Special for you women: Let's be aware of Vulvar Cancer

Many times, women are a little embarrassed, maybe even afraid, to talk about changes in their external genital area (vulva). Imagine, even if you notice something like an itch, a small lump, or a change in skin color , there are times when you ignore it, thinking, 'It will get better on its own.' But these seemingly minor symptoms can sometimes be the first sign of a serious condition that we don't even realize. So today we are talking about another very important topic, cancer of the external genital area, or `(Vulvar Cancer)`.

Simply put, what is Vulvar Cancer?

Vulvar cancer is the uncontrolled growth of cancer cells in a woman's external genital area, the 'vulva'. This is different from vaginal cancer, which is cancer that occurs inside the vagina .

Okay, now let's see what belongs to this external genital area (vulva).

• Opening of the vagina : The entrance to the passageway from the uterus to the outside.
• Labia: Two folds of skin that look like lips. The fleshy outer part is called ``Labia majora`` and the thinner inner folds are called ``Labia minora``.
• Clitoris: A very sensitive lump covered with skin where the labia minora join.
• Mons pubis: The soft, raised area in front of the pelvic bones that becomes covered with hair during puberty.
• Perineum: The skin between the external genitalia and the anus.

These parts can cause cancer anywhere.

What are the symptoms of this cancer?

There may be no symptoms at first. However, over time, the following symptoms may appear. Check to see if you have one or more of these.

Are there types of vulvar cancer?

Yes, there are several main types of this cancer.

• Squamous Cell Carcinoma: This is the most common type. It starts in the skin cells . Especially in young women, it can be linked to a virus called `Human Papillomavirus (HPV).`
• Adenocarcinoma: This type usually starts in the Bartholin's glands, which are located on either side of the vaginal opening. Sometimes it can look like a cyst.
• Melanoma : A type of cancer that begins in the cells that give skin its color. It usually occurs on sun-exposed skin, but can rarely occur on the external genital area.
• Sarcoma: A type of cancer that starts in cells in the bone, muscle, or connective tissue. It can develop at any age, even in young children.

What are the causes and risk factors for developing this cancer?

The exact cause of this is not yet clear, but certain things may increase the risk of developing this cancer.

• Age: Common among women over 70 years of age.
• HPV infection: Infection with the `Human Papillomavirus (HPV)` is a major risk factor.
• Smoking: People who smoke are at increased risk, especially those with HPV infection.
• Reduced immunity: Weakened immunity due to conditions such as HIV or AIDS.
• Precancerous conditions: Cellular changes that occur before cancer, such as `Vulvar Intraepithelial Neoplasia (VIN).`
• Lichen Sclerosus: A condition that causes thinning and itching of the skin in the external genital area.
• Other cancers: Having a history of cervical or vaginal cancer.
• Family history: If someone in the family has had melanoma.

Doctor, how do you diagnose this?

When you see a doctor, he or she will likely perform some of these tests.

1. Medical History: The doctor will ask questions about your health habits and illnesses.

2. Pelvic Exam: The external genital area, uterus, vagina, and surrounding organs are examined.

3. Colposcopy: A closer examination of suspicious areas with a magnifying instrument (colposcope).

4. Biopsy: A procedure in which a small piece of tissue is taken from a suspicious area and examined under a microscope. This test is used to definitively determine whether or not it is cancerous.

5. Imaging Tests: Scans such as `(X-rays, CT, PET scans, MRIs)` are performed to find out how far the cancer has spread.

What are the stages of cancer?

If the tests confirm that there is cancer, the doctor will next look at the size of the tumor and whether it has spread. This is called 'staging'.

What are the treatments?

Treatment is determined by many factors, including the type of cancer, its stage, and your overall health. There are four main treatment options.

1. Surgery

This is the most common treatment. It involves removing the cancer and surrounding tissue. The type of surgery performed depends on the size and spread of the cancer. You may need to remove part or all of the external genitalia (a vulvectomy). If the cancer has spread, the surrounding sebaceous glands may also be removed.

2. Radiation Therapy

Using radiation, such as high-energy X-rays, to destroy cancer cells. This can be done by delivering radiation externally using a machine or by placing a small radioactive seed near the tumor.

3. Chemotherapy (Chemotherapy / “Chemo”)

Giving drugs that kill cancer cells or stop them from growing. These can be given as pills, as an injection (IV), or sometimes as a cream applied to the skin.

4. Immunotherapy

A modern treatment method that stimulates the body's own immune system and helps the body fight cancer cells.

What happens after treatment?

After treatment, you will need to be monitored regularly. This includes regular follow-up visits to your doctor . You will need to have check-ups every 3-6 months for the first two years, and then every 6-12 months for the next 3-5 years.

Treatment can cause some side effects. It is important to keep the wound clean after surgery. Also, swelling in the legs (Lymphedema), urinary tract infections, and pain during sex can occur. Let your medical team know about any discomfort you are experiencing . They can help you manage them.

It's normal to experience some degree of sexual dysfunction. Changes in body image, pain, and other emotional effects can also be experienced. Don't be shy about talking openly about this with your doctor, nurse, or counselor.