Vulvar Cancer

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June 19th, 2008 by admin

Cancer of the vulva is not a common disease. There are about 4,000 new cases each year in the United States. Although it can occur in women in the third and fourth decade it is usually diagnosed in older women. Over 95% of vulvar cancers arise from the squamous epithelium. The remainder are mostly melanomas. The cause of squamous cancer of the vulva is unknown but there is a weak association with Human Papilloma Virus (HPV). The most important feature about vulvar cancers is the premalignant phase.

PREMALIGNANT VULVAR CANCER

The premalignant phase of vulvar squamous cell cancer has several different names: carcinoma-in-situ, vulvar intraepithelial neoplasia grade III, (VIN III), severe dysplasia and Bowen’s disease. This condition is diagnosed by tissue biopsy and is characterized by a full thickness disorder of maturation of the squamous epithelium (see Dysplasia). It is usually symptomatic with itching and burning and can be present for years. It is usually misdiagnosed as a yeast infection and a multitude of anti-fungal agents will have been prescribed, none of which will have been effective. It is easy to see on examination and will appear as a raised red, white or pigmented patch. A simple biopsy will confirm the diagnosis.

It is best treated by excision or sometimes by laser evaporation. If a large area is involved and must be removed, then a skin graft can be applied. These premalignant conditions are likely to recur after treatment so continued follow up is a necessity. Another condition that can occur on the vulva and also cause itching and soreness is called lichen sclerosis. It is not a premalignant change, but an atrophy of the skin. It will not be improved by anti-yeast medications either. It can be diagnosed by biopsy. These two conditions, lichen sclerosis and VIN III, can be present for years and be misdiagnosed as yeast infections.

The most important point about premalignant vulvar changes is that there is usually a long delay in diagnosis. Often these women are not examined properly or the examiner is unfamiliar with this condition and prescribes yet another course of cream, salve, or ointment. Usually the condition is fully visible and simply needs to be biopsied to establish the diagnosis.

INVASIVE VULVAR CANCER

Squamous cell cancer of the vulva usually causes pain, soreness and itching. There is usually an obvious growth on the skin or an ulcerated area. Diagnosis is by simple biopsy. These cancers are usually slow growing and do not spread early. When they do spread it is usually by way of the lymph nodes. The regional lymph nodes are located at the top of the thigh in the groin area. Vulvar cancers are staged by a combination of examination and surgery. The TNM staging system is used.

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Vulvar cancer

June 19th, 2008 by admin

Vulvar cancer is a type of cancer that affects the vulval region. It accounts for about three per cent of all gynaecological cancers and is most commonly diagnosed in older women aged around 70 years or over. However, an increasing number of women aged 35-45 are being diagnosed with this form of cancer.

The most common site for vulvar cancer is the labia majora, while just one in 10 cases originates in the clitoris. The vulva has lots of blood and lymphatic vessels, which means that vulval cancer cells can easily spread to nearby body parts such as the bladder, vagina and anus. Without treatment, the patient can suffer from severe infection and pain.

The vulva is a general term that describes the external female genitals. The vulva is made of three main parts: the labia majora (outer lips), the labia minora (smaller inner lips) and the clitoris.

Symptoms

In its early stages, vulvar cancer often has no symptoms. This is because the cancer is so tiny. The progression of symptoms can include:

— An unusual lump or bump can be felt somewhere on the vulva.

— The lump becomes itchy and painful.

— The lump progresses to an ulcerated sore that refuses to heal.

— The raw-looking sore can be white, red or pink. The sore gets bigger with time.

— There could be unusual bleeding or discharge from the vagina.

— The lymph glands in the groin may swell.

— Problems with bowel motions and passing urine may indicate the cancer has spread into these structures.

— Secondary cancers may cause a range of symptoms, such as aching bones.

Risk factors

Some of the risk factors for vulvar cancer include:

— Age - vulvar cancer usually occurs in postmenopausal women, but there appears to be an increasing number of young women diagnosed

— Other sexually transmitted infections

— Multiple sex partners

— Never having children (nulliparity)

— Chronic vulval itching (pruritis)

— Genital warts (human papillomaviral infection)

— Vulvar intraepithelial neoplasia (a pre-cancerous condition)

— Prior incidence of squamous cell cancer of the cervix

— Prior incidence of squamous cell cancer of the vagina.

