Vulvar Cancer

Cancer of the vulva forms in the vulva, the external genital organ area of a woman. The vulva includes these parts:

• Labia—the lips around the opening of the vagina;
• Clitoris—a small mass of tissue at the opening of the vagina; and
• Bartholin's glands—small mucus-producing glands on either side of the vaginal opening.

It is crucial for women to be aware of their risk of vulvar cancer and remain vigilant about changes in their bodies, discussing any concerns with a doctor.

Vulvar cancer is a relatively rare malignancy that can develop on any part of the external genital organs, but most often affects the labia majora or labia minora. Accounting for 0.6 percent of all cancers in women, vulva cancer typically forms slowly over many years. Nearly 90 percent of vulvar cancers are squamous cell carcinomas, with melanoma being the second most common type, usually found in the labia minora or clitoris. Other types of vulvar cancer include:

• Adenocarcinoma
• Paget's disease
• Sarcomas
• Verrucous carcinoma
  

Basal cell carcinoma

A risk factor is any element that could increase an individual's likelihood of developing a disease. It can be an activity, such as smoking, diet, family history, or other variables. Different diseases, including cancers, are associated with different risk factors.

It is important to note that having one or more risk factors doesn't guarantee the development of a disease. Some individuals with identified risk factors never experience the associated disease, while others may develop the disease without apparent risk factors.

Understanding your risk factors for any disease can be helpful in appropriate actions, including changing behaviours and undergoing clinical monitoring for early detection and intervention. 

The following have been suggested as risk factors for vulvar cancer:

• Age of the women who develop vulvar cancer, about 75% are over age 50, and half over age 70
• Chronic vulvar inflammation
• Infection with the human papillomavirus (HPV)
• Human immunodeficiency virus (HIV) infection
• Lichen sclerosus - can cause the vulval skin to become very itchy and may slightly increase the possibility of vulvar cancer
• Melanoma or atypical moles on non-vulvar skin - a family history of melanoma and dysplastic nevi anywhere on the body may increase the risk of vulvar cancer
• Low socioeconomic status
• Vulvar intraepithelial neoplasia (VIN), a pre-cancer lesion, although most cases do not progress to cancer
• Other genital cancers
• Smoking 

The following are the most common symptoms of vulvar cancer. However, individual experiences with symptoms can vary. Common symptoms may include:

• Constant itching;
• Changes in the colour and the appearance of the vulva;
• Bleeding or discharge not related to menstruation;
• Severe burning/itching or pain; and
• Skin of the vulva appears white and feels rough.
  

The symptoms of vulvar cancer may resemble those of other conditions or medical problems. Please consult your doctor when in doubt.

Vulvar cancer is diagnosed by biopsy, which involves the removal of a tissue section for examination by a pathologist.

This may involve any or all of the following:

• Surgery, including:
• Excision, whereby the cancer cells and a margin of normal appearing skin around the cancer is removed.
• Vulvectomy, which is the surgical removal of part or all of the tissues of the vulva.
• Lymph node removal, involving the removal of glandular tissues in the groin.
• Radiation therapy
  
• Chemotherapy