On Vulvar Cancer, One of the Most Overlook Female Cancer

By | 30/03/2020
vulvar cancer

When we’re talking on the issue of women’s health, especially women cancer, it’s easy to overlook vulvar cancer. Despite its low rate of incidences, vulvar cancer deserves a highlight as women with certain risk factors may develop it at any particular age. Vulvar cancer learned as one that grows slowly but still matters as it affects women’s quality of life.

Just like the name, vulvar cancer is a malignancy that occurred on the vulva, the outer surface area of woman genitalia. Vulva itself is an epithelial skin which prone to be more sensitive compared to others. Hence, the discourse on vulvar cancer will have a close relation to skin cancer that we might have known prior.

Learning Anatomy and the Symptoms

As we’re learning more in-depth on the anatomy of a woman’s reproductive organs, we will learn about the vulva. It’s the term that we used to describe the thin skin surrounds urethra and vagina. This way, vulva will include labia majora or sometimes called as the outer lips, labia minora as the inner lips, and also clitoris. Vulvar cancer usually affects the labia parts.

Compared to other female cancer that mostly occurred in a young adult, this vulvar cancer is more likely to happen in postmenopausal ladies.  More than half of the patients are above 56 years old. Interestingly, a younger case might happen too.

There are at least four types of vulvar cancer, with squamous cell becomes one of the most common vulvar cancer. The squamous is the thin flat cells that cover the surface of the vulva. The other type is vulvar melanoma that begins in the pigment-producing cell and adenocarcinoma that starts in the gland cell. The rarest type is the sarcoma found in the muscles, bone, and interconnective tissue, and severely can affect children too.

Most of the patients reported itchiness, burning sensation, and soreness that lasts for more than a month. In the younger patients, abnormal vaginal discharge and bleeding out of a reasonable period did happen. Aside from that, vulvar cancer symptoms bring skin changes such as discoloration, thickening, and even the growth of lump and ulcer.

Within this condition, it’s possible to experience discomfort during sexual intercourse. If you’re noticing that you’re recently developing any of these symptoms, you might need to go to see your physician.

Causes and Risk Factors

Similar to most non-communicable diseases, let alone cancer, there is no single contributor for the vulvar cancer cause. It’s pretty hard to determine what makes the cell grows abnormally, invading the healthy cells, and then spreading to other organs. However, some risk factors contribute to the growth of vulvar cancers, such as:

1. Smoking

Smoking is one of the most leading factors that relate to increasing cancer cases all over the world. A smoker may develop certain types of cancer in many stages of life.

2. Increasing Ages

It happens naturally, and none can avoid it. Getting older is automatically put women on more risks of getting vulvar cancer, mostly due to the change of skin.

3. Being Immunocompromised

It’s when you’re having an autoimmune disease, HIV, or currently taking any immunosuppressant drugs. With any of these underlying issues, then your risk of getting a vulvar cancer is slightly higher compared to those immunocompetent people.

4. Being Exposed to HPV

If you had a history of getting infected with HPV, then you need to be very careful. It increases the risk of not only developing cervical cancer, but also vulvar cancer. However, please note that this is usually happening to women at a younger age, especially under 30.

5. Having History of Precancerous Cells

A few women with vulvar cancer reported having a precancerous lump that is known as Vulvar Intraepithelial Neoplasia (VIN). It makes the vulva becomes red, thicker, and sometimes darker.

Please note that having those risk factors doesn’t mean that sooner or later, you’ll be catching the vulvar cancer diagnosis. It’s an underlying factor that might relate to, and you might take this as an alarming message to reduce your risk factors while it’s possible.

Preventing and Early Detection

Adopting a healthy lifestyle will surely help you in preventing vulvar cancer. Increasing the intake of balanced diets, exercise, sleep, managing stress, and not smoking are the best investment in the long run. However, you can also add another intervention like getting an HPV vaccine, stick to safe sexual intercourse, and getting a regular check-up.

