfully more common for this type of gynecologic cancer.
Vulvar Cancer Types
Vulvar Melanoma
This type of vulvar cancer begins in pigment-producing cells of the vulva called melanocytes, as do other melanomas. Melanomas typically occur on skin exposed to the sun, but can happen anywhere on the skin, including the vulva.
Vulvar Squamous Cell Carcinoma
This type of vulvar cancer begins in the squamous cells of the vulva, the flat, thin cells on the outer surface of vulvar skin that act as the first barrier against the external world.
Extramammary Paget's Disease of the Vulva
This type of vulvar cancer originates in the sweat glands near the vulvar skin. It sometimes co-occurs with other kinds of cancer, including cancers of the colon, breast, urinary system, or female reproductive system.
Vulvar Cancer Symptoms
- Open sores, lumps, or wartlike bumps on the vulva
- Non-menstrual genital bleeding
- Continuous genital itching
- Pain and/or tenderness of the vulva
- Change in color or thickness of the vulvar skin
Vulvar Cancer Causes and Risk Factors
- Older age — the average age of diagnosis is 65
- HPV exposure
- Smoking tobacco
- Weakened immune system (including those who take immune-suppressing medicines, such as organ transplant recipients)
- History of precancerous vulvar conditions such as intraepithelial neoplasia
- Other vulvar skin conditions such as lichen sclerosus
Vulvar Cancer Diagnosis
Vulvar cancer diagnosis begins with a pelvic exam, checking for unusual skin changes. Following this, a Pap smear can be performed to test for cancerous changes; an HPV test may also be performed to gauge risk from infection. A colposcopy may be used to view the vulva, vagina, and cervix in greater detail. A biopsy of the abnormal tissue and testing for cancer cells determines for sure if a patient has vulvar cancer.
Vulvar Cancer Treatment
Surgery for Vulvar Melanomas
Vulvar cancer treatment is similar to treatment of other skin cancers, as vulvar cancers are melanomas. Laser surgery can be used to cut into tissue and remove cancerous surface lesions. Local excision can also be used to remove cancerous tissue; sometimes nearby lymph nodes can be excised for testing, or removed entirely if the cancer has spread. In a vulvectomy, part or all of the vulva is removed, potentially along with nearby lymph nodes; skin grafts can be used to replace lost vulvar tissue. For the most extensive cases, a pelvic exenteration is performed, which removes the lower colon, rectum, bladder, cervix, vagina, ovaries, and nearby lymph nodes all together; in this case, new openings are created to allow urine and stool to be expunged into a collection bag.
Other Vulvar Cancer Treatments
As is the case with other cancers, radiation therapy, chemotherapy, and/or immunotherapy are used before and/or after surgery to remove cancerous tissues. These therapies work with surgery to remove as much cancer as possible and prevent re-occurrence. As vulvar cancer is a melanoma, both chemotherapy and immunotherapy interventions are available as prescription topical creams.
Vulvar Cancer Prognosis
Vulvar cancer has a roughly 70% relative five-year survival rate, but survival rates are even higher when people are diagnosed and treated in the early stages. The relative five-year survival rate for a localized cancer remaining only in the vulva is 86%, while that rate drops down to 30% once the cancer spreads. These are averages only; each patient's prognosis is individual and based on their own specific health and cancer diagnosis.
Why Choose UsTrusted Providers of Gynecologic Oncology in the Phoenix, AZ Metro Area
Women's Cancer Institute of Arizona offers top quality gynecologic oncology treatments in the metro Phoenix area. Our gynecologic oncology specialists provide the best vulvar cancer treatments to meet each individual patient's needs, ensuring that every patient has the best opportunity for recovery from vulvar cancer.