Vulvar Cancer

Vulvar cancer is a type of cancer that begins in the cells of the vulva. The vulva is the area of skin and tissue surrounding the vagina (the canal that leads to the uterus) and the urethra (the tube that carries urine out of the body). It includes the clitoris and the labia (the folds of skin on either side of the vagina).

Vulvar cancer often starts as a noticeable growth, lump, or sore on the vulva. This can sometimes cause itching. While it can affect people of any age, vulvar cancer is more commonly diagnosed in older adults.

Treatment for vulvar cancer usually begins with surgery. The surgeon removes the cancerous growth and a small bit of healthy tissue around it to make sure all the cancer cells are gone. In some cases, especially if the cancer is more advanced, the entire vulva may need to be removed. Early detection is very important. The sooner vulvar cancer is found, the less extensive the surgery needed to treat it is likely to be. This is why regular check-ups and attention to any unusual changes in the vulva are crucial.

Changes in your vulva can sometimes be a sign of a problem. If you notice anything unusual, it's important to see a doctor. Possible signs of vulvar cancer include:

• A noticeable lump, growth, or sore: This could look like a wart, a bump, or an open wound on your vulva.

• Unexpected bleeding: Bleeding from your genitals that isn't related to your period is a cause for concern.

• Persistent itching: If the itching around your vulva doesn't go away, it could be a sign of something more serious.

• Pain or tenderness: Any pain or soreness in the vulva area should be checked out by a doctor.

• Changes in your skin: Noticeable changes like a change in skin color or the skin becoming thicker could be a sign to get checked.

If you have any of these symptoms, schedule an appointment with your doctor, gynecologist, or other healthcare provider. Don't ignore any unusual changes in your vulva. Early detection is key to successful treatment.

If you're experiencing any health concerns, it's important to schedule a visit with your doctor, gynecologist, or another healthcare provider. Don't ignore symptoms that bother you. Talking to a medical professional can help you understand what's going on and get the care you need.

Understanding Vulvar Cancer

Vulvar cancer develops on the skin surrounding the vagina and urethra, known as the vulva. It's not always clear what causes this type of cancer.

Essentially, vulvar cancer happens when the DNA inside cells of the vulva changes. DNA acts like a set of instructions for the cell. In healthy cells, these instructions tell the cells to grow, multiply, and die at specific times. But in cancer cells, the DNA instructions are altered. These altered instructions tell cancer cells to multiply rapidly, and they can survive even when healthy cells would normally die. This uncontrolled cell growth leads to a buildup of cells, potentially forming a mass called a tumor.

Tumors can grow, invading and damaging healthy tissues. Sometimes, cancer cells break off and spread to other parts of the body. This spread is called metastasis.

While the exact cause of DNA changes leading to vulvar cancer is often unknown, healthcare professionals believe some cases are linked to human papillomavirus (HPV). HPV is a common virus often spread through sexual contact. It's frequently associated with the most common type of vulvar cancer, called vulvar squamous cell carcinoma.

Different Types of Vulvar Cancer

The specific type of cell where the cancer begins helps doctors determine the type of vulvar cancer. Knowing the type helps them choose the best treatment. Several types exist:

• Vulvar Squamous Cell Carcinoma: This is the most common type. It begins in flat, scale-like cells (squamous cells) that are part of the skin. While skin cancers often occur on sun-exposed areas, this type can appear anywhere, including the vulva. As mentioned, it's strongly linked to HPV infection.

• Vulvar Melanoma: This cancer starts in cells that produce pigment (melanocytes). While most melanomas are on sun-exposed skin, they can also develop on the vulva.

• Extramammary Paget's Disease of the Vulva: This cancer begins near sweat glands in the skin. It frequently affects the vulva. Importantly, it can sometimes occur alongside other cancers, such as those in the breast, colon, urinary system, or female reproductive organs.

It's crucial to remember that if you have concerns about vulvar health, consulting a healthcare professional is essential for diagnosis and treatment.

