A rare kind of cancer called vulvar cancer usually affects the vulva which is the external genital area of a female body. It most likely takes place in the outer lips of the vagina. It has mostly been found in women over 60 yrs of age during periodic pelvic exams after menopause. Most of them are a type of skin cancer which in its earliest forms is called dysplasia. If it gets diagnosed early, it is curable. After the cancer cells develop in the vulva, they get spread to other places as well like vagina, urethra, anal canal etc. Sometimes, those cancerous cells spread more rapidly and may also reach to lungs, brain etc. It could also spread to bones resulting in pain in bone and easy bone fracture.
There are various parts of the vulva like the vestibule of the vagina, labia majora etc. This type of cancer usually affects the outer part of the vagina. At first, cancer originates in the vulva which is called the primary vulvar cancer, then it spread to other parts resulting in a state called secondary vulvar cancer.
There are various other types of vulvar cancer like:
- Squamous Cell Carcinoma: It affects the flat, outer layers of the skin. Around 90 percent of all vulvar cells are squamous cell carcinoma. It takes some time to detect its symptoms. Most of the women usually have this type of vulvar cancer.
- Vulvar Melanoma: A melanoma is a dark patch of discoloration. It usually spread to other parts via a process called metastasis. It may affect younger women.
- Sarcoma: It is a malignant tumor of connective or non-epithelial tissue.
What are the symptoms of Vulvar Cancer?
Many times women feel embarrassed and avoid the signs. Their condition gets worse due to this. It is important to get a diagnosis as soon as any of the following symptoms appear:
1. Pain and burning
2. Painful sexual intercourse
3. Rawness and sensitivity
4. Thickened skin
5. Lump on vaginal opening
8. Dark discoloration in case of melanoma
9. Painful urination
What are the stages?
There are different stages of cancer:
- Stage 0: This is the starting stage also called carcinoma in situ. It starts from the surface of the skin. It is generally a precancerous stage often called dysplasia.
- Stage 1: In this stage, the cancer is restricted to the vulva and is less than 1 inch(2 cm) in size.
- Stage 2: It is same as stage 1, just the difference is that the size of cancer increases more than 2 cm.
- Stage 3: With this stage, more complications tend to begin. Cancer starts spreading to vagina, anus or maybe lymph nodes which increase risks.
- Stage 4: This is the last and more deadly stage. In this, cancer spread to the groin and the complications are at its peak. In this stage, it is hard to treat it as the cancerous cells have reached to the lymph nodes on both the sides of the groin and also the bowel, the bladder or the urethra which is the passage through which urine gets passed.
How is the vulvar cancer diagnosed?
To diagnose vulvar cancer, there are various tests conducted to get to know the complete details. Firstly, when the patient goes through a gynecological evaluation that comprises of checking the vulva properly. If there is any kind of lump or a mass is found, a biopsy is required. Depending on the biopsy, various other tests are conducted:
1. Proctoscopy: In this, the rectum is examined to identify whether cancer has spread to the area or not.
2. Imaging Scans: Some imaging tests like an MRI or an X-Ray are conducted to check how distant cancer cells have reached to.
How is vulvar cancer treated?
Different kinds of treatment are done to cure vulvar cancer. They include:
- Surgery: It is one of the effective ways to treat vulvar cancer. It helps in removing cancer while keeping the sexual function intact. If the vulvar cancer is diagnosed at an early stage, it could be cured with limited surgery. Surgery would be more extensive, it the cancerous cells has reached to other parts like vagina, urethra etc.
There are various types of surgeries like laser surgery, radical vulvectomy etc.
- Chemotherapy: Often used with radiotherapy, it is done as a part of palliative care. It may be used on the skin as some kind of lotion.
- Radiation Therapy: In this, a high beam of radiations are emitted from a machine to shrink the size of the tumor. It relieve the symptoms and increases the quality of life.