Vulvar cancer is a type of cancer that occurs on the outer surface of women’s genital organs. The vulva includes the skin around the urethra and vagina, the clitoris, and the labia. Cancer in this area typically presents as a lump or sore that causes itching in the vulva. However, cancer can occur at any age but is more commonly diagnosed in older adults.
Vulvar cancer can appear in different types. These types may include verrucous carcinoma, adenocarcinoma, melanoma, and sarcoma.
What Causes Vulvar Cancer?
The exact cause of cancers that occur in the vulva is not yet fully understood. However, some risk factors may exist. These may include human papillomavirus (HPV) infection, smoking, a weakened immune system, and skin diseases such as lichen sclerosus.
What Are the Types of Vulvar Cancer?
Cancers that occur in the vulva can appear in different forms. The most common type of this cancer is squamous cell carcinoma. Squamous cell carcinoma is a type of cancer that originates from squamous cells. Squamous cells are flat or scaly cells that make up the outer layer of the skin, the inner surfaces of hollow organs, and the mucous membranes of the respiratory and digestive systems. Squamous cell carcinoma usually starts on the labia of the vulva. Variants of this type of cancer include keratinized, basaloid, warty, and verrucous types.
Another common type of vulvar cancer is melanoma, which is often seen in postmenopausal women.
Other rare types of cancer include Paget’s disease, a slow-growing skin cancer that affects the surface of the vulva. Paget’s disease is more frequently seen in postmenopausal women and causes itching and pain in the body.
Other very rare types of vulvar cancer may include verrucous carcinoma, basal cell carcinoma, sarcomas, and carcinoma of the Bartholin glands.
How is Vulvar Cancer Diagnosed?
The diagnosis of vulvar cancer is made through a biopsy taken from an abnormal-looking area on the outer surface of the vulva. A biopsy is usually performed under local anesthesia by cutting out a small piece of tissue. The biopsy sample is sent to a pathologist for examination under a microscope. The pathologist determines the presence, type, and grade of cancer cells.
To determine the stage of the cancer, additional tests may be performed on the patient. These may include pelvic examination, colposcopy, vulvoscopy, cytology, ultrasonography, magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET). These tests show which parts of the vulva the cancer has spread to and whether it has metastasized to lymph nodes or distant organs. The stage of the cancer is important for treatment planning.
What Are the Symptoms of Vulvar Cancer?
Some symptoms may arise in the body as a result of cancers occurring in the vulvar area. These symptoms may include:
- A lump or sore (ulcer) on the outer surface of the vulva that causes itching,
- Color changes or thickening in the vulva,
- Pain or tenderness in the vulva,
- Bleeding outside of menstruation,
- Burning or discomfort during urination or sexual intercourse.
These symptoms may be associated with vulvar cancer as well as other conditions. Therefore, it is important to see a doctor if any of these symptoms are present.
What Are the Treatment Methods for Vulvar Cancer?
The treatment of vulvar cancer may vary depending on the type, stage, location of the cancer, and the overall health of the patient. Some of the methods used in treatment include:
- Surgery: An operation performed to remove cancerous tissue and surrounding healthy tissue.
- Radiotherapy: A treatment that uses high-energy rays to kill or shrink cancer cells. Radiotherapy may be used before or after surgery or in patients who cannot undergo surgery.
- Chemotherapy: A treatment that uses drugs to kill cancer cells or stop their growth. Chemotherapy may be applied in conjunction with radiotherapy or in cases of cancer that is resistant to radiotherapy or has spread to distant organs.
- Immunotherapy: A treatment that uses drugs to stimulate the body’s immune system to fight cancer. Immunotherapy may be used in vulvar cancers that do not respond to other treatments or recur.
How is Vulvar Cancer Treatment Done?
For early diagnosis of cancers occurring in the vulvar area, women should regularly attend gynecological examinations and also check their vulvar area themselves. Gynecological examinations are performed to determine whether there are any abnormal lesions, swelling, color changes, sores, or ulcers in the vulva. To check the vulvar area, it is necessary to observe all parts of the vulva with the help of a mirror or camera and notice any changes.
