Vulvar cancer

Vulvar cancer

Vulvar cancer develops on the outer surface of the female genitals, particularly in the vulvar area, which includes the urethra, vagina, labia, and clitoris. It often presents as an itchy lump or sore, and although it can occur at any age, it is more commonly diagnosed in older women.

To develop the most effective treatment, doctors must identify the type of cells causing vulvar cancer. The main types are:

Squamous cell carcinoma of the vulva: This cancer begins in the thin, flat cells on the surface of the vulva and makes up the majority of vulvar cancers.
Vulvar melanoma: This type begins in the pigment-producing cells of the vulvar skin.

Risk factors

The precise causes of vulvar cancer are not fully understood, but several risk factors have been identified:

Age: Risk increases with age, with most diagnoses occurring around age 65.
Human papillomavirus (HPV): Exposure to HPV, a sexually transmitted infection, increases the risk of several cancers, including vulvar and cervical cancer. HPV can cause cellular changes that may increase the risk of vulvar cancer.
Smoking: Smoking is linked to an increased risk of developing vulvar cancer.
Weakened immune system: People with compromised immune systems, such as organ transplant recipients or those with HIV, are at greater risk.
History of precancerous conditions: Conditions such as vulvar intraepithelial neoplasia may increase the risk, although they rarely develop into cancer.
Skin conditions: Conditions such as lichen sclerosus affecting the vulva may increase the risk of cancer.

Screening

Routine screening for asymptomatic women is uncommon. For women with symptoms, an ultrasound may be performed. Vulvar cancer is often identified in the early stages due to symptoms such as abnormal vaginal bleeding. Diagnosis involves:

A physical examination of the vulva to check for abnormalities.
A colposcopy to enlarge and closely inspect the vulva.
A biopsy to remove and test tissue from suspicious areas.

Diagnosis

A physical examination of the vulva to check for abnormalities.
A colposcopy to enlarge and closely inspect the vulva.
A biopsy to remove and test tissue from suspicious areas

Treatment

Treatment depends on the stage of the cancer, other health problems, and the patient's preferences, and typically involves surgery, chemotherapy, radiation therapy, or a combination of these. Specific treatments include:

Surgery: This may involve removal of the tumor and a small margin of healthy tissue, part or all of the vulva, and possibly nearby lymph nodes.
Radiation therapy: High-intensity energy beams target and destroy cancer cells, often used before surgery to shrink tumors or in combination with chemotherapy.
Chemotherapy: Chemical drugs are used to kill cancer cells, either orally or by intravenous injection, which are especially effective in advanced stages.
Targeted therapy: Exploits specific vulnerabilities in cancer cells, suitable for advanced cases.
Immunotherapy: Stimulates the immune system to fight cancer by preventing cancer cells from hiding from the immune system.
Each treatment option is selected based on its potential to manage the spread of the disease and improve the patient's quality of life.

Vulvar cancer

Risk factors

Screening

Symptoms and signs

Diagnosis

Staging

Treatment