Vulvar Cancer

Vulvar cancer is a rare cancer of a woman’s vulva. There are about 6,000 new cases of vulvar cancer in the U.S. each year. About half the cases are caused by human papillomavirus and half are caused by lichen sclerosus.

Causes of Vulvar Cancer #

About half the cases of vulvar squamous cell cancer are caused by human papillomavirus. The remaining half are related to a chronic skin condition called lichen sclerosus.

Symptoms of Vulvar Cancer #

• Changes in the vulvar skin color (more red or white/pale than normal).

• Growths or lumps in the vulva that look like a wart or ulcer; or a rash or other sore that doesn’t heal.

• Itching or burning in the vulvar area that does not go away.

• Bleeding in the vulvar area not related to menstruation (periods).

• Tenderness in the vulvar area.

• Pelvic pain while having sex or peeing.

Diagnosis of Vulvar Cancer #

Bladder and urethra exam #

A cystoscope (a lighted tube with camera) will be inserted into your urethra to look for anything abnormal in your urethra and bladder and to take tissue samples if something abnormal is found.

Rectum and anus exam #

A proctoscope (a lighted tube with viewing lens) will be inserted into your rectum to look for anything abnormal in your rectum or anus and take tissue samples if something abnormal is found.

X-rays of Vulvar Cancer #

X-rays help show if cancer has spread to organs and bones inside the chest, and the pelvic bones.

Intravenous pyelogram (IVP) #

This test uses a contrast dye, injected into a vein, and X-rays to look for blockages in your kidneys, ureters or bladder.

CT scan (CAT scan) and MRI (magnetic resonance imaging) #

CT and MRI scans take detailed pictures of the inside of your body. A contrast dye can be used along with a CT scan to help see organs and tissues more clearly. MRI scans use a magnet and radio waves to make its pictures.

PET scan (positron emission tomography scan) #

This scan takes pictures of the inside of your body after radioactive sugar (glucose) has been injected into a vein. The glucose collects in cancerous cells, which are easily seen in the pictures.

Sentinel lymph node biopsy #

In this procedure, the first few lymph nodes nearest a cancerous tumor (into which the tumor drains) are removed. A tissue biopsy is taken to find out if the cancer has spread to these lymph nodes. If no cancer is found, this means it’s unlikely that the cancer has spread and removing additional lymph nodes may not be needed.

Treatment of Vulvar Cancer #

Laser surgery #

This surgery uses a laser beam to make bloodless cuts in tissue or to remove cancerous surface lesions.

Local excision #

This surgery removes the cancer and a small-to-large amount of normal tissue around the cancer. Sometimes nearby lymph nodes are removed.

Vulvectomy #

This surgical procedure removes part or all of the vulva and possibly some nearby lymph nodes. Skin grafts may be used to replace removed skin.

Pelvic exenteration #

In this surgery, your lower colon, rectum, bladder, cervix, vagina, ovaries and nearby lymph nodes are removed. Artificial openings are created to allow urine and stool to flow from your body into a collection bag.

Radiation therapy #

• Radiation therapy kills cancer cells using high-energy x-rays or other types of radiation.

• External radiation therapy uses a machine to deliver radiation through your skin to the targeted cancer site.

• Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.

• Choice of radiation therapy delivery method depends on the type and stage of the cancer being treated.

Chemotherapy #

• Chemotherapy is cancer-killing medications.

• When taken by mouth, or injected into a vein or muscle, the chemotherapy can attack cancers throughout your body.

• When chemotherapy is placed directly into the spinal column, in an organ or a body cavity such as the abdomen, or applied directly to the skin in a cream or lotion, the chemotherapy attacks cancer more locally in those specific areas.

• Type of chemotherapy given depends on the stage and type of cancer.