What is Vulvar Cancer?

Vulvar cancer happens when abnormal cells grow together in the female external genitals, known as the vulva, to form masses called tumors. The vulva surrounds the urethra and vagina, and cancer may form on the labia majora, labia minora or clitoris.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of vulvar cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Symptoms

Even at early stages, vulvar cancer signs and symptoms can include:

• A vulvar lump or sore
• Bleeding unrelated to menstruation
• Changes in vulvar skin, such as thickening, color changes, or wart- or ulcer-like growths
• Itching, burning or tenderness of the vulvar skin
• Pain and tenderness

Diagnosis

To diagnose vulvar cancer, we ask questions about medical history and do a physical exam. As part of the exam, the vulva, vagina and cervix will all be evaluated for vulvar carcinoma. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Biopsy: The physician may remove a sample of cells from the tumor which are examined under a microscope for signs of cancer. This biopsy may be done as a cytology smear, similar to a Pap smear.

Colposcopy: During this exam, the physician uses a special magnifying device to closely inspect the vagina and cervix for abnormal changes that may indicate vulvar cancer.

Cystoscopy: During this exam, the bladder and urethra are checked for abnormal cells using a cystoscope, when indicated.

Proctoscopy: During this exam, the rectum and anus are checked for abnormal cells using a proctoscope, when indicated.

Imaging tests: If vulvar cancer is suspected, imaging tests may be done to determine if cancer has spread to the inside of the body. Those tests may include:

• Computed tomography (CT) scan: A series of detailed pictures, taken from different angles, are created by a computer linked to an X-ray machine.
• Magnetic resonance imaging (MRI): This scan uses a large magnet, radio waves and a computer to produce pictures of lymph nodes and organs in the pelvis.
• Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to see if cancer has spread to other areas.

Risk Factors

Risk factors that can contribute to vulvar cancer include:

Aging: Vulvar cancer is most common in older women. The average age at diagnosis is 65.

History of precancerous vulvar conditions: Vulvar intraepithelial neoplasia is a precancerous condition that increases the risk of vulvar cancer. A small number of women affected by this condition go on to develop invasive vulvar cancer.

Having a weak immune system: People who take medication to suppress their immune system or those who have a condition that weakens the immune system, such as HIV, have an increased risk of vulvar cancer.

Human papillomavirus (HPV): HPV is a sexually transmitted infection that increases the risk of several cancers, including vulvar and cervical types. Many people naturally clear this infection, but some women experience cell changes that can increase the risk for cancer development.

Vulvar skin conditions: Specifically, lichen sclerosis, which causes the vulvar skin to become thin and itchy, can increase the risk of vulvar cancer.

Prevention

While many risk factors cannot be controlled, there are ways you can help prevent some types of vulvar cancer:

Don’t smoke: Smoking is a known cause of most cancers.

Get the HPV vaccine: Adolescent girls and young women should consider the HPV vaccine, which protects against strains of the virus thought to cause most cases of vulvar cancer.

Practice safe sex: While using condoms won’t prevent all cases of HPV, they can reduce your risk and can be very effective in preventing HIV infection, which can lead to vulvar cancer.

Ask about your risk: If you have been diagnosed with HPV, HIV, vulvar intraepithelial neoplasia, lichen sclerosis or other conditions that may predispose you to developing vulvar cancer, ask your physician about regular exams to detect abnormalities at an early stage.

Causes

There are no known vulvar cancer causes. However, all cancer develops from mutated DNA within cells. The mutation results in a surplus of divided cells that sometimes form cancerous tumors.

Prognosis

The earlier that vulvar cancer is diagnosed, the better the outcome. The prognosis for vulvar cancer depends on the type and scope of cancer within the body. Vulvar cancer sometimes reoccurs.

Treatment and Recovery

Vulvar cancer treatment depends upon the stage of the cancer, a person’s overall health and her preferences. Vulvar cancer treatments may include:

Surgery
Surgery is the most common and effective treatment for vulvar cancer. Surgical procedures vary based on where the cancer is located.

Chemotherapy
Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. Chemotherapy may be given before surgery to shrink a tumor, after surgery to kill remaining cancer cells and as a means of reducing symptoms.

Radiation Therapy
High energy radiation is directed to the tumor to kill cancer cells. Radiation therapy for vulvar cancer typically includes external beam radiation. Most often, radiation treatments are given five days a week for several weeks.

Recovery After Surgery
Recovery after a surgical procedure will depend upon the type of procedure and your overall health. Your doctor will explain how to care for your surgical wound as well as when you may be physically active again and about what activities to avoid during recuperation.

Complications

Vulvar cancer can recur, so follow-up care after successful treatment is important. In addition, the cancer itself and some treatments can result in complications. These include:

Pain or numbness: Removal of part or all of the vulvar padding, skin and organs may cause discomfort with sitting or wearing tight pants.

Lymphedema: If lymph nodes in the groin were removed during surgery, excess fluid can build up in the genital or legs and cause discomfort.

Sexual changes: Depending on the type of surgery, genital numbness and an inability to achieve orgasm may result.

Schedule a Pelvic Exam with Your Doctor

We recommend that you schedule an appointment with your gynecologist to discuss a possible pelvic exam. They will be able to share insights into the process and answer any questions you may have about a pelvic exam.