Vulvar cancer can refer to several different types of malignancies that begin on the vulva. The condition is very rare, and it is not well understood by doctors and medical researchers. Most cases are directly linked with human papillomavirus (HPV) infections, but some otherwise healthy women may be genetically predisposed to developing a form of vulvar cancer late in life. Palpable lumps on the vulva, skin thickening and discoloration, and unusual bleeding may all be early warning signs of a tumor. Early detection and surgical treatment is essential in providing the best chances of recovery.
HPV is a common type of sexually transmitted infection in women. There are many different strains of the virus, and most do not lead to cervical or vulvar cancer. If an HPV infection goes unnoticed or it is left untreated for several years, the risk of cancer increases dramatically. In absence of HPV, a familial history of vulvar cancer or skin melanoma makes it more likely that a woman will develop a tumor around the age of 70. Finally, many cases appear to be sporadic and cannot be predicted based on health or genetics.
A tumor can appear anywhere on or around the vulva, but most cancers arise on the labia majora or clitoral hood. Lesions on the labia minora and clitoris are possible, but much less common. Early symptoms of vulvar cancer include thickening and hardening of skin tissue, one or more lumps or lesions, and tenderness. A lesion may bleed, burn, or itch if it breaks open. If vulvar cancer goes untreated, it can potentially spread to the cervix, lymph nodes, or the skin around the external genitalia.
A gynecologist can diagnose vulvar cancer by performing a careful physical examination and collecting a small skin sample for a biopsy. A pap smear test is usually performed as well to confirm or rule out HPV involvement. If cancerous cells are indeed discovered during a biopsy, further diagnostic tests are conducted to make sure the cancer is isolated to the vulva.
Vulvar cancer that is diagnosed in its earliest stages can usually be cured with surgery. A surgeon may choose to excise a tumor with a scalpel or use a laser to ablate superficial cancer cells. If malignancies are deep within skin tissue, a procedure called a vulvectomy may be necessary to remove part or all of the vulva. Chemotherapy, radiation treatments, and additional surgeries can be considered if cancer has already spread.