Let's learn more about vulvar cancer. Don't be afraid, let's talk!

Have you ever heard of something called "Vulvar Cancer"? You may be a little scared when you hear this name. But don't worry. This is a very rare type of cancer. However, it is very important to be aware of this. Because, if it is detected early, it is also easier to treat. Let's talk about this in detail and very simply today.

What is Vulvar Cancer?

Simply put, Vulvar Cancer is a cancer that develops in the tissues of your vulva. "Vulva" is the general name for all of a woman's external genitalia. Do you remember, when we were little, we were a little shy to talk about these organs, but it's very important to know about every part of our body.

Imagine, your vulva has these parts:

• Vaginal opening: The muscular tube used for sexual intercourse, childbirth, and menstruation (menstruation).
• Labia Minora: The folds of tissue surrounding the opening of the vagina and extending over the clitoris.
• Labia Majora: The fleshy area surrounding the inner lips.
• Clitoris: The small, sexually sensitive lump above the opening of the vagina.
• Mons Pubis: The round area in front of the pelvic bones that becomes hairy during puberty.
• Opening of the Urethra: The opening of the tube through which urine exits the body.
• Perineum: The area of ​​skin between the vagina and the anus.

This type of vulvar cancer usually develops slowly, over many years. It starts as precancerous tissue (lesions). Doctors usually first see these abnormal growths in the outermost layer of the skin. These precancerous lesions are called "vulvar intraepithelial neoplasia" (VIN) .

What are the types of vulvar cancer?

Doctors classify vaginal cancer based on the type of cell from which the cancer begins. The most common types are:

• Vulvar Squamous Cell Carcinoma: This type accounts for about 90% of vulvar cancers. It develops in the cells on the surface of the skin.
• Vulvar Melanoma: This type of melanoma accounts for about 5% of vulvar cancers. It grows quickly and has a high risk of spreading to other parts of the body.

The remaining types of vulvar cancer are much rarer. They include:

• Basal Cell Carcinoma
• Bartholin Gland Adenocarcinoma
• Paget Disease of the Vulva
• Sarcoma
• Verrucous Carcinoma

How common is vulvar cancer?

In fact, vulvar cancer is a very rare cancer. For example, in the United States, fewer than 6,500 new cases of vulvar cancer are diagnosed each year.

Importantly, 80% of people diagnosed with the disease are over 50 years old. Also, more than half of diagnoses occur in people over 70 years old. The average age of diagnosis is around 68 years old.

That means, it seems like this risk increases with age, right?

What are the symptoms of vulvar cancer?

Now let's look at the symptoms of this disease. The first symptoms are usually seen as skin changes on your outer labia majora or inner labia minora. However, cancer can occur anywhere in the vulva.

Symptoms of vaginal cancer may include:

• Skin discoloration: Some areas may become darker or lighter than usual, or white patches may appear.
• Thickening or roughening of the skin: Some areas may feel thick and rough when touched.
• Lumps or growths: You may develop lumps, warts, non-healing sores, or cysts.
• Itching or burning: You may feel a persistent, non-reducing itching or burning sensation.
• Bleeding that is not related to your period: If you have vaginal bleeding that is not related to your period, that should also be taken into consideration.
• Pain and soreness to the touch: You may feel pain during sex or urination.

If you have one or more of these symptoms, be sure to see a doctor. Symptoms of vaginal cancer may not be apparent in the early stages. Therefore, it is best to get tested as soon as possible.

However, these symptoms can often be seen in other non-cancerous conditions. Therefore, it is important not to panic, but to see a doctor to find out for sure whether these changes are signs of cancer or something else.

What are the causes of vulvar cancer?

In vaginal cancer, cells begin to multiply uncontrollably. If left untreated, these cancer cells can spread to other parts of the body.

Vulvar Squamous Cell Carcinoma, the most common type, is caused by two main conditions:

• Human Papillomavirus (HPV) infection: This is a common sexually transmitted infection (STI) that is spread through skin-to-skin contact. Some types of HPV increase the risk of several types of cancer, including cervical cancer, anal cancer, and vulvar cancer.
• Lichen Sclerosus: This is a chronic (lifelong) skin condition. Lichen Sclerosus can cause symptoms such as inflammation of the vulva, skin changes, and itching.

What are the risk factors?