Vulvar cancer risk factors

Several factors increase the chances of developing vulvar cancer, although it can happen at any age. Here are some key risk factors:

• Age: The risk of vulvar cancer goes up as you get older. Most people diagnosed are over 65, but it's possible to develop it at any point in life.

• HPV (Human Papillomavirus): HPV is a common virus spread through sexual contact. Many people get HPV, and for most, it clears up on its own. However, for some, HPV can cause changes in the cells of the vulva and other parts of the body, which might increase the risk of cancer. This risk is higher if the infection persists for a long time. Young, sexually active people can get HPV.

• Smoking: Smoking tobacco is linked to a higher risk of vulvar cancer. The more you smoke and the longer you smoke, the greater the risk.

• Weakened Immune System: Your body's immune system helps fight off infections. If your immune system is weakened, it might be less effective at fighting off abnormal cells that could lead to cancer. This can happen due to certain medical treatments (like medicines taken after an organ transplant), or health conditions like HIV infection.

• Precancerous Conditions: Sometimes, there's a precancerous condition on the vulva called vulvar intraepithelial neoplasia (VIN). VIN doesn't always turn into cancer. But in some cases, it can progress to invasive vulvar cancer.

• Skin Conditions of the Vulva: Certain skin conditions on the vulva, like lichen sclerosus, can increase the risk of vulvar cancer. Lichen sclerosus causes the skin to become thin, itchy, and irritated.

It's important to note that having one or more of these risk factors doesn't guarantee you'll develop vulvar cancer. Many people with these factors never get the disease. However, understanding these factors can help you talk to your doctor about any concerns and get appropriate screenings.

Vulvar cancer risk can be lowered by avoiding tobacco and taking steps to protect yourself from HPV.

HPV, or human papillomavirus, is a common virus that's linked to most cases of vulvar cancer. Smoking significantly raises your risk of getting vulvar cancer. If you don't smoke, don't start. If you already smoke, talk to your doctor about quitting. There are resources, like medications and counseling, that can help.

HPV is often spread through sexual contact. It's important to understand that HPV can increase your risk of vulvar cancer. Here are some ways to lower your risk of getting HPV:

• Use condoms every time you have sex. Condoms can help reduce your risk of getting HPV, but they don't provide complete protection.

• Get the HPV vaccine. This vaccine protects against certain types of HPV that are known to cause vulvar cancer. Talk to your doctor about whether the HPV vaccine is right for you. It's especially important to get vaccinated before becoming sexually active, as the vaccine is most effective when given before exposure to HPV. However, getting the vaccine later in life can still offer some protection.

Remember, these steps can help reduce your risk, but they don't eliminate it entirely. Regular checkups with your doctor are also important for early detection and treatment of any potential health issues.

Diagnosing vulvar cancer often starts with a physical exam by a healthcare professional. They will check your vulva, the area around your vagina, for any unusual changes. They might also use a special magnifying tool called a colposcope to get a closer look. A colposcope can help them examine the vagina and cervix, too.

To confirm if there's a problem, a small piece of tissue needs to be taken and tested in a lab. This is called a biopsy. For vulvar cancer, a skin sample from the affected area is taken.

The biopsy can be done in the doctor's office. First, the area is numbed with medicine. The doctor might use a small blade or a special circular tool to remove the tissue sample. Sometimes, the biopsy is done in a surgery room. In that case, you'll be given medicine to put you to sleep during the procedure so you won't feel anything.

If the biopsy shows vulvar cancer, the next step is to figure out how far the cancer has spread. This is called staging. Doctors use the results of staging tests to create a treatment plan.

Staging tests usually include:

• Checking for spread in the pelvis: The doctor will carefully examine your pelvis to see if the cancer has spread to nearby tissues.
• Imaging tests: Images of your chest, belly, or pelvis can show if the cancer has spread to other parts of your body. These tests might include X-rays, MRIs, CT scans, and PET scans (positron emission tomography).

Vulvar cancer is staged from 1 to 4. Stage 1 cancer is small and only on the vulva. As the cancer grows or spreads, the stage number increases. Stage 4 cancer has grown into the pelvic bone or spread to other parts of the body.