Vulvar cancer: Causes, symptoms, and treatments

Vulvar cancer, or vulval cancer, is a relatively rare type of cancer that affects the vulva, the external genital organs that protect a woman’s reproductive system.

It is most likely to appear in the outer vaginal lips. Typical symptoms include a lump, itching, and bleeding.

Vulvar cancer accounts for around 0.6 percent of all cancers in women. The American Cancer Society predict that in 2017 there will be about 6,020 diagnoses of vulvar cancers in the United States, and that 1,150 women will die of vulvar cancer.

Fast facts on vulvar cancer:

Here are some key points about the vulvar cancer. More detail is in the main article.

Vulvar cancer affects the external genital organs of a woman, most commonly the outer lips of the vagina.

Symptoms include a lump, itching, and bleeding, and with some types discoloration of the skin and pain.

Early diagnosis increases the chance of successful treatment dramatically, but without treatment, cancer can spread to other parts of the body.

Regularly attending smear tests and checking for changes to the vaginal lips can help diagnose vulvar cancer in the early stages.

Avoiding smoking and unprotected sex can reduce the risk.

Types

pelvic pain
Symptoms of vulvar cancer include itching and pain.

The vulva includes the labia majora, mons pubis, labia minora, clitoris, the vestibule of the vagina, the bulb of the vestibule, greater and lesser vestibular glands, and vaginal orifice.

Vulvar cancer most commonly affects the outer lips of the vagina.

Cancer that originates in the vulva is called primary vulvar cancer. If it starts in another part of the body and then spreads to the vulva, it is called secondary vulvar cancer.

There are several types of vulvar cancer.

Squamous cell carcinoma affects the flat, outer layers of skin. In medicine, the word squamous refers to flat cells that look like fish scales. About 90 percent of all vulvar cancers are squamous cell carcinomas. It takes several years for noticeable symptoms to develop.

Vulvar melanoma accounts for about 5 percent of all vulvar cancers. A melanoma presents as a dark patch of discoloration. There is a high risk of this type of cancer spreading to other parts of the body, a process known as metastasis. It may affect younger women.

Adenocarcinoma originates in glandular tissue, and in this case, the cells line the glands in the vulva. It accounts for a very small proportion of vulvar cancers.

Sarcoma originates in the connective tissue. Most cancers of this type are malignant. It is rare.

Verrucous carcinoma is a subtype of the squamous cell cancer, and it tends to appear as a slowly growing wart.

The outlook is normally good if diagnosis happens in the early stages, before the cancer spreads, and if the woman receives prompt and appropriate treatment.

Signs and symptoms

The first sign is usually a lump or ulceration, possibly with itching, irritation, or bleeding.

Sometimes, a woman may not seek medical help at once due to embarrassment, but an early diagnosis will improve the outlook.

Most typical symptoms include:

painful sexual intercourse

bleeding

pain and burning

dark discoloration in cases of melanoma

painful urination

persistent itching

rawness and sensitivity

wart-like growths

thickened skin

ulceration

Different types of vulvar cancer may have different symptoms, and in some cases, there may be no noticeable symptoms. Any changes that take place should be checked with a doctor.

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Causes

Cancer happens when cell growth is out of control.

Most cancers harm the body when damaged cells divide uncontrollably to form lumps or masses of tissue, or tumors. Tumors can grow and affect body function. A benign tumor stays in one place and does not spread, but a malignant tumor spreads and causes further damage.

Malignancy occurs when two things happen:

a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue via a process called invasion.

the cell divides and grows through a process called angiogenesis, making new blood vessels to feed itself.

Without treatment, cancer can grow and spread to other parts of the body. This is called metastasis. If it enters the lymphatic system, it can reach other parts of the body, including vital organs.

Risk factors

Experts do not know exactly why cells start to grow too fast, but certain risk factors increase the chance of developing the disease.

Age: Over half of all cases are in women aged over 70 years, and fewer than 1 in 5 occur before the age of 50 years.

Human papilloma virus (HPV): Women infected with HPV have a higher risk of developing vulval cancer.

Vulvar intraepithelial neoplasia (VIN): This is a general term for a precancerous state, in which certain cells within the vulvar epithelium have a range of low-grade carcinoma. Women with VIN have a significantly higher risk of developing vulvar cancer.

Lichen sclerosus et atrophicus (LSA): This causes the skin to become thick and itchy, and it may increase the susceptibility to vulvar cancer slightly.

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