Vulvar Cancer Treatment — Gynecologic Oncology Experts
Written & medically reviewed by Dr. Shaivalini Kamarapu
MBBS · MS (Obstetrics & Gynaecology) · Fellowship in Reproductive Medicine · 20+ years of clinical experience
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What is vulvar cancer?
A lump on the vulva causing intense itching and pain in the area may be a sign of vulvar cancer. Cancer is the abnormal growth of cells that clump together to form tumours — if a tumour is malignant, the cancer cells can spread through the bloodstream to other parts of the body.
Symptoms
Persistent itching
Pain and tenderness
Bleeding not related to menstruation
Discoloration
Skin thickening
A lump or sores
Abnormal bleeding
Burning
Diagnosis
To diagnose the condition, the doctor may perform a physical examination. Any abnormality of the vulva can be detected through colposcopy, a procedure using a device that works like a magnifying glass to check for abnormalities.
A biopsy is done to check for cancer cells in the area — local anaesthesia is given, and a small part of the affected area is removed for testing using a scalpel. Stitches may be needed depending on how much tissue is removed.
Staging tests are done to determine the stage or extent of the cancer's spread — the doctor examines the pelvis for signs of spread.
Imaging tests
CT scan
Computerized Tomography creates 2D and 3D images of the affected areas.
X-ray
Used to check the chest and abdomen for signs of cancer spread.
MRI
Magnetic Resonance Imaging uses a magnetic field to produce clear images of the organs.
Ultrasound
Uses high-frequency sound waves to create images of the organs.
Stages of vulvar cancer
The tumour is present on the vulva with no spread of cancer to other parts of the body or lymph nodes.
The tumour spreads to nearby areas like the urethra, anus and vagina.
Lymph nodes are affected by cancer spread.
Cancer spreads to the lymph nodes, bladder, urethra, vagina, rectum and pelvic bone.
Distant parts of the body are affected by cancer spread.
Treatment
Treatment depends on the stage of cancer and the general health of the patient. A procedure involving excision of tissue affected with cancer, along with a margin of normal tissue, is done to ensure all cancer cells are removed.
Partial vulvectomy
A surgical procedure in which the affected part of the vulva is removed.
Radical vulvectomy
The entire vulva, including the clitoris and surrounding tissues, is surgically removed.
Pelvic exenteration
For severe cancer that has spread beyond the vulva, the entire vulva and all affected organs are surgically removed.
Reconstructive surgery
Performed if the removal of skin is extensive, to restore form and function.
Lymph node removal
Affected lymph nodes are also surgically removed.
Radiation therapy
High-power X-rays are used to kill cancer cells.
Chemotherapy
Chemical drugs, given orally or intravenously, are used in combination with radiation therapy.
Regular checkups after treatment are essential. The doctor recommends follow-up examinations twice every year for the first 5 years after treatment.
Prevention
Practice safe sex — HPV, which spreads through sexual transmission, can cause vulvar cancer, so using a condom helps protect against it.
Limiting the number of sexual partners reduces exposure to HPV.
Having sex at an early age increases the risk of HPV infection.
Undergo regular pelvic exams in which the vulva is examined for any abnormalities.
Gardasil and Cervarix are two vaccinations developed to give protection against HPV.