The vulva refers to the female external genitalia. It is composed of labia majora and labia minora (inner and outer lips of the vagina), Bartholin glands, clitoris, and vaginal and urethral opening. A rare cancerous growth in this area is referred to as vulvar cancer. This is slow-growing cancer and precancerous cells may be apparent as asymmetrical cells in the lining of the vulva.
Types of Vulvar Cancer
Depending on the cell affected, vulvar cancer is of the following types:
- Squamous Cell Carcinoma: This is a common type of vulvar cancer which starts on the surface of the vulva.
- Verrucous Carcinoma: This is a sub-type of squamous cell carcinoma which also starts on the surface of the vulva.
- Adenocarcinoma: This rare cancer starts in the sweat glands of the vulva or Bartholin glands.
- Melanoma: This cancer starts in the pigment-producing cells in the vulva.
- Sarcoma: This cancer starts in the connective tissue in the vulva.
In the early stages, the symptoms of cancer may not be apparent. The symptoms, however, may appear gradually. The common symptoms include:
- Lump in the vulva or groin area.
- Change in colour or texture of the skin in the vulva.
- Itching or burning in the vulva.
- Pain during urination.
- Persistent ulcer in the vulva.
- Unusual bleeding.
- Genital warts.
The exact cause of vulvar cancer is not known. The possible causes, however, are:
- HPV infection.
- Poor immunity.
- Vulvar intraepithelial neoplasia.
Vulvar cancer is diagnosed by:
- Physical examination: The doctor will examine to check for the signs of cancer.
- Colposcopy: This procedure will be performed to examine the vulva, vagina, and cervix. In this procedure, the doctor will insert a tool called a speculum into the vagina to get a magnified image of the area. If cancerous lesions are found, a biopsy will be recommended.
- Biopsy: The doctor will retrieve a small tissue from the vulva and examine for the presence of cancerous cells.
- Imaging tests: Various imaging tests such as ultrasound, CT scan, and MRI will be performed to gauge the size, location, and stage of the tumour.
The treatment strategy for vulvar cancer depends on the stage and type of cancer, age, and overall health of the patient. Surgery is usually the mainstay of cancer. This is combined with chemotherapy, radiation therapy, and immunotherapy.
- Surgery: Surgery will be performed to remove the tumour, or a part of the vulva depending on the stage and severity of cancer.
- Radiation therapy: High energy X-rays will be used to destroy cancer cells.
- Chemotherapy: High doses of anti-cancer drugs will be administered to destroy cancer cells. In some cases, chemotherapy is combined with radiation therapy to remove cells from the body.
- Targeted therapy: Certain drugs will be administered to target specific protein particles in the cancerous cells. This therapy is considered in chances of relapse.