There are several factors that increase the risk of developing vulvar cancer:

• Age: The risk of developing vulvar cancer increases with age.
• Exposure to HPV: Not all strains of HPV cause cancer, but some types can cause cell changes that can eventually lead to vulvar cancer.
• Vulvar skin diseases: Developments associated with conditions such as `Lichen Sclerosus` can progress to vulvar cancer.
• Vulvar intraepithelial neoplasia (VIN): VIN is a precancerous condition that, if left untreated, can develop into vulvar cancer.
• Human Immunodeficiency Virus (HIV) Infection: When the immune system is weakened by a condition like HIV, it becomes difficult for the body to fight cancer.
• Smoking: Smoking increases the risk of many types of cancer, including vulvar cancer.

How is Vulvar Cancer Diagnosed?

When you see a doctor, he or she will ask about your medical history, risk factors, and symptoms. A number of tests are usually performed to make a diagnosis.

Tests to detect vaginal cancer

These tests may include:

• Pelvic Exam: The doctor will visually examine your vagina and look for any unusual skin changes. They will insert one or two gloved, lubricated fingers into your vagina and manually examine it for lumps or other signs of cancer. The anus may also be examined in the same way. They may also use a device called a speculum to widen the vagina and look for abnormalities.
• Pap Smear: During a pelvic exam, your doctor may take a sample of cells and check them for cancerous changes. The sample may also be tested for HPV to see if you have an HPV infection.
• Colposcopy: The doctor can use a lighted, magnifying instrument called a "colposcope" to look at your vulva, vagina, and cervix (the organ between the vagina and the uterus) in more detail. He or she may also apply a special solution that can highlight abnormal cells and make them easier to see.
• Biopsy: The doctor may take a sample of abnormal tissue and test it for cancer cells. A biopsy is the only way to know for sure if you have vaginal cancer.

Tests to see if the cancer has spread

If you have cancer, your doctor will do more tests to see if it has spread beyond the vulva. If left untreated, vulvar cancer can spread to the vagina or other nearby organs, to the lymph nodes in the pelvis, and eventually to the bloodstream. Metastatic cancer is very difficult to treat.

These tests include:

• Scope Exams: You may have a cystoscopy to see if cancer has spread to the urethra or bladder. A proctoscopy looks for cancer cells in the rectum or anus.
• Imaging tests: X-rays, CT scans, MRIs, and PET scans can show whether the cancer has spread from the vulva to other tissues.
• Sentinel Node Biopsy: Your doctor may remove a lymph node (sentinel node) closest to your cancerous lump to check for cancer cells. In vulvar cancer, cancer usually spreads to the sentinel lymph nodes in the groin area.

What are the stages of vulvar cancer?

Staging of vaginal cancer helps doctors determine whether your cancer has spread beyond the vagina. This information helps guide treatment decisions. There are four main stages:

• Stage I: Early stage vulvar cancer is confined to the vulva or perineum (the area between the anus and vagina). It is divided into IA or IB, depending on the size of the tumor and how far it has spread to nearby tissues.
• Stage II: The tumor (of any size) has spread to the lower urethra, lower vagina, or anus.
• Stage III: The cancer has spread to one or more nearby lymph nodes. This is divided into IIIA, IIIB, and IIIC, depending on the number and size of lymph nodes involved.
• Stage IV: The cancer has spread to the upper part of the urethra, the vagina, or other parts of the body. This is divided into IVA and IVB, depending on whether the spread is near or far from the vagina.

It is very important to ask your doctor about how the stage of your cancer will affect your treatment.

How is Vulvar Cancer treated?

The treatment you receive will depend on factors such as your general health, the stage of the cancer, and whether the cancer was recently diagnosed or has recurred. Your doctor will explain to you the best treatment plan for your diagnosis.

Surgery

The most common treatment for vaginal cancer is surgery.The goal is to completely remove the cancer while preserving your sexual function. There are several types of surgery:

• Laser Surgery: This involves using a laser beam to make bloodless cuts in tissue or remove superficial cancerous lesions.
• Local Excision: This surgery removes the cancer and a small or large amount of normal tissue around it. Sometimes, nearby lymph nodes are removed to check for cancer cells, or if there is evidence of cancer, those lymph nodes are removed.
• Vulvectomy: This procedure removes part or all of your vulva, possibly along with nearby lymph nodes. Skin grafts may also be used to replace the removed skin.
• Pelvic Exenteration: This surgery removes your lower colon, rectum, bladder, cervix, vagina, ovaries, and nearby lymph nodes. The doctor makes incisions to allow urine and stool to drain into a bag that collects them from your body.

