Vulval cancer is a rare form of cancer that begins in the vulva, the external part of the female genitalia, which includes the labia, clitoris, and vaginal opening. Though it is not as common as other gynecological cancers like cervical or ovarian cancer, it still poses significant health risks. The exact cause of vulval cancer remains unclear, but it is most often linked to changes in the cells caused by persistent infection with certain strains of human papillomavirus (HPV), particularly HPV types 16 and 18.
Vulval cancer is generally diagnosed in older women, although it can occur at any age. Early detection and treatment are key to successful outcomes, as it is highly treatable when caught early. However, if left untreated, vulval cancer can spread to other areas of the body and become more challenging to treat.
What is Vulval Cancer?
Vulval cancer occurs when abnormal cells in the vulva grow uncontrollably, forming a tumor. These abnormal cells may spread to surrounding tissues or other parts of the body in advanced stages. Vulval cancer is typically categorized into two types based on the cells involved:
Squamous cell carcinoma (SCC): The most common type, accounting for about 90% of vulval cancer cases. It develops in the squamous cells that line the outermost layer of the vulva.
Melanoma: This type begins in the melanocytes, the cells responsible for producing pigment in the skin. It is rarer but can be more aggressive.
Symptoms of Vulval Cancer
The symptoms of vulval cancer can vary from person to person, but common signs include:
Itching or pain in the vulva: Persistent itching, discomfort, or pain in the vulval area is a common symptom.
Changes in appearance: Any visible changes in the color or appearance of the vulva, such as lumps, sores, or warts, should be addressed by a doctor.
Bleeding or discharge: Unexplained bleeding or unusual discharge from the vulva, particularly after menopause, could indicate a problem.
Pain during intercourse: Women may experience pain or discomfort during sexual activity.
Swelling or lumps: A noticeable lump, mass, or swollen area in the vulval region may be a sign of cancer.
Causes of Vulval Cancer
Several risk factors are known to raise the chance of getting vulval cancer, while the precise origin of the disease is not entirely understood:
Human papillomavirus (HPV) infection: Vulval cancer risk is increased by persistent infection with high-risk HPV strains, particularly HPV-16 and HPV-18. Vulva cell alterations brought on by HPV have the potential to develop into a malignancy.
Age: Vulval cancer is most commonly diagnosed in women over the age of 50, although younger women can also develop it.
Chronic vulvar inflammation: Conditions such as lichen sclerosus, a chronic skin disorder that causes thinning and scarring of the vulva, can increase the risk of vulval cancer.
Smoking: Smoking weakens the immune system and it is linked to an increased risk of developing vulval cancer.
Weakened immune system: Women with weakened immune systems, such as those with HIV/AIDS or who are on immunosuppressive medications, are at higher risk for vulval cancer.
History of genital warts or other STIs: A history of genital warts, herpes, or other sexually transmitted infections (STIs) may increase the risk.
Diagnosis of Vulval Cancer
Vulval cancer is often diagnosed through a combination of physical examinations, imaging tests, and biopsies. The steps involved in diagnosing vulval cancer typically include:
Pelvic Exam: Your doctor will visually check your vulva for skin changes and use gloved, lubricated fingers to feel for lumps or abnormalities in the vagina. They may also use a speculum to widen the vagina for a more detailed inspection.
Pap Smear: During the examination, an HPV test may be conducted to identify infection and a sample of cells may be obtained to check for malignant alterations.
Colposcopy: Your vulva, vagina, and cervix may be closely examined using a colposcope, a bright magnification device. Abnormal cells may be highlighted using a specific solution.
Biopsy: In order to confirm the presence of cancer, a sample may be obtained if aberrant tissue is discovered. The only surefire way to detect vulvar cancer is to have a biopsy.
Treatment of Vulval Cancer
The treatment of vulval cancer depends on the stage of cancer, the size of the tumor, and whether the cancer has spread to other parts of the body. Common treatment options include:
Surgery: Surgery is the most common treatment for vulval cancer. It may involve the removal of the tumor, a portion of the vulva, or even the entire vulva in more advanced cases. Lymph node dissection may also be performed to check if the cancer has spread.
Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells or shrink tumors. It is often used after surgery to ensure that any remaining cancer cells are destroyed, or it may be used in cases where surgery is not possible.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells or prevent their growth. It is typically used when vulval cancer has spread beyond the vulva to other parts of the body.
Targeted Therapy: Targeted therapy uses drugs that specifically target and attack cancer cells while minimizing damage to normal cells. It is sometimes used in cases where chemotherapy may not be effective.
Immunotherapy: Immunotherapy boosts the body’s immune system to help it fight cancer. It is an emerging treatment option for some types of vulval cancer.
Prevention of Vulval Cancer
While it may not always be possible to prevent vulval cancer, several measures can significantly reduce the risk:
HPV Vaccination: Vaccines such as Gardasil and Cervarix protect against the most common high-risk strains of HPV that can lead to vulval cancer. Vaccination is recommended for both boys and girls at age 11 or 12 but can also be administered up to age 26 for those who missed earlier vaccination.
Regular Screening: Women should have regular gynecological exams and report any unusual symptoms such as itching, swelling, or changes in the appearance of the vulva to their healthcare provider. Early detection can improve treatment outcomes.
Safe Sexual Practices: Using condoms during sexual activity can help reduce the risk of contracting HPV and other STIs, which are associated with vulval cancer.
Quit Smoking: Smoking is a known risk factor for vulval cancer, so quitting can reduce the likelihood of developing the disease.
Manage Chronic Skin Conditions: Conditions like lichen sclerosus can increase the risk of vulval cancer. Early management and treatment of these conditions can help prevent cancer development.
Vulval cancer is a rare but treatable condition, especially when detected early. Women should be aware of the symptoms and risk factors associated with the disease and seek medical attention if they notice any unusual changes in the vulva. Regular screenings, HPV vaccination, and a healthy lifestyle can help reduce the risk of vulval cancer and improve early detection and treatment outcomes.
Frequently Asked Questions (FAQs)
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01What were your first symptoms of vulvar cancer?
Common early symptoms of vulvar cancer include itching, pain, or tenderness in the vulvar area, changes in skin color, or the presence of lumps or sores.
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02How to check for vulvar cancer?
A doctor can check for vulvar cancer through a pelvic exam, biopsy, and colposcopy. Self-exams at home may also help identify unusual changes, such as sores, lumps, or skin color changes.
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03What are the symptoms of a vulvar disease?
Symptoms may include itching, pain, swelling, abnormal discharge, sores, or changes in skin color or texture in the vulvar region.
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04Is vulvar cancer curable?
Yes, vulvar cancer is often treatable, especially if caught early. Treatment options include surgery, radiation, and sometimes chemotherapy.
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05What is the life expectancy of a person with vulvar cancer?
The life expectancy depends on the stage of cancer at diagnosis. Early-stage vulvar cancer has a high survival rate, while advanced stages can be more difficult to treat.
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06How fast does vulvar cancer grow?
Vulvar cancer typically grows slowly, but the rate can vary depending on the type and stage of cancer. Early detection is key to effective treatment.