Vulvar Cancer

Vulvar cancer is a rare type of cancer that affects women, primarily those over 65 years old. It is uncommon in women under 50 years old who have not yet gone through menopause.

The vulva refers to the external female genitalia, which includes:

• Thelabia majora and labia minora (the outer and inner folds of skin surrounding the vaginal opening)
• Theclitoris, a sensitive organ involved in sexual pleasure
• TheBartholin’s glands, two small glands on either side of the vaginal opening

Causes of Vulvar Cancer

The exact cause of vulvar cancer is unknown, but certain risk factors increase the likelihood of developing the disease:

• Aging– Risk increases with age
• Vulvar intraepithelial neoplasia (VIN)– Pre-cancerous changes in vulvar cells
• Persistent HPV infection– Certain types of the human papillomavirus (HPV) increase the risk
• Chronic skin conditions– Such as lichen sclerosus, which affects the vulva
• Smoking– Tobacco use is linked to an increased risk

Reducing Your Risk

• Quit smoking – Tobacco weakens the immune system and increases cancer risk.
• Prevent HPV infection – Getting the HPV vaccine and practicing safe sex can lower your risk.

Symptoms of Vulvar Cancer

Early detection is crucial. Symptoms may include:

• Persistent itchingin the vulva
• Pain or tendernessin the vula
• Unusual bleeding or blood-stained discharge(between periods or after menopause)
• An open sore (ulcer) on the vulvathat does not heal
• Burning sensation during urination
• Changes in the appearance of moles on the vulva(size, shape, or color)

If you notice any changes in your vulva, consult your doctor immediately.
While these symptoms are often caused by other conditions, they should always be checked by a specialist.

Diagnosis

A gynecologist will examine the vulva and discuss your symptoms. If needed, they may recommend a biopsy to check for cancerous cells.

Biopsy Procedure

· A small tissue sample is removed and analyzed under a microscope.

· The procedure is typically done under local anesthesia and is not painful.

· Mild bleeding or discomfort may occur for a few days.

· The results are usually available within 7 to 10 days.

Further Tests

If cancer is confirmed, additional tests will determine the stage and extent of spread. These may include:

• Colposcopy– A magnified examination of the vagina and cervix to check for abnormal cells
• Cystoscopy– A camera-based examination of the bladder
• Proctoscopy– A camera-based examination of the rectum
• Lymph node biopsy– To assess if cancer has spread via the lymphatic system
• CT or MRI scans– Imaging tests to check for cancer spread
• Chest X-ray– To ensure the cancer has not spread to the lungs

The results of these tests will determine the stage of the cancer and guide treatment decisions.

Treatment for Vulvar Cancer

The treatment plan depends on factors such as:

• Thestage of cancer (how much it has spread)
• Youroverall health
• Personal treatment preferences

Main Treatment Options

• Surgery
• Radiotherapy
• Chemotherapy

Most women undergo a combination of treatments.

Early-Stage Vulvar Cancer

If detected early, surgery can often remove the cancer completely. However, if the cancer has spread, a combination of therapies may be necessary.

Surgical Treatment

Types of Surgery

• Wide Local Excision– Removal of the cancerous area along with some surrounding healthy tissue
• Vulvectomy– Partial or total removal of the vulva (depending on cancer size and spread)
• Lymph Node Removal– If cancer has spread, lymph nodes in the groin may need to be removed

Modern surgical techniques aim to remove cancer while preserving as much normal tissue as possible.

Radiotherapy & Chemotherapy

• Radiotherapy– Uses high-energy radiation to destroy cancer cells. It is often used:
• After surgery (adjuvant radiotherapy) to reduce the risk of recurrence
• Instead of surgery, if the tumor istoo large to remove surgically
• Chemotherapy – Uses anti-cancer drugs to shrink tumors or treat advanced cases

Follow-Up & Monitoring

• After treatment,regular check-ups are necessary to monitor for cancer recurrence.
• Even after successful treatment,vulvar cancer can return, making long-term follow-up crucial.

Specialized Care at Thely Clinic

At Thely Clinic, our gynecologic oncology team has extensive experience in treating vulvar cancer, using advanced surgical techniques developed in leading UK medical centers.