Vulvar Cancer Diagnosed and Treated by Mercy Gynecologic Oncologists

Vulvar cancer forms on the outer surface of the vulva. A rare cancer that mostly affects older women, vulvar cancer develops slowly as abnormal cells can grow for a long period of time eventually forming lumps or sores. These growths need to be tested for vulvar cancer. In some cases, they are a precancerous condition known as vulvar intraepithelial neoplasia (VIN) or dysplasia.

Vulvar Cancer Symptoms

Vulvar cancer develops over time and does not present any early symptoms. If women suspect they have any abnormalities or have unusual symptoms, they should seek the advice of doctors who are best at detecting vulvar cancer. Some abnormalities that could lead to vulvar cancer include:

• Lump in the vulva
• Itching, burning, or tenderness
• Bleeding not from the menstrual cycle
• Pain
• Skin changes including abnormal coloring or thickening

Tests for Vulvar Cancer

There is not a standard test to detect vulvar cancer. If vulvar cancer is suspected, a thorough pelvic exam should be conducted. If any suspicious growths or abnormalities are found, a biopsy may be conducted to test for the presence of vulvar cancer cells. Because there is not a standard test for vulvar cancer, it is important for women to have annual pelvic exams so any abnormalities can be detected and treated prior to becoming vulvar cancer.

Stages of Vulvar Cancer

Determining the stage of vulvar cancer is important in developing an appropriate treatment plan. At The Gynecologic Oncology Center at Mercy, Dr. Dwight Im, Dr. Neil Rosenshein, and Dr. Hyung Ryu, are among the best doctors to effectively stage vulvar cancer. Though it is most often detected early, the stages of vulvar cancer include:

• Stage I - vulvar cancer is limited to the vulva area
• Stage II - vulvar cancer spreads to the lower portions of the urethra, vagina, and anus
• Stage III - vulvar cancer spreads to the lymph nodes
• Stage IVA - vulvar cancer spreads to the upper portions of the urethra or vagina as well as to the bladder, rectum, and pelvic bone
• Stage IVB - vulvar cancer spreads to other parts of the body

Surgery is most often the course of treatment for vulvar cancer. The extent of surgery is determined by the stage of the vulvar cancer. For early stages, the cancer tumor is removed along with a margin of healthy tissue to help ensure all the cancer is removed and limit the possibility of recurrence.

A partial vulvectomy or a radical vulvectomy are performed in the later stages of vulvar cancer. In a partial vulvectomy, part of the vulva along with surrounding tissue is removed. In a radical vulvectomy, the entire vulva and underlying tissue is removed. If the vulvar cancer has spread to other organs, surgery also may include removing the other affected areas.

Radiation and chemotherapy also can be used in combination or individually prior to or following surgery. Radiation can be used to shrink the vulvar cancer tumor prior to surgery. Chemotherapy is administered to help kill the vulvar cancer cells and in some instances help radiation be more effective.