Vulvar Cancer | Questions about Gynecologic Cancer

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Gynecologic cancer | Vulvar cancer

What is cancer of the vulva? What are its causes and risk factors?

Cancer of the vulva is a rare type of gynecological cancer found in the tissues of the vulva, or outer vagina. It is found primarily in women over fifty, but it is seen with increasing frequency in women under 40 as well. Histologically, vulvar cancer is predominantly squamous cell in type, although other types including basal cell carcinoma, verrucous carcinoma, sarcoma, histiocytosis X, or malignant melanoma do occur. Evidence suggests that HPV is a risk factor for vulvar cancer and its development, in many cases, is preceded by condyloma or squamous dysplasias. Women who have constant itching and changes in the color or appearance of the vulva are at high risk for developing vulvar cancer.

How is vulvar cancer diagnosed?

Symptoms of vulvar cancer include abnormal bleeding or discharge, severe burning, itching, or pain in the vulva, or if the skin of the vulva looks white and feels rough. Diagnosis of vulvar cancer is made after a visual and manual examination of the vulva. If something suspicious is observed, a biopsy will be taken from the tissue of the vulva. Usually this can be done as an outpatient. If necessary, the patient may be examined under anesthesia.

How is vulvar cancer staged?

Cancer of the vulva is staged on a surgical basis according to FIGO and AJCC TNM classifications. Other tests, such as cystoscopy, proctoscopy, x-ray examination of the lungs, and intravenous urography are also used. FIGO stage groupings are:

Stage 0 Carcinoma in situ, intraepithelial carcinoma; cancer is found in the vulva only and is only on the surface of the skin

Stage I Lesions 2cm or less confined to the vulva or perineum; no lymph node metastases

Stage II Tumor larger than 2cm confined to the vulva and/or perineum; no lymph node metastases

Stage III Tumor of any size arising from the vulva that has spread to nearby tissues such as the lower part of the urethra, vagina, anus, and/or has spread to nearby lymph nodes

Stage IV Tumor has spread beyond urethra, vagina, and anus into lining of bladder and the colon or into pelvic lymph nodes and distant parts of the body

How is vulvar cancer treated?

Surgery is the most common treatment for vulva cancer, but radiation therapy and chemotherapy are also used. Chemotherapeutic ointments and various types of surgeries are used to treat early stage disease. These include laser surgery, wide local excision, radical local excision, skinning vulvectomy, and simple, partial and radical vulvectomies. Sometimes lymph nodes are removed. More advanced cancers are often treated by combined modalities and exenterative surgery.

Source:

NCI/PDQ for Vulvar Cancer, updated 2/2000