"The aim of these modern radiation techniques is to spare as much normal tissue as possible to reduce side effects."

Overview

Vulvar cancer is rare cancer occurring constituting less than 1% of cancers in women. Occurring mainly in older women, cancer causes a lump or ulcer in the external genitalia or a lump in the groin.


This disease tends to involve lymph glands in the groin as well in the pelvis. The treatment is in the form of surgery of the local area as well as the groin. Patients who are noted to have high-risk features on pathological examination of the tissue removed surgically, require radiotherapy. Patients who cannot undergo surgery for medical reasons such as diabetes mellitus or a cardiac ailment, as well as patients in whom the disease is not amenable to surgery, are also treated with radiotherapy. In most circumstances, chemotherapy is administered at weekly intervals along with radiotherapy.


Types of Vulvar Cancers

Invasive squamous cell cancer of the vulva

Almost all women with invasive vulvar cancers will have symptoms. These can include:


  • An area on the vulva that looks different from normal – it could be lighter or darker than the normal skin around it, or look red or pink.
  • A bump or lump, which could be red, pink, or white and could have a wart-like or raw surface or feel rough or thick.
  • Thickening of the skin of the vulva
  • Itching
  • Pain or burning
  • Bleeding or discharge not related to the normal menstrual period
  • An open sore (especially if it lasts for a month or more)

Verrucous carcinoma, a subtype of invasive squamous cell vulvar cancer, looks like cauliflower-like growths similar to genital warts.


These symptoms are more often caused by other, non-cancerous conditions. Still, if you have these symptoms, you should have them checked by a doctor or nurse.

Vulvar Melanoma

Patients with vulvar melanoma can have many of the same symptoms as other vulvar cancers, such as:


  • A lump
  • Itching
  • Pain
  • Bleeding or discharge

Most vulvar melanomas are black or dark brown, but they can be white, pink, red, or other colors. They can be found throughout the vulva, but most are in the area around the clitoris or on the labia majora or minora.


Vulvar melanomas can sometimes start in a mole, so a change in a mole that has been present for


The most important sign of melanoma is a change in size, shape, or color of a moleb .If you have a mole that has changed, ask your doctor to check it out.

Bartholin gland cancer

A distinct mass (lump) on either side of the opening to the vagina can be the sign of a Bartholin gland carcinoma. More often, however, a lump in this area is from a Bartholin gland cyst, which is much more common (and is not a cancer).

Paget disease

Soreness and a red, scaly area are symptoms of Paget disease of the vulva.

Preventing Vulvar Cancers

Vaccines have been developed to stop people from becoming infected with the HPV virus. The vaccine given to prevent cervical cancer protects from vulvar cancers.

Living with vulvar cancer

Post treatment you will be followed up closely for the first couple of years. Lymphedema can be a problem post groin node surgery for Vulvar cancer. You will be followed up and supported by lymphoedema team. Rehabilitation session may help you to return back to normal life faster. Please inform your doctors if you notice any skin changes, ulcers, pain or swelling in your groin.


Feeling anxious and depressed are normal after Vulvar cancer treatment. Some are affected more than others. But everyone can benefit from help and support from friends, family, religious groups, support groups and professional counsellors.

Care at APCC

Apollo team offers you comprehensive care with compassion, clinical excellence and with multi-disciplinary team (MDT). We have nationally and internationally recognized doctors treating you, and are up to date with current evidence and research.


We discuss every patient in the tumour board to decide what treatment options are available and tailor it as appropriately on an individual basis.


We offer full range of treatment options under one roof in all aspects of cancer care such as chemotherapy, radiotherapy and surgery. We have state of the art radiotherapy equipment along with proton therapy to minimize complications associated with radiation. For early Vulvar cancer we offer sentinel node (first drainage nodes) removal by injecting a radio nucleotide dye to prevent morbidity associated with complete removal of groin nodes.


We can assure you that we support you in all aspects during and after your treatment and give you the best possible care available in the world.

Symptoms

 

  • Lasting itch
  • Pain or soreness
  • Thickened, raised, red, white or dark patches or lump on the skin
  • Lump in the groin

Risks and Causes

  • Age
    This is a rare cancer usually in women aged 75 and over.

  • Human papilloma virus (HPV)
    HPV is an important factor in the development of some vulvar cancers.HPV can pass from one person to another by skin to skin contact, and during sexual contact. Around 80 out of 100 people (80%) have the HPV virus at some time during their lifetime. So it is a very common infection. Around (50%) of vulvar cancers are caused by the human papilloma virus.There is now a vaccine that can protect against HPV infection.

  • Vulvar intraepithelial neoplasia (VIN)
    Vulvar intraepithelial neoplasia (VIN) means there are pre-cancerous changes in the top layer of the skin (epithelium) covering the vulva. VIN is not cancer, but there is a risk that it may go on to develop into vulvar cancer. This usually takes many years

  • Chronic skin conditions
    Lichen sclerosis and lichen planus Around 5 in 100 women (5%) with lichen sclerosis or lichen planus develop vulvar cancer.

  • Pre-cancerous changes on cervix (CIN)
    This link is probably due to both cancers sharing risk factors such as HPV.

  • Immune system
    HIV (human immunodeficiency virus) can increase the risk of vulvar cancer because it weakens your immune system.

  • Screening
    There is no national screening for vulvar cancer.

  • Vulvar examination
    The cervical screening test (smear test) does not screen for vulvar cancer. But when you have your smear test, the nurse or doctor should routinely examine your vulva. They may be able to see signs of early changes on the vulva.

Other Gynaecological Cancers