The progression of vulvar cancer

Vulvar intraepithelial neoplasia (VIN) is a pre-cancerous condition of the vulva. It is uncommon but appears to have a high risk of becoming cancerous if untreated. Of those women who are treated, 5-10 per cent may still develop vulvar cancer. If cancer cells reach the pelvic lymph nodes, secondary cancers can spread to almost anywhere in the body.

Different types

Vulvar cancer is classified according to its cell of origin. This can include:

— Squamous cell carcinoma - originating in the skin cells. This type accounts for about 90 per cent of cases.

— Melanoma - originating in the pigment cells deeper in the skin. This type accounts for about five per cent of cases.

— Adenocarcinoma - originating from the Bartholin’s glands, the structures that supply lubricant. This type accounts for less than one per cent of cases.

— Sarcoma - originating from fat cells. This type is quite rare.

— Lymphoma - originating from the immune cells. This type is quite rare.

— Basal carcinoma - a form of skin cancer. This type is quite rare.

Diagnosis methods

Vulvar cancer is diagnosed after:

— Taking a medical history.

— Doing a physical examination.

— Doing a colposcopy examination of the vulva, which makes the lesions of certain diseases (including VIN and vulvar cancer) more obvious.

— Taking a biopsy of the sore or lump using a scalpel (with local anaesthesia) or a punch biopsy (this instrument extracts a little core sample).

— Excising (removing some tissue) under general anaesthetic.

Treatment options

Treatment for vulvar cancer can include:

— Vulvectomy - the first line of treatment is to surgically remove the tumour. Depending on factors including the location, type, stage and severity of the cancer, surgery may include radical vulvectomy (removal of the vulva) with or without removal of the groin lymph nodes from one or both sides.

— Radiation therapy - the use of precisely targeted x-rays to kill cancer cells. This may be used as the primary treatment to avoid removal of the clitoris.

— Chemotherapy - the use of cancer-killing drugs, often in combination. Chemotherapy can be helpful to control secondary cancers because the whole body is treated. It may also be used with radiation to increase the effectiveness of the radiotherapy.

How to reduce the risk

It is possible to reduce your risk by avoiding known risk factors. The most significant risk reduction strategy is to protect yourself from sexually transmissible infections (STIs). This is because women with previous dysplasia or CIN (cervical intraepithelial neoplasia) of the cervix, genital warts and herpes are at increased risk of developing vulvar intraepithelial neoplasia (VIN). Which is the precursor of (comes before) vulvar cancer. Other risk reduction strategies include:

— Don’t smoke cigarettes.

— Don’t dismiss chronic vulval itching as a persistent thrush infection. Don’t treat a vaginal itch with over-the-counter preparations - see your doctor for tests.

— Have regular gynaecological check-ups.

— If you think you may be at increased risk of vulvar cancer, ask your doctor to show you how to perform a self-examination.

Where to get help

— Your doctor

— Women’s health clinic

— Family Planning Victoria Tel. (03) 9257 0100

— Cancer Council Victoria Tel. 131 120

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Vulvar Cancer

June 19th, 2008 by admin

What is vulvar cancer?

The vulva is the skin and fatty tissue between the upper thighs of women, from the area of the anus to about an inch below the pubic hairline. Cancer of the vulva most often affects the two skin folds (or lips) around the vagina, known as the labia.

Vulvar cancer is not very common. However, it is very serious because it can affect a woman’s sexual functioning. It can make sex painful and difficult. This makes some women feel sad and worthless. If found early, vulvar cancer has a high cure rate and the treatment options involve less surgery.

Who is affected?

Vulvar cancer most often affects women 65 to 75 years of age. However, it can also occur in women 40 years of age or younger. Vulvar cancer may be related to genital warts, a sexually transmitted disease caused by the human papillomavirus (HPV).

What are the signs of vulvar cancer?

Tell your doctor if you have any of these warning signs of vulvar cancer:

— Vulvar itching that lasts more than one month

— A cut or sore on the vulva that won’t heal

— A lump or mass on the vulva

— Vulvar pain

— Bleeding from the vulva (different from your usual monthly bleeding)

— Burning in the area that lasts even after your doctor has treated the burning

— Any change in size, color, or texture of a birthmark or mole in the vulvar area

How is vulvar cancer diagnosed?