Due to its low number of cases, until this time, there’s no standard for early detection of vulvar cancer. This circumstance means that women need to be assertive and do regular self-monitor. With this kind of awareness, the medical world expects that any of the early symptoms will get checked earlier too.

Having regular monitoring should never be a daunting activity as you can also have it while getting a pap test. Your gynecologist will check your medical histories, and do a physical exam like checking uterus, cervix, vagina, and ovary. If there’s any suspicious symptom, then you might be referred to a gynecologist oncologist who had years of experience in handling female genital cancer.

Diagnosis and Staging

It takes some testings to get to know whether a woman is getting vulvar cancer. One of its testing methods is by using a designated magnifying device to get a closer look inside. This method is called a colposcopy. If the oncologist found a vulvar cancer lump, then a biopsy should be done. In this procedure, the physician will take a sample tissue and examine it under the microscope.

Another standard procedure has a blood test to get the overall look of health conditions in general. In the advanced case and to anticipate the possibility of having spread and event a distant metastasizing, some imaging procedures will be taken. Some of them are x-raying chest, CT-Scan, MRI, and PET-Scan. After all the processes,  it will be easier to know the diagnosis and staging.

vulvar cancer 2

Vulvar cancer staging is almost no different than any other cancer. Three main aspects contribute, the size of the tumor, the involvement of lymph nodes, and also whether there’s a distant spread to any other organs.

Stage 1 is marked by a small tumor no more than 2 cm that confined in the vulva. Stage 2 is almost the same as stage 1; only the tumors have grown to lower portions of urethra, vagina, and anus. While the vulvar cancer stage 3 is starting to get more alarming as cancer has spread to lymph nodes. Lastly, stage 4 vulvar cancer symptoms, which are a terminal stage, are marked by a distant metastasized to bladder, rectum, and even pelvic bone.

Vulvar Cancer Treatment

Knowing the staging of vulvar cancer is beneficial to decide which treatment or which regiment might works best in the situation. When it comes to cancer, it’s reasonable to take more than one medication. Here are the most common treatment for treating vulvar cancer:

1. Vulvectomy

It’s a surgical procedure to remove the tumor and a healthy tissue that surrounds it. There’s a partial vulvectomy and also a radical one. An option for total vulvar cancer surgery is almost rare, especially as there’s a risk for infection, complication, and problems with the healing. Most women will feel numbness, and it might affect sexual life

2. Radiations

This treatment uses an external beam that will target the surface of the cancerous vulva. In some cases, it needs to be performed before the vulvectomy to shrink the cells.

3. Chemotherapy

Usually performed after the vulvectomy, chemotherapy uses chemical drugs to kill the cells. This procedure is administered through a vein or sometimes taken orally.

vulvar cancer 3

Post-Treatment

The post-treatment also determines the betterment of a vulvar cancer prognosis, so here’s to the importance of having a follow-up. In the first two years after diagnosis, usually, the patient needs to come back for a check-up every two to three months. If it’s all went well, in the third year, the visit frequency might set to two times in a year. When no recurrence happens until the fifth year, then the patient is stepping ahead into the remission stage. Hopefully, this can be an answer to the question of can vulvar cancer be cured.

Closing: On Navigating Life as a Cancer Survivor

Getting through a cancer diagnosis is a life-altering journey, and it takes a lot of determination, self-compassion, and support. While it can be daunting to see how cancer affects the body, especially as a woman, but this invisible illness can be detrimental too to the mental health condition. Hence, it’s essential to find reliable support and making sure that you’re not fighting alone.

Some of the best advice is to get the team of doctors that you trust, connect to others who go through the same diagnosis, and talk to your inner circle on how you feel. Vulvar cancer has affected many lives, and everyone needs to know that this type of female cancer does exist. With the increase of awareness, come a better understanding that leads to better knowledge in handling cancer the right way.

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