Gynecological cancer refers to the cancers that begin in the female reproductive system. Vulvar cancer falls under the ‘Gynaecological cancer’ category. The vulva has two folds of skin that form the outer part of the female genitals. The exterior fold is (labia majora), and the interior fold is (labia minora). It covers and protects the opening of the urethra and the vagina.

Vulvar cancer begins in the vulva. It is a rapid overgrowth of the vulva cells that interrupts the normal functioning of the human body.

What are signs & symptoms?

The common symptoms of vulvar cancer include skin changes in the vulva, a bump, thick or rough skin, excessive itching (pruritus), burning, an open sore, bleeding, or discharge from the vagina. 

What are the diagnostic tests for vulvar cancer?

Biopsy: The doctor removes the pieces of the cancerous part of the vulva with a long, hollow needle. It is the only way to assure if you have cancer.

CT scan: It creates detailed images of the body using x-rays. A CT scan detects the spread of cancer outside the vulva.

MRI: The radio waves and strong magnets help make precise images of the affected area. MRI identifies the size of cancer and other tumors in the vulva.

Pelvic test under anesthesia: The drugs make you sleep. Meanwhile, the doctor takes a close look at the vulva to check the symptoms of the cancer spread.

PET scan detects the cancer spread. The doctor puts a small amount of a low-level radioactive substance into the blood. It attaches to the cancer cells. A special camera shows any areas of radioactivity.

How advanced is my vulvar cancer? 

Vulvar cancer is classified as stages I, II, III, IV.

Stage I: 

The tumor is limited to the vulva without any spread. The stage is sub-divided into smaller groups (IA, IB) to describe cancer in detail.

Stage II: 

The tumor spread to nearby body parts (the lower part of the urethra, vagina, or anus) except lymph nodes or distant body parts.

Stage III: 

Cancer spread to nearby tissue (the vagina, anus, urethra, and groin lymph nodes) without any distant metastases. The stage is sub-divided into smaller groups (IIIA, IIIB, IIIC).

Stage IV: 

Cancer spread to the upper part of the vagina or urethra or a distant part of the body. The stage is sub-divided into smaller groups (IVA, IVB)

You can discuss with your doctor about the stages.

What are the suitable treatments for me?

Several kinds of treatment are available for vulvar cancer, including surgery, radiation, immunotherapy, targeted therapy, and chemotherapy.

SURGERY

Surgery helps to cure or control cancer and make symptoms better. It helps to cure vulvar cancer if not spread to other body parts. The standard vulvar cancer surgeries are laser surgery, simple vulvectomy, and radical vulvectomy.

The common side effects of breast cancer surgery are pain, nausea, fatigue (tiredness), delayed wound healing, and wound infection.

Ask the doctor about the kind of surgery needed and what to expect.

RADIATION THERAPY

Radiation destroys cancer cells left in the vulva after surgery. There are two ways to treat vulvar cancer with radiation. The first is by aiming the rays at the vulva from a machine outside the body. The second is by putting radioactive pellets, or tiny seeds, near the vulva.

The common side effects are fatigue, diarrhea (dysentery), frequent urge to urinate, and skin discoloration.

Most side effects may improve after radiation ends. Ask your doctor about what to expect.

CHEMOTHERAPY

You can take chemo medicines intravenously or orally. The drugs spread through the body via the blood. Chemo is divided into cycles or rounds. After every cycle of treatment, there is rest time. Chemo is helpful if cancer has spread outside the vulva.

The common side effects are fatigue, body pain, infection, numbness, and hair loss. These side effects go away after chemo treatment ends. If you have side effects, discuss them with your doctor.

TARGETED THERAPY

Targeted therapy drugs are helpful for advanced vulvar cancer. These drugs majorly affect cancer cells and rarely normal cells. The drugs move inside the cancer cells and block particular proteins or enzymes that nourish cancer cells.

Delayed wound healing, bleeding, high blood pressure, and kidney ailments are the common side effects. Ask your doctor if any complications arise.

Immunotherapy

Immunotherapy boosts the immune system to destroy cancer cells. The cancer cells produce proteins that protect them from the immune system. Hence, the human immune system can not attack cancer cells. Immunotherapy works by interrupting the process. You can administer the drugs intravenously, as a shot, or as pills.

Immunotherapy is beneficial for treating advanced vulvar cancer.

The common side effects are fatigue, headache, constipation, skin rash, and appetite loss (anorexia).

What are the other treatment options? 

The other treatment options may or may not be standard medical treatments. These treatments include vitamins, herbs, and diets. Talk to your doctor about other treatment options.

What to expect after treatment?

You may have fear of cancer recurrence. Visit your doctor every three months after the treatment ends. Do not skip follow-up visits. Your doctors will ask you about new symptoms. A physical examination and diagnostic tests may help to check recurrence.

For the first year, the follow-up visits may be every three months. After the first year, follow-up visits might be every six months, and then at once a year after five years.

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