Vulval Cancer

Vulval cancer is a rare type of cancer that affects the vulva, which is the external part of the female genitalia. It accounts for about 1% of all cancers in women.

Types of Vulval Cancer

• Squamous cell carcinoma: This is the most common type of vulval cancer, accounting for about 90% of cases. It develops from the squamous cells that cover the surface of the vulva.
• Melanoma: This type of vulval cancer develops from the pigment-producing cells called melanocytes. It is more aggressive than squamous cell carcinoma and accounts for about 5% of cases.
• Adenocarcinoma: This type of vulval cancer develops from the glandular cells in the vulva. It is rare and accounts for about 1-2% of cases.
• Sarcoma: This type of vulval cancer develops from the connective tissue in the vulva. It is very rare and accounts for less than 1% of cases.

Causes and Risk Factors

The exact cause of vulval cancer is not known, but certain factors can increase a woman's risk of developing the disease. These include:

• Age: Vulval cancer is most common in women over the age of 60.
• Human papillomavirus (HPV) infection: HPV is a sexually transmitted virus that can cause changes in the cells of the vulva, leading to cancer.
• Smoking: Smoking can increase the risk of developing vulval cancer.
• Weakened immune system: Women with weakened immune systems, such as those with HIV/AIDS or taking immunosuppressive medications, are at increased risk of developing vulval cancer.

Symptoms

The symptoms of vulval cancer can vary depending on the location and size of the tumor. Common symptoms include:

• Abnormal vaginal bleeding or discharge
• Persistent itching or burning in the vulva
• A lump or ulcer in the vulva
• Pain in the vulva or pelvis

Diagnosis

Vulval cancer is typically diagnosed through a combination of physical examination, biopsy, and imaging tests. The diagnosis process may include:

• Physical examination: A doctor will examine the vulva to look for any abnormalities.
• Biopsy: A sample of tissue from the vulva is removed and examined under a microscope for cancer cells.
• Imaging tests: Tests such as ultrasound, CT scan, or MRI may be used to determine the size and extent of the tumor.

Treatment

The treatment for vulval cancer depends on the stage and location of the tumor. Treatment options may include:

• Surgery: Surgery is often the primary treatment for vulval cancer. The goal of surgery is to remove the tumor and any affected tissue.
• Radiation therapy: Radiation therapy may be used to treat vulval cancer that has spread to other parts of the body or to relieve symptoms such as pain.
• Chemotherapy: Chemotherapy may be used to treat vulval cancer that has spread to other parts of the body.

Stages of Vulval Cancer

Vulval cancer is typically staged using the FIGO (International Federation of Gynecology and Obstetrics) staging system. The stages are:

• Stage I: The tumor is limited to the vulva and is 2 cm or less in size.
• Stage II: The tumor is larger than 2 cm but has not spread to other parts of the body.
• Stage III: The tumor has spread to nearby tissues, such as the vagina or anus.
• Stage IV: The tumor has spread to distant parts of the body, such as the lymph nodes or lungs.

Prognosis

The prognosis for vulval cancer depends on the stage and location of the tumor. Generally, the earlier the cancer is diagnosed and treated, the better the prognosis. The 5-year survival rate for women with vulval cancer is:

• 85-90% for Stage I
• 60-70% for Stage II
• 30-40% for Stage III
• 10-20% for Stage IV