Vulvar cancer treatment typically involves removing the cancer and a small amount of surrounding healthy tissue. Sometimes, vulvar cancer surgery may require the removal of the entire vulva. Early diagnosis of cancer can contribute to effective recovery from the disease.
What is the Process of Vulvar Cancer?
Cancer that occurs in the vulva generally has a slow progression, and symptoms may not be noticed for a long time. As a result of the disease, lesions such as itching, pain, bleeding, discharge, swelling, color changes, sores, or warts may appear in the vulva.
Vulvar cancer can have different stages. The grade of the cancer indicates how abnormal the cells are. The stage of the cancer indicates how far it has spread in the body. The diagnosis and treatment process for cancer may vary according to the patient’s condition and preferences. Surgical, radiotherapy, chemotherapy, or immunotherapy methods may be used in treatment.
What is the Process After Vulvar Cancer Treatment?
After vulvar cancer treatment, follow-up and care of patients are important. Follow-up is done to detect the recurrence or spread of cancer early, manage the side effects of treatment, and support the patient’s quality of life. The follow-up plan may vary based on the patient’s condition, type of treatment, and risk factors. Generally, it is recommended that patients have a doctor’s check-up every three months for the first two years, every six months for the next three years, and then annually.
During follow-up examinations after the disease, the vulvar area, lymph nodes, pelvic organs, and other areas of the body are examined. If necessary, tests such as biopsy, blood tests, X-rays, ultrasound, CT, MRI, or PET may be performed.
After treatment for cancer occurring in the vulvar area, patients may experience physical, sexual, psychological, and social issues. To cope with these issues, it is recommended that patients seek professional help, join support groups, maintain a healthy diet, exercise, and avoid smoking and alcohol use.
Frequently Asked Questions About Vulvar Cancer
Some frequently asked questions about vulvar cancer are as follows:
The most common form of cancer seen in the vulva is squamous cell carcinoma. This condition is mostly associated with human papillomavirus (HPV). The resulting cancer primarily spreads to superficial inguinal lymph nodes through the lymphatic system, and then to deep inguinal lymph nodes. Therefore, lymph node involvement is an important factor in staging and treating vulvar cancer.
The answer to the question, ‘Is there a definitive solution for vulvar cancer?’ may vary depending on the stage, type, spread, and response to treatment of the disease. Appropriate treatment methods such as surgery, radiotherapy, or chemotherapy can be applied in the early stage to cure cancer seen in the vulvar area. However, advanced stage or metastatic cancer may require a more challenging treatment process. For a definitive solution in curing the disease, early diagnosis, reduction of risk factors, prevention of HPV infection, and implementation of personalized treatment plans with a multidisciplinary approach are important.
When vulvar cancer is caught early and appropriate treatment is planned, it can offer a high chance of recovery. However, the resulting cancer may often not show symptoms or may be confused with other diseases. Therefore, early diagnosis of cancer is one of the most important factors affecting the course and outcome of the disease.
Early diagnosis of vulvar cancer can contribute to recovery in the early stages of the disease. For early diagnosis, women should regularly attend gynecological examinations, check their vulvar area themselves, and consult a doctor when they notice any abnormal symptoms or lesions.
The emergence of vulvar cancer is influenced by human papillomavirus (HPV) infection. Vulvar cancers associated with HPV show similarities genetically with other cancers associated with HPV. HPV causes mutations in the DNA of cells, activating oncogenes or inactivating tumor suppressor genes. These mutations are often acquired over a lifetime rather than being present before birth.
The hereditary likelihood of HPV-associated vulvar cancers is low. However, some genetic factors may increase susceptibility to HPV infection and cancer. For example, variations in genes related to the immune system may affect the risk of developing cancer in the vulva associated with HPV.
The treatment of cancer may include various methods such as surgery, radiotherapy, and chemotherapy. The aim of treatment is to completely eliminate cancerous tissue and prevent recurrence. The side effects of treatment may negatively affect the patient’s quality of life and sexual functions. Therefore, psychological and social support before and after treatment is important.
Early diagnosis of vulvar cancer increases the chance of success in treating the disease and reduces surgical morbidity (illness). Regular hospital check-ups play a vital role in the early diagnosis of cancer. Women should pay attention to their vulvar health and consult a doctor in any suspicious situation.
