Vulvar cancer is cancer that attacks the outer surface of the vagina. This cancer is more common in women over the age of 65 years and generally who have experienced menopause.
Vulvar cancer is usually characterized by lumps or open sores on the vulva, which are often accompanied by itching. The vulva itself is the external part of the female sexual organs, which includes the labia (minora and majora), the clitoris, and the Bartholin's glands on both sides of the vagina.
Based on the type of cell in which the cancer cells originate, the following are the two most common types of vulvar cancer:
- Vulvar melanoma, which is cancer of the vulva that begins in the pigment-producing cells found in the skin of the vulva
- Vulvar squamous cell carcinoma (vulvar squamous cell carcinoma), which is cancer of the vulva that begins in the thin cells that line the surface of the vulva
Of the two types of vulvar cancer above, the majority of cases that occur are vulvar squamous cell carcinoma.
Causes of Vulvar Cancer
Vulvar cancer begins when cells in the DNA undergo mutations or changes. These mutations cause cells to grow uncontrollably and become cancer cells, which continue to grow and spread to other organs of the body.
It is not known what causes mutations in these cells, but there are factors that can increase a person's risk of developing vulvar cancer, including:
- Suffering from HPV infection (human papillomavirus)
- Have a weak immune system, for example due to HIV infection
- Have a history of precancer in the vulva, for example vulvar intraepithelial neoplasia
- Suffering from skin diseases in the vulvar area, such as: lichen sclerosus and lichen planus
- Have a history of melanoma, vaginal cancer or cervical cancer
- 65 years and over
- Smoke
Symptoms of Vulvar Cancer
In its early stages (stage), vulvar cancer may not cause any symptoms. However, as the disease progresses, sufferers may experience the following symptoms:
- Annoying itching in the vulva
- Open sores on the vulva
- Pain and tenderness in the vulva
- Bleeding outside of menstruation
- The skin in the vulva area thickens and turns a darker color
- Wart-like bumps on the vulva
- Changes in skin color around the vulva
- Pain when urinating
When to go to the doctor
Check with your doctor if you experience the above symptoms, especially if you are at high risk of suffering from this disease. The sooner vulvar cancer is detected, the more likely it is to be cured.
If you have been diagnosed, are undergoing treatment, or have recovered from vulvar cancer, check with your doctor regularly. In some cases, vulvar cancer can recur in patients who have recovered.
Vulvar Cancer Diagnosis
The doctor will ask about the patient's symptoms, medical history, and sexual intercourse habits. Then, the doctor will perform a physical examination to see abnormalities in the vulva.
Doctors can also perform investigations to confirm the diagnosis of vulvar cancer. Some of the supporting examinations are:
- Colposcopy, to see the presence of abnormal cells in the vagina, vulva and cervix
- Tissue sampling (biopsy), to confirm the spread of cancer cells in the lymph nodes
If the cancer is suspected to have spread to other organs, the doctor may order other tests, such as:
- Examination of the pelvic organs, to see if the cancer has spread to the area
- Scans with X-rays, CT scans, PET scans, or MRIs, to see the extent of the spread of cancer to other organs
After the results of the examination are obtained, the doctor will determine the stage or severity of vulvar cancer. This determination will help the doctor in choosing the right treatment method. The stages of vulvar cancer include:
Stage 1 Stage 2 Stage 3 Stage 4 Treatment of vulvar cancer depends on the overall condition of the patient, as well as the type of vulvar cancer and its severity. Methods that doctors can use to treat it are surgery, chemotherapy, and radiotherapy. Here is the explanation: There are several types of surgery that can be performed by doctors to treat vulvar cancer, namely: Chemotherapy is the administration of drugs to kill cancer cells. The drugs used can be injected or taken (oral). Chemotherapy can be combined with radiotherapy if the vulvar cancer has spread to the lymph nodes. Chemotherapy and radiotherapy can also be combined to shrink cancer cells before surgery, increasing the chances of successful surgery. Radiotherapy is a treatment method that uses X-rays or proton beams to kill cancer cells. Besides being useful for shrinking cancer cells before surgery, radiotherapy is also done to kill cancer cells in the lymph nodes, which were not successfully removed by surgery. The process of treating vulvar cancer with radiotherapy is done in stages. Radiotherapy is generally done 5 times a week, with the length of treatment can be up to several weeks. Vulvar cancer that has been successfully removed can still attack again. Therefore, the patient must be checked regularly so that the progress of the disease condition can be known. The recommended examination is a pelvic exam every 3 or 6 months for the first 2 years, and every 6 or 12 months for the next 3-5 years. Doctors will also advise patients to get cancer screening. How to prevent vulvar cancer is to avoid risk factors, among others, by quitting smoking if you smoke. You can prevent vulvar cancer by reducing your risk of getting infected with HPV through the following steps: You can also do regular pelvic exams to detect if there is disease in the vulva and reproductive organs. In addition, talk to your doctor about how much you are at risk of developing vulvar cancer.Vulvar Cancer Treatment
Operation
Chemotherapy
Radiotherapy
Complications of Vulvar Cancer
Vulvar Cancer Prevention