Our Gynecologic Oncology practice is dedicated to providing you with the best care for vulvar cancer. From diagnosis through treatment and follow-up, your care is designed to meet your individual needs by a team of gynecologic oncologists, radiation oncologists, reconstructive surgeons, colorectal surgeons, pathologists and radiologists.
Vulvar cancer is rare. More than 4,500 women are diagnosed with vulvar cancer in the United States each year. This is less than 1% of all cancers in women and only 4% of cancers of the female reproductive organs. Vulvar cancer typically grows slowly over several years. Precancerous lesions may be identified before they become cancer.
The external part of the female genitals is called the vulva. It includes the clitoris, vaginal lips, opening to the vagina, and the surrounding skin and tissue.
About half of all vulvar cancers stem from an infection of certain types of HPV. Vaccines that protect against infection with these types of HPV may reduce the risk of vulvar cancer.
Vulvar cancer types
The main types of vulvar cancer are:
- Squamous Cell Carcinoma: This starts in the skin areas of the vulva and is usually found on the vaginal lips. Lesions may be wart-like. This is the most common type of vulvar cancer.
- Adenocarcinoma: Cancer that begins in cells that make mucus and other fluids, and is typically found on the sides of the vaginal opening.
Risk factors for vulvar cancer include:
- Age: The majority of women diagnosed with vulvar cancer are over 70 years old
- HPV (human papillomavirus)
- HIV (human immunodeficiency virus)
- Vulvar intraepithelial neoplasia (VIN)
- Other genital cancers
- Lichen Sclerosus
Not everyone with risk factors will get vulvar cancer. However, if you have these risk factors, talk with your doctor about ways to reduce your risk.
The most common symptoms of vulvar cancer are:
- Lump or growth on the vulva
- Burning, pain or itching of the genitals that doesn't go away
- Bleeding not related to menstruation
- Tenderness in the vulvar area
These symptoms do not always mean that you have vulvar cancer. However, if these are present, discuss them with your doctor.
In order to diagnose vulvar cancer, your physician will address your medical history and do a physical exam, including checking the vulva for a lump and other signs of disease. If needed a biopsy, removal of samples of cells or tissues from the vulva, will be done.
Treatment will be personalized to you based on your type of cancer, stage of cancer and overall health.
Surgery is often recommended for treatment of vulvar cancer. Surgery may include:
- Laser Surgery: This is used to treat precancerous lesions. A laser beam is used to destroy precancer cells.
- Excision: The cancer and some of the surrounding skin is removed.
- Vulvectomy: All or part of the vulva is removed.
- Pelvic exenteration: This is a complex surgery that includes the removal of the vulva, rectum, anus, bladder, vagina, uterus and cervix. This may be done for cancer that has progressed or recurred.
- Inguinal lymph node dissection: Lymph nodes in the groin are removed.
- Sentinel lymph node biopsy: The surgeon uses a special dye to remove the lymph node closest to the cancer. If this node does not have cancer, no further lymph nodes are removed. If this node does have cancer, additional lymph nodes are removed.
Topical therapy, chemotherapy and radiation therapy
Topical therapies may be used for precancerous lesions. These include 5-Flurouracil (5-FU) and Imiquimod.
Chemotherapy may be used to treat advanced or recurrent disease, or given with radiation if cancer has spread.
Radiation therapy may be used to treat cancer or to treat lymph nodes.