Vulval Cancer

Vulval cancer is a rare type of malignancy that affects the outer part of the female genitals: outer vaginal lips, clitoris, and opening of the vagina.

Vulval cancer in India, is rare but not uncommon. This type of cancer forms as a sore or lump on the vulva. It may cause itching and sometimes bleeding. Vulval cancer can occur at any age; however, it is more common in older women.

Types of Vulval Cancer

The most common type of vulval cancer is squamous cell carcinoma. The other rare types of vulval cancer include:

What are the symptoms of vulval cancer?

There are different signs and symptoms of vulval cancer. If you notice any of the following on your genitals, you should consult your doctor promptly:

  • Thickened skin
  • Wartlike bumps or a lump
  • Ulceration
  • Dark discoloration
  • Continuous itching
  • Bleeding
  • Pain and soreness
  • Painful urination or sexual intercourse

Note – Different types of vulval cancer exhibit different symptoms. In some cases, it takes a long time for the symptoms to show. If you notice any odd changes, you should consult with your doctor without delay.

What are the risk factors?

Even though the exact reason for the development of vulval cancer is not known, a few risk factors increase the chances of developing this cancer. Here are some:

  • Age – The risk of development of vulval cancer increases with advancing age. The average age of the patient at the time of diagnosis is around 65 years.
  • Human papillomavirus (HPV): HPV is associated with the development of vulval cancer. This virus is usually spread by sexual intercourse. Safe sex practices such as condom use and HPV vaccination minimize the risk of vulval cancer.
  • Vulval intraepithelial neoplasia (VIN): If your doctor has diagnosed this condition, you have a higher chance of developing this cancer. The good news is that not all ladies with this condition develop cancers. However, one should be aware of the risks and should remain under the doctor’s follow-up.
  • Smoking: As with many other cancers, smoking increases the risk of vulval cancer.
  • Human immunodeficiency diseases (HIV): HIV infection diminishes the body’s immunity. Women living with HIV infection are prone to get vulval cancers.

Management of vulval cancer

Suppose cancer is confined to the genitals and nearby lymph nodes alone. In that case, the doctor will choose a curative approach to eradicate cancer forever. The primary treatment in such an approach would be surgery called radical vulvectomy. The surgeon may remove the lips of genitals, clitoris, part of the vaginal opening, and neighboring skin. Apart from this, the surgeon may also remove lymph nodes in the groin and pelvis where cancer could potentially spread. The extend of surgery depends upon the stage of the disease. Sometimes, adjuvant radiation and chemotherapy might be required after the surgery, based on the final biopsy report.

However, if cancer has spread to other parts of the body, it is generally considered non-curable. In such a scenario, your doctor will choose treatment to decrease the symptoms and increase the patient’s longevity while maintaining a good quality of life. This palliative treatment may include short-course palliative radiotherapy and chemotherapy. In addition, newer treatments such as targeted therapy and immunotherapy are also effective.

Hence early diagnosis is the key. If you notice any unusual changes in your genitals, do not shy away. You should consult your doctor without delay and rule out cancer.

Dr. David K Simson
The author, Dr. David K Simson is a trained radiation oncologist specializing in advanced radiation techniques such as intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), volumetric modulated arc therapy (VMAT) / Rapid Arc, stereotactic body radiotherapy (SBRT), stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS). He is also experienced in interstitial, intracavitary, and intraluminal brachytherapy.