1) Vulvar cancer is a rare form of cancer and accounts for about 4 percent of cancers of the female reproductive organs. An estimated 4,340 new cases will be diagnosed in the United States in 2011. It is most commonly diagnosed in older women. The average age at diagnosis is 65. In 2011, an estimated 940 women will die of vulvar cancer.
2) Vulvar cancer forms on the outer surface of the vulva, which is a woman’s external genitalia. The vulva includes the inner and outer lips of the vagina, the clitoris and the opening of the vagina. It most often affects the outer vaginal lips. The inner vaginal lips and clitoris are less often affected.
3) The exact cause is unknown, but certain risk factors have been identified. The risk for developing vulvar cancer increases with age, exposure to the human papillomavirus or HPV, a history of smoking, infection with the human immunodeficiency virus or HIV, having vulvar intraepithelial neoplasia, which is a precancerous condition involving the vulva, and lichen sclerosus, which is a skin conditon involving the vulva.
4) Ongoing research in the field of genetics reveals a correlation between DNA mutation and the increased risk for developing cancer. HPV appears to have a role in up to half of all cases of squamous cell cancer of the vulva. This is seen in cases of younger women who often are smokers. Mutations of the p53 tumor suppressor gene were seen in cases of vulvar cancer in women who were over the age of 55.
5) Routine pelvic exams and awareness of the signs of vulvar cancer greatly improve the chances of early detection. Signs include a lump or wart-like bump on the vulva, persistent vulvar itching or tenderness, changes in the color and thickness of vulvar skin and vaginal bleeding that is not associated with menstruation.
6) Diagnosis is made by pelvic examination, colposcopy examination, which allows a physician to closely examine vulvar tissue, and biopsy of suspicious tissue. Upon confirmation of diagnosis, the tumor is staged or classified based on the extent of the tumor, whether it has spread to the lymph nodes and whether the cancer has spread to distant parts of the body.
7) Treatment options depend on the patient’s age, overall health and the type and stage of the tumor. Laser therapy uses a laser beam to remove cancerous cells. Surgical options include wide local incision, radical local incision and a vulvectomy. A vulvectomy is a surgical procedure to remove part of or all of the vulva. Radiation therapy and chemotherapy may be used after surgical removal of the cancer.
Sources:
American Cancer Society: Vulvar Cancer/ Statistics
http://www.cancer.org/Cancer/VulvarCancer/DetailedGuide/vulvar-cancer-key-statistics
Cleveland Clinic: Vulvar Cancer
http://my.clevelandclinic.org/disorders/vulvar_cancer/hic_vulvar_cancer.aspx
Mayo Clinic: Vulvar Cancer Risk Factors
http://www.mayoclinic.com/health/vulvar-cancer/DS00768/DSECTION=risk-factors
American Cancer Society: Vulvar Cancer/Causes
http://www.cancer.org/Cancer/VulvarCancer/DetailedGuide/vulvar-cancer-what-causes
Mayo Clinic: Vulvar Cancer Symptoms
http://www.mayoclinic.com/health/vulvar-cancer/DS00768/DSECTION=symptoms
National Cancer Institute: Vulvar Cancer Treatment
http://www.cancer.gov/cancertopics/pdq/treatment/vulvar/Patient/page4
Reviewed August 10, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith