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What is Vulvar Cancer

Florida Hospital Cancer Institute offers the latest and most effective treatment for vulvar cancer in Orlando for residents of Central Florida and the surrounding regions. Vulvar cancer affects the external genital organs in women. This includes the clitoris, labia (vaginal lips) and the opening of the vagina itself. There are nearly 3,500 new cases each year of vulvar cancer in the United States and 900 die from it. If vulvar cancer is diagnosed early, there’s a good chance that it can be cured. Once the cancer has spread beyond the vulvar, however, it becomes more difficult to treat and the chance of controlling it are diminished. Thankfully, vulvar cancer is relatively rare compared to other forms of cancer. Even so, the Gynecologic Oncology Center is experienced in treating this form of cancer with the latest diagnostics, treatments and procedures. To learn more about treatment for vulvar cancer in Orlando, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

 

Symptoms of Vulvar Cancer

Early detection and treatment of vulvar cancer can greatly improve the survival rate. If you have any of these symptoms, you’ll want to make an appointment to be tested with the Gynecologic Oncology Center as soon as possible. That way, our expert team of physicians and specialists can make an informed diagnosis and discuss treatment options with you if you test positive for vulvar cancer.

Signs and symptoms of Vulvar Cancer

Women with vulvar cancer may have the following symptoms:

  • Itching in the area of the vulvar that lasts more than a month
  • A cut or sore on the vulva itself that won’t heal
  • A lump or mass on the vulva
  • Vulvar pain
  • Bleeding from the vulva that isn’t related to your monthly cycle
  • A burning sensation that won’t go away, even with treatment
  • And changes in the size, texture or color of a birthmark or mole in the area of the vulva
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Causes of Vulvar Cancer

Vulvar cancer usually develops over time. Known as vulvar intraepithelial neoplasia, or dysplasia, the abnormal cells take time to grow on the surface of the vulvar skin. Vulva cancer is essentially skin cancer of the vulva. 

Vulvar Cancer Statistics

  • In the U.S. vulvar cancer accounts for 4% of all cancers of the female reproductive organs. According to the American Cancer Society, nearly 3,500 women develop vulvar cancer each year and about 900 will die from the cancer.
  • Vulvar cancer is most prevalent in women ages 55 to 85, though it can also occur in women who are younger than 40.
  • 90% of all vulvar cancers are squamous cell carcinomas, a type of skin cancer. A small percentage of vulvar cancers start out as melonomas. 
  • When the cancer is restricted to the vulva, the survival rate is extremely high, over 90%. If the cancer has spread to the surrounding lymph nodes, the survival rate drops to 50% to 70%.
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Stages of Vulvar Cancer

Staging is used by the Gynecologic Oncology Center to determine the extent of vulvar cancer.

Following are the stages of vulvar cancer:

Stage 0 Vulvar Cancer - Cells are found on the surface of the skin of the vulvar. These cells are abnormal and may become cancerous, but haven’t yet.

Stage 1 Vulvar Cancer - Cancer has formed and is located in the vulva or the vulva and the perineum only. The tumor is no larger than 2 centimeters and has spread to the epidermis of the vulva.

Stage 1A: The tumor has spread to a depth of 1 millimeter or less beneath the epidermis.

Stage 1B: The tumor is greater than 1 millimeter beneath the epidermis.

Stage 2 Vulvar Cancer - Cancer is found only in the vulva or the vulva and perineum and the tumor is larger than 2 centimeters.

Stage 3 Vulvar Cancer - Cancer is of any size and is either:

Found in the vulva alone or in the vulva and perineum. It has also spread to the nearby lymph nodes in one groin, or

Has spread to nearby tissues such as the lower part of the urethra and or vagina and/or anus. It may have also spread to the nearby lymph nodes in one groin.

Stage 4 Vulvar Cancer

Stage 4A: Cancer has spread to the lymph nodes in both groins or has spread to the upper part of the urethra, bladder or rectum. It may have also become attached to the pelvic bone.

Stage 4B: Cancer has spread to distant parts of the body involving other organs and tissues.

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Tests to Diagnose Vulvar Cancer

Tests to diagnose vulvar cancer may include the following:

  • Physical exam and history: Your physician will perform an initial exam of your body to check general signs of health, including signs of disease in the vulva (such as lumps or anything unusual). 
  • Biopsy: During this procedure, a sample of cells or tissue is removed from the vulva in order to be analyzed under a microscope by a pathologist for signs of cancer. 
  • Colposcopy: During this procedure, a small lighted, magnifying instrument is used to check the vagina and cervix for abnormalities. 
  • Cystoscopy: Your physician looks inside your bladder and uretrha to check for abnormalities. 
  • Proctoscopy: Your physician looks inside the rectum and anus to check for abnormalities. 
  • X-rays: Using energy beams that go through the body, an x-ray makes a picture of the inside of your body. 
  • Intravenous pyelogram (IVP): During this procedure, a series of x-rays are taken of the kidney, ureters, and bladder to find out if cancer has spread to these organs. 
  • CT scan (CAT scan): A CT scan takes a series of very detailed pictures of the inside of the body from different angles. 
  • MRI (magnetic resonance imaging): This procedure uses a magnet, radio waves, and a computer to make a series of detailed images of the inside of the body. 
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. 
  • Sentinel lymph node biopsy: The removal of the sentinel lymph node during surgery. 

Research

A lot of research is currently underway to find ways to prevent and treat vulvar cancer.

Oncognes and tumor suppressor genes  - Scientists have begun to learn more about oncogenes and tumor suppressor genes that control cell growth and turn normal cells into cancerous ones. The goal is to develop a gene therapy that will replace the damaged genes in the cancer cells with normal ones to stop their abnormal behaviors.

HPV vaccines - Currently, Gardisil is the only vaccine approved for use to treat HPV infections. With this initial success, it’s hoped that other vaccines can be developed to treat other types of HPV that can cause female reproductive cancers. 

Other vaccines are being investigated to help women who have vulvar cancer (therapeutic vaccines). These vaccines are intended to create an immune reaction in parts of the virus that contribute to the abnormal growth of cells, specifically the E6 and E7 proteins. It’s hoped that this immune reaction will kill the cancer cells or stop them from growing more.

Combined therapies - Finally, researchers are looking at the most effective ways to combine surgery, radiation therapy and chemotherapy to combat vulvar cancer. Clinical trials are investigating how radiation after surgery can contribute to the killing of cancer cells. Other trials are studying the effectiveness of chemotherapy or pelvic radiation therapy to treat cancer that has spread to the lymph nodes.

Clinical trials are underway on a number of fronts. Currently, the National Cancer Institute lists nearly 50 trials being conducted for vulvar cancer and the Gynecologic Oncology Center offers patients one of the widest ranges of clinical trial options in the nation. Many of these promising treatments won’t be available to the general public for months, if not years, to come.

For a complete list, click here.

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Risk Factors of Vulvar Cancer

While the cause is not generally known, there are certain risk factors that increase the chance you will develop vulvar cancer.

Risk factors include:

  • An HPV infection (human papillomavirus) or history of Condyloma (warts)
  • Age greater than 40
  • History of smoking

Early signs and symptoms of vulva cancer include:

  • A lump in the vulva
  • Bleeding that is not related to menstruation
  • Itching in the vulva region that won’t go away, even with treatment
  • Tenderness in the area of the vulvar

Women who have one or more of these risk factors should let their doctor know about them. This will allow your doctor to monitor your health and look for additional signs of vulvar cancer. Early detection and treatment is essential to improving survivability.

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Treatment for Vulvar Cancer

Depending on the size and stage of the cancer, your physician may recommend the following treatments for vulvar cancer:

Surgery
In most cases, surgery will be the initial treatment for vulvar cancer. The goal of surgery will be to remove as much of the cancer without limiting any of the woman's sexual function. 

Radiation Therapy
Depending on the stage of the cancer, either external or internal radiation may be recommended in order to kill any remaining cancer cells. 

Chemotherapy
Dependant upon the stage of the cancer, your physician may recommend chemotherapy for treating vulvar cancer. During this procedure, special drugs are used to stop the growth of cancer cells. 

Biologic Therapy
Biologic therapy (also called immunotherapy) focuses on using the patient's immune system to fight the cancer. Substances made naturallly by the body or in a laboratory are used to boost, direct, or restore a patient's natural immune system defense against cancer. 

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Request an Appointment

To learn more about treatment for vulvar cancer in Orlando, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

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