Vulvar cancer is a type of cancer that occurs in the vulvar area. This is a part of a woman's external sexual organ which includes the vaginal lips (labia minor and labia major), clitoris, and Bartholin's gland.
The exact cause of vulvar cancer is still unknown. But there are several risk factors associated with vulvar cancer, such as:
- Age, generally occurs in women who are elderly or have undergone menopause
- History of abnormal cells in the potentially cancerous vagina, VIN (vaginal intraepithelial neoplasia)
- HPV infection (human papillomavirus), one of the sexually transmitted diseases
- Skin disorders of the vulva such as lichen sclerosus
- Smoke
- HIV or AIDS sufferers
- History of genital warts
After confirming the presence of cancer cells in the vulva, other follow-up examinations may be done. For example, a CT scan and MRI to determine the stage of vulvar cancer. Cystoscopy and proctoscopy to examine the bladder and rectum.
Some symptoms of vulvar cancer include:
- Persistent itching in the vulva
- Pain in the vulva
- Skin that is elevated or thickened is red, white or dark
- Lumps or warts on the vulva
- Bleeding from the vulva
- Bleeding vaginal discharge between menstruation
- Open wounds on the vulva
- Burning sensation when urinating
- Moles that change color or appear on the vulva
- Stage 1, where there is a small tumor in the vulva and the cancer has not spread to other areas of the body.
- Stage 2, the tumor has spread to the surrounding area. Areas that might be affected are the urinary tract, vagina, and anus.
- Stage 3, a condition in which cancer has spread to the lymph nodes.
- Stage 4, divided into 2, namely stage 4A and stage 4B. In stage 4A, the cancer has spread to a wider area, such as the urethra, bladder and rectum. Whereas in stage 4B, the cancer has spread to further areas of the vulva.
Treatment of vulvar cancer depends on the stage and type of disease and the age and general condition of the patient.
Stage I vulvar cancer
- Extensive local excision
- Radical local excision plus removal of all groin lymph nodes and the closest upper thigh on the same side as cancer.
- Radical vulvectomy and removal of groin lymph nodes on one or both sides of the body.
- Radiation therapy only.
- Radical vulvectomy and removal of left and right groin lymph nodes. If cancer cells are found in the lymph nodes, it is done after surgery, irradiation is directed to the pelvis.
- Radiation therapy only (in certain patients).
- Radical vulvectomy and removal of groin lymph nodes and lymph nodes above the left and right thighs. If inside the lymph nodes are found cancer cells or if cancer cells are only found inside the vulva and the tumor is large but has not spread, after surgery radiation therapy is carried out on the pelvis and groin.
- Radiation therapy and chemotherapy are followed by radical vulvectomy and removal of the left and right lymph nodes.
- Radiation therapy (in certain patients) with or without chemotherapy.
- Radical vulvectomy and removal of the lower colon, rectum or bladder (depending on the location of the spread of cancer) accompanied by removal of the uterus, cervix and vagina (pelvic exenteration)
- Radical vulvectomy followed by radiation therapy
- Radiation therapy is followed by radical vulvectomy
- Radiation therapy (in certain patients) with or without chemotherapy and may also be followed by surgery