Vulval Intrapithelial Neopasia (VIN) is a pre-cancerous condition of the vulva, the opening to the vagina. Changes occur in the top layer of skin that may develop into cancer over time, or may not. Having these pre-cancerous cells does not mean you have cancer, just that you are at a higher risk of getting it.
So few studies have been done into vulval cancer, that scientists aren’t sure of its relationship with VIN.
VIN has no relation to the HPV virus.
Types of VIN
There are three types of VIN:
• VIN 1 – only one third of the cells examined in the top layer of skin are pre-cancerous. This is the mildest form of VIN.
• VIN 2 – two thirds of the cells examined are abnormal.
• VIN 3 – all of the cells present in the epidermis are abnormal. This is the most severe type of VIN and is the most common presentation, maybe because women often do not show symptoms in milder forms.
Symptoms of VIN
Symptoms include vulval pain that has not been attributed to another condition, pain with intercourse, vulval itching which can be severe and a lump at the vulval opening.
Some women do not have any signs that they have VIN and it is only detected at a routine Pap smear or other examination.
How is VIN Diagnosed?
If your gynecologist suspects that you have VIN, based upon an examination, he will order a biopsy. A tiny amount of tissue will be taken from the area and looked at under a microscope to see if there are any cell changes. This is the only way VIN can be diagnosed.
Treatment for VIN
Often, treatment is not required and the gynecologist will just monitor you at regular check ups to ensure you aren’t developing cancer. This is because some women who have cells considered to be abnormal do not develop cancer.
If symptoms are problematic or there is a lump in the skin, laser treatment may be offered to remove the affected skin. This will be done under general anesthetic so you don’t feel any pain.
You will be in pain afterwards, during the recovery period and you’ll require quite strong pain relief.
Although the procedure does not normally scar like surgery does, it is an unpopular method of treatment due to the pain it causes. It is also fairly common for VIN to reoccur after laser treatment.
Surgery can be done. Usually the affected area can be removed without damaging the vulva but in some cases, if a large area of tissue has to be removed, this can disfigure the vulva. You may also experience pain with sex and scar tissue problems.
Topical medication can be given that helps trigger the body’s own immune system to attack the pre-cancerous cells by releasing cytokines into the body. However, it has an unpleasant burning side-effect that many women cannot tolerate which means that some may discontinue treatment before it has had chance to take effect.
Other ways you can prevent VIN are by quitting smoking. A larger number of smokers get VIN than non-smokers. Making sure you keep your vulval area clean with warm water is also important. Avoid the use of soaps as these can irritate and also disrupt the natural balance of the vagina, which may make VIN and vulval pain disorders more likely.
Eating a healthy diet, regular exercise and getting enough sleep can also help your immune system combat any abnormal cell changes.
Source: The Vulval Pain Society, UK.
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.