If your doctor finds an abnormal area on the vulva, he or she may want to take a small piece of skin to look at under the microscope. This procedure can be done in the doctor’s office. It is called a biopsy. A biopsy is the only way to find out if you have vulvar cancer.

How is vulvar cancer treated?

Vulvar cancer is usually treated with surgery. The type of surgery depends on the size, depth and spread of the cancer. Your doctor will review all the options for surgery and the pros and cons of each option. Some people may also need radiation therapy.

When vulvar cancer is found and treated early, the cure rate is over 90 percent. The key to a cure is to tell your doctor about any warning signs early and to have a biopsy right away.

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Can Vulvar Cancer Be Prevented?

June 19th, 2008 by admin

The risk of vulvar cancer can be reduced by avoiding controllable risk factors and by treating pre-cancerous conditions before an invasive cancer develops. These steps cannot guarantee prevention but can greatly reduce your chances of developing vulvar cancer.

Avoiding Risk Factors

Human papillomavirus (HPV) infection is a vulvar cancer risk factor that can be reduced by avoiding certain sexual practices outlined in the section on risk factors and by delaying onset of sexual activity. Until recently, it was thought that the use of condoms (”rubbers”) could prevent infection with HPV. But recent research shows that condoms cannot fully protect against infection with HPV. This is because HPV can be passed from one person to another by skin-to-skin contact with any HPV-infected area of the body such as skin of the genital or anal area not covered by the condom.

It is still important to use condoms to protect against HIV/AIDS and other sexually transmitted diseases that are passed on through some body fluids. Because HPV can be present for years with no symptoms and passed on to another person even when there are no visible symptoms, the absence of visible warts cannot be used to decide whether caution is warranted.

The earlier sexual contact with others is begun, the more likely it is that a person will become infected with HPV, and the more time any HPV infection will have to progress to cancer. For these reasons, postponing the beginning of sexual activity in life and limiting the number of sexual partners are 2 ways to reduce the risk of developing HPV infection and vulvar cancer.

A new vaccine has been approved by the FDA that will protect against infection with HPV types 16 and 18. It is currently recommended for use in young females before they become sexually active (to prevent cervical cancers and pre-cancers), and it is being looked at for possible use in males. While studies have not yet been done, the hope is that this may eventually help prevent other cancers linked to HPV, including vulvar cancers.

Not smoking is another way to lower vulvar cancer risk, in addition to obvious benefits of greatly reducing your risk of developing far more common cancers of the lungs, mouth, throat, bladder, kidneys, and several other organs.

Detecting Pre-cancerous Conditions

Pre-cancerous vulvar conditions can be identified by having regular reproductive system (gynecologic) checkups and by having a doctor evaluate any persistent vulvar rashes, moles, lumps, or other abnormalities. Treatment of vulvar intraepithelial neoplasia (VIN) can prevent many cases of invasive squamous cell vulvar cancer.

Some vulvar melanomas can be prevented by removal of atypical moles.

Examination of the vulva is routinely done at the same time a woman has a Pap test and pelvic examination. The American Cancer Society recommends:

— All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.

— Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years with either the conventional (regular) or liquid-based Pap test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.

— Another reasonable option for women over 30 is to get screened every 3 years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test.

— Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.

Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.

See the American Cancer Society documents on “Cervical Cancer,” “Pap Test,” and “Cancer Detection Guidelines” for more information about early detection of female reproductive system cancers.

Some doctors recommend self-examination of the vulva as a strategy for early detection of vulvar cancer, as well as certain other vulvar disorders. A woman can become aware of any changes in the skin of her vulva by examining herself monthly. Using a mirror, look for any areas that are red and irritated, white, or darkly pigmented. You should note any abnormal growths, nodules, bumps, or ulcers and report these to a doctor, since they may indicate vulvar cancers or pre-cancerous conditions.

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Vulvar Cancer

June 19th, 2008 by admin

Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.
Vulvar cancer forms in a woman’s external genitalia. The vulva includes the inner and outer lips of the vagina, the clitoris (sensitive tissue between the lips), and the opening of the vagina and its glands.

Vulvar cancer most often affects the outer vaginal lips. Less often, cancer affects the inner vaginal lips or the clitoris.

Vulvar cancer usually develops slowly over a period of years. Abnormal cells can grow on the surface of the vulvar skin for a long time. This precancerous condition is called vulvar intraepithelial neoplasia (VIN) or dysplasia. Because it is possible for VIN or dysplasia to develop into vulvar cancer, treatment of this condition is very important.

HPV infection and older age can affect the risk of developing vulvar cancer.

Risk factors include the following:

— Having human papillomavirus (HPV) infection.

— Older age.

Possible signs of vulvar cancer include bleeding or itching.

Vulvar cancer often does not cause early symptoms. When symptoms occur, they may be caused by vulvar cancer or by other conditions. A doctor should be consulted if any of the following problems occur:

— A lump in the vulva.

— Itching that does not go away in the vulvar area.

— Bleeding not related to menstruation (periods).

— Tenderness in the vulvar area.

Tests that examine the vulva are used to detect (find) and diagnose vulvar cancer.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking the vulva for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Biopsy: The removal of cells or tissues from the vulva so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

— The stage of the cancer.

— The patient’s age and general health.

— Whether the cancer has just been diagnosed or has recurred (come back).

Stages of vulvar cancer

After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body.

The process used to find out if cancer has spread within the vulva or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

Cystoscopy: A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. Tissue samples may be taken for biopsy.

Proctoscopy: A procedure to look inside the rectum and anus to check for abnormal areas. A proctoscope (a thin, lighted tube) is inserted into the anus and rectum. Tissue samples may be taken for biopsy.

X-rays: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. To stage vulvar cancer, x-rays may be taken of the organs and bones inside the chest, and the pelvic bones.

Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer has spread to these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters and bladder, x-rays are taken to see if there are any blockages. This procedure is also called intravenous urography.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

The following stages are used for vulvar cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found on the surface of the vulvar skin. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed and is found in the vulva only or in the vulva and perineum (area between the rectum and the vagina). The tumor is 2 centimeters or smaller and has spread to tissue under the skin. Stage I vulvar cancer is divided into stage IA and stage IB.

— Stage IA: The tumor has spread 1 millimeter or less into the tissue of the vulva.

— Stage IB: The tumor has spread more than 1 millimeter into the tissue of the vulva.

Stage II

In stage II, cancer is found in the vulva or the vulva and perineum (space between the rectum and the vagina), and the tumor is larger than 2 centimeters.

Stage III

In stage III vulvar cancer, the cancer is of any size and either:

— is found only in the vulva or the vulva and perineum and has spread to nearby lymph nodes on one side of the groin; or

— has spread to nearby tissues such as the lower part of the urethra and/or vagina or anus, and may have spread to nearby lymph nodes on one side of the groin.

Stage IV

Stage IV is divided into stage IVA and stage IVB, based on where the cancer has spread.

— Stage IVA: Cancer has spread to nearby lymph nodes on both sides of the groin, or has spread beyond nearby tissues to the upper part of the urethra, bladder, or rectum, or has attached to the pelvic bone and may have spread to lymph nodes.

— Stage IVB: Cancer has spread to distant parts of the body.

Recurrent Vulvar Cancer

Recurrent vulvar cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the vulva or in other parts of the body.

Treatment option overview

There are different types of treatment for patients with vulvar cancer. Different types of treatments are available for patients with vulvar cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Four types of standard treatment are used:

Laser therapy Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

Surgery

Surgery is the most common treatment for cancer of the vulva. The goal of surgery is to remove all the cancer without any loss of the woman’s sexual function. One of the following types of surgery may be done:

Wide local excision: A surgical procedure to remove the cancer and some of the normal tissue around the cancer.

Radical local excision: A surgical procedure to remove the cancer and a large amount of normal tissue around it. Nearby lymph nodes in the groin may also be removed.

Vulvectomy: A surgical procedure to remove part or all of the vulva:

— Skinning vulvectomy: The top layer of vulvar skin where the cancer is found is removed. Skin grafts from other parts of the body may be needed to cover the area.

— Simple vulvectomy: The entire vulva is removed.

— Modified radical vulvectomy: The vulva containing cancer and some of the normal tissue around it is removed.

— Radical vulvectomy: The entire vulva, including the clitoris, and nearby tissue is removed. Nearby lymph nodes may also be removed.

