What is Vulval cancer?

Vulval cancer is the third most common form of cancer in women. It accounts for about 1% of all cancers in women and is more common in women than in men.

Vulval cancer can be non-cancerous (benign) or cancerous (malignant). Both types are uncommon. Vulval cancer is more common in women of African, Asian, and Latin American descent.

Vulval cancer is most common in women who are sexually active between ages 15 and 35. It is less common in women who have never been sexually active. It is more common in women who have never been pregnant.

What causes vulval cancer?

Vulval cancer is most commonly caused by exposure to human papillomavirus (HPV).

HPV is a group of viruses that cause genital warts. HPV is common and is the leading cause of skin cancer in the United States.

HPV is sexually transmitted. It is spread through skin-to-skin contact with an infected person. It can also be transmitted from an infected person to a pregnant woman during childbirth.

About 4% of women will be infected with HPV, which causes genital warts. About 11% of women will develop precancerous lesions of the vulva.

Other risk factors include:

  • Using an intrauterine device (IUD)
  • Having a weakened immune system
  • Having certain types of HPV
  • Having had genital warts
  • Having had an abnormal Pap smear

What are the symptoms of vulval cancer?

Most vulval cancers are painless. The most common symptom of vulval cancer is a change in the size or shape of the vulva. The vulva is the area between the genitals and the anus.

Other symptoms of vulval cancer can include:

  • Pain in the vulva
  • A lump or swelling in the vulva
  • A red or white patch in the vulva
  • Discharge from the vulva
  • Bleeding from the vulva
  • A sore on the vulva

How is vulval cancer diagnosed?

If you have a lump or change in the size or shape of the vulva, your doctor will check to see if it is cancerous.

To do this, your doctor will:

  • Ask about your symptoms
  • Ask about your past health
  • Do a physical exam
  • Order tests to find out whether you have cancer
  • Order a biopsy

Your doctor will likely take a sample of the suspicious area and send it to a lab for analysis. It may take a few days for the lab to get your results.

If you have vulval cancer, the lab will look for cancer cells under a microscope. If the lab finds cancer cells, your doctor will examine the cells under a microscope.

Your doctor will also do a biopsy of the suspicious area to confirm the diagnosis.

How is vulval cancer treated?

Your treatment choices depend on:

  • How much the cancer has grown
  • If it has spread to nearby lymph nodes
  • Whether you have cancer that has come back after treatment
  • Your age

If you have vulval cancer that hasn’t spread, your doctor might suggest one of the following treatments:

Surgery

Surgery is the main treatment for most vulval cancers. Your doctor will remove the cancerous area and a small area of normal tissue around it.

You may need to have a colostomy bag or a cut in your abdomen to pass stool. This is because the skin of your bottom is very sensitive and you might have a bowel movement every day.

If the cancer is small, it may be possible to remove it by doing a minor procedure.

Radiation therapy

Radiation therapy uses high-energy X-rays to kill cancer cells. It can be very effective when you have vulval cancer that hasn’t spread to your lymph nodes or to other parts of your body.

You will be treated with external beam radiation therapy (EBRT). This is an outpatient procedure. It will be given 5 days a week for 6 to 8 weeks.

Chemotherapy

Chemotherapy is a drug-based treatment. It uses drugs to kill cancer cells.

There are different types of chemotherapy. Your doctor will choose the type that is best for you. They will choose the type that is best for your cancer type and your overall health.

If you have vulval cancer, you may need to take a drug for 4 to 6 weeks. The treatment will be repeated until you no longer need it.

Targeted therapy

Targeted therapy uses drugs to attack only the cancer cells. It might not destroy the normal cells in your body that also have cancer.

Your doctor can help you decide which type of targeted therapy might be best for you.

Immunotherapy

Immunotherapy is a drug-based treatment. It uses your immune system to fight the cancer.

It might be an option if you have vulval squamous cell cancer that has spread to your lymph nodes.

What’s the outlook for people with vulval cancer?

The long-term outlook depends on the type of vulval cancer you have and how far it has spread.

The outlook for people who have vulval cancer depends on whether it is non-invasive or invasive.

Non-invasive vulval cancers tend to be mild and may not need any treatment.

Invasive vulval cancers tend to be more serious. They are more likely to spread to other parts of your body and require more intensive treatments.

Outlook for people with vulval cancer depends on factors such as:

  • The type of vulval cancer you have
  • How far it has spread
  • Your overall health

The outlook for people with vulval cancer who have not spread to their lymph nodes is good. It’s the same as the outlook for people with vulvar cancer who have not spread to other parts of their body.

Bottom line

Vulval cancer can start anywhere in the genital area. It most commonly occurs in the vulva of the female genital region.

It can also occur in the urethra or anus. It can also spread to the lymph nodes or other parts of the body.

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