Radiation Therapy

Radiation therapy uses X-rays or other high-energy beams to destroy cancer cells. The most common treatment for vaginal cancer is external beam radiation therapy (EBRT). EBRT uses a machine to direct radiation through your skin to the targeted cancer site.

Often, patients are given radiation therapy and chemotherapy together (this is called chemoradiation). You may have radiation therapy before surgery to shrink a tumor, or after surgery to kill any remaining cancer cells.

Chemotherapy

Chemotherapy uses drugs to attack cancer cells throughout the body. Your doctor may give you the medicine as an injection into a vein or muscle, or you may be given a pill to take. You may also be given a cream that you can apply directly to your vagina. This type of chemotherapy attacks the cancer more locally — meaning only in the area in question.

Cisplatin (Cisplatin - Platinol®, Platinol-AQ®) and fluorouracil (Fluorouracil - Carac®) are the most commonly prescribed chemotherapy drugs for vulvar cancer.

Immunotherapy

Immunotherapy works by helping your body's immune system recognize cancer cells and fight them more effectively. Imiquimod Cream (Aldara®, Zyclara®) is a common immunotherapy drug used to treat vulvar cancer.

What kind of follow-up should I expect after vulvar cancer treatment?

After treatment, your doctor may perform tests at various times to monitor your condition and make sure the cancer has not returned.

These tests often include the same tests used to diagnose and stage vaginal cancer.

Is vaginal cancer serious?

Yes, it can. Untreated vulvar cancer is life-threatening. Treating cancer that has spread to the lymph nodes or other parts of the body is much more difficult than treating cancer that is detected early.

Although there is always a risk that the cancer will come back after treatment, many people who receive treatment in the early stages of the disease live cancer-free.

What is the survival rate of vaginal cancer?

The relative five-year survival rate for people with vaginal cancer is about 70%. However, survival rates are even higher when the disease is detected and treated in the early stages. For example, the five-year survival rate for localized cancer (in the vagina itself) is about 86%. When the cancer has spread, this rate drops to about 30%.

However, your prognosis depends on factors unique to your diagnosis, such as your health status and your response to treatment. Ask your doctor about the likely outcomes based on your diagnosis.

How quickly does vaginal cancer spread?

Most types of vulvar cancer grow slowly, over many years. Less common types, such as melanoma, tend to grow and spread quickly.

Can vulvar cancer be prevented?

The best way to reduce your risk is to get the HPV vaccine to prevent HPV infection. In the United States, adults up to age 45 can get the Gardasil 9® vaccine, depending on their risk of HPV exposure. Cervarix® and Gardasil® are HPV vaccines available in other countries.

If you have any symptoms of vaginal cancer, see a doctor immediately. Schedule regular checkups, including a physical exam at least once a year, for your gynecological health.

How do I take care of myself?

Many people may feel embarrassed or embarrassed about changes in their vagina. But having vaginal cancer doesn't mean you have to give up physical intimacy. Don't be shy about asking your doctor how your diagnosis might affect your sex life. He or she can connect you with resources that can support your physical and emotional needs as you deal with this diagnosis and treatment.

Where does vaginal cancer usually start?

Vaginal cancer usually starts on the surface of the skin around your vagina, either the outer labia majora or the inner labia minora. Less commonly, it can also develop in other parts of the vagina, such as the Bartholin's gland and the clitoris.

What is the first stage of vaginal cancer?

Stage I is the first stage of vulvar cancer. At this stage, the cancer has not spread beyond the vulva or perineum. Stage IA The vulvar cancer is two centimeters (the size of a peanut) or smaller. It has not spread to nearby tissues by more than one millimeter (the size of a pencil tip). Stage IB Cancers are larger and may have spread deep into nearby tissues.

Finally, the most important thing to say to you! (Take-Home Message)

You play a big role in your health. Be aware of every part of your body, including your vagina. Knowing how you look now will help you spot changes later. If you notice any changes, make an appointment to see a doctor right away. In the meantime, never skip a visit to your gynecologist. They can detect pre-cancerous changes before they become serious.

Remember, don't be afraid. Awareness is the greatest strength. You are not alone.

` Vaginitis, female cancer, HPV, vulvar symptoms, cancer treatment, vaginal health, cancer prevention