Pelvic exenteration: A surgical procedure to remove the lower colon, rectum, and bladder. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may have chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, a body cavity such as the abdomen, or onto the skin, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Topical chemotherapy for vulvar cancer may be applied to the skin in a cream or lotion.
New types of treatment are being tested in clinical trials.

Treatment options by stage

Stage 0 (Carcinoma in Situ)

Treatment of stage 0 may include the following:

— Wide local excision and/or laser therapy.

— Skinning vulvectomy with or without skin grafting.

— Simple vulvectomy.

— Topical chemotherapy.

Stage I Vulvar Cancer

Treatment of stage I vulvar cancer may include the following:

— Wide local excision.

— Radical local excision with removal of nearby lymph nodes.

— Radical vulvectomy and either removal of nearby lymph nodes or radiation therapy to the lymph nodes.

— Radiation therapy.

Stage II Vulvar Cancer

Treatment of stage II vulvar cancer may include the following:

— Modified radical vulvectomy and removal of nearby lymph nodes or radiation therapy to the lymph nodes. Radiation therapy to the area of surgery may also be given.

— Radiation therapy.

Stage III Vulvar Cancer

Treatment of stage III vulvar cancer may include the following:

— Modified radical vulvectomy and removal of nearby lymph nodes, with or without radiation therapy.

— Radical vulvectomy and removal of nearby lymph nodes, with or without radiation therapy.

— Radiation therapy followed by surgery.

— Radiation therapy with or without chemotherapy.

— A clinical trial of a new treatment.

Stage IV Vulvar Cancer

Treatment of stage IV vulvar cancer may include the following:

— Radical vulvectomy and pelvic exenteration.

— Radical vulvectomy followed by radiation therapy.

— Radiation therapy followed by surgery, with or without chemotherapy.

— Radiation therapy with or without chemotherapy.

— A clinical trial of a new treatment.

Treatment options for Recurrent Vulvar Cancer

It is important to have regular follow-up exams to check for recurrent vulvar cancer. Treatment of recurrent vulvar cancer may include the following:

— Wide local excision with or without radiation therapy.

— Radical vulvectomy and pelvic exenteration.

— Radiation therapy and chemotherapy given during the same period of time, with or without surgery.

— Radiation therapy followed by surgery or chemotherapy.

— Radiation therapy as palliative treatment to relieve symptoms and improve quality of life.

— A clinical trial of a new treatment.

For more information from the NCI, please write to this address:

NCI Public Inquiries Office

Suite 3036A

6116 Executive Boulevard, MSC8322

Bethesda, MD 20892-8322

U.S. residents may call the National Cancer Institute’s (NCI’s) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. Information about ongoing clinical trials is available from the NCI Web site www.cancer.gov/clinicaltrials.

Source: National Institutes of Health; National Cancer Institute

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What is vulvar cancer?

June 19th, 2008 by admin

It is an abnormal growth of malignant cells (neoplasm, tumor) in the vulva. The vulva is defined as the female external genitalia, and includes the labia majora, labia minora, clitoris, and vestibule, or entryway, of the vagina.

About 70% of vulvar cancers involve the labia, (mainly the labia majora), 15% - 20% involve the clitoris, and another 15% - 20% involve the perineum, which is the area of sensitive skin located between the vagina and the anus. In about 5% of cases, the cancer is present at more than one site.

What are the different types of vulvar cancer?

The vulva is essentially epithelial skin, and so the main tumor types that affect this area are skin-related cancers.

The majority of vulvar cancers are squamous cell carcinomas, which typically develop at the edges of the labia majora/ minora or the vagina. As with vaginal squamous cell carcinomas, vulvar squamous cell cancers are slow-growing and usually develop from “precancerous”, pre-invasive areas called vulvar intraepithelial neoplasia (VIN).

Melanoma is the second most common type and represents about 5% - 10% of vulvar cases; roughly half involve the labia majora.

The most common skin-cancer in sun-exposed areas is basal cell carcinoma, and as expected, this type rarely occurs on the vulva.

Adenocarcinomas of the vulva are also rare, but can develop from glands such as the Bartholin’s glands at the vaginal opening.

How common is vulvar cancer?

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Can Vulvar Cancer Be Prevented?

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What is vulvar cancer?