Early symptoms of vulvar cancer

viulva

The appearance of early symptoms of vulvar cancer depends on whether it is pre-cancer or cancer, and also on the type of cancer. For example, vulvar intraepithelial neoplasia – a precancerous condition that consists of changes in the skin covering the vulva – tends to be asymptomatic, or have symptoms that can be caused by other conditions and are as such difficult to identify, even for physicians. However, the most common form of vulvar cancer is squamous cell carcinoma, which accounts for about 90% of vulvar cancers. This type of cancer almost always has symptoms.

Vulvar cancer symptoms include:

·         Persistent itching or burning in the vulva.

·         Pain and tenderness in the vulva.

·         Non-menstruation bleeding.

·         Changes in the color (looking redder or whiter, or darker or lighter than usual) and thickness of the skin of the vulva.

·         A lump, bumps resembling genital warts, or an open ulcer in or on the vulva that last longer than one month.

·         Pain in the pelvis when urinating or during intercourse.

·         A change in the appearance of an existing mole (vulvar melanoma).

Researchers do not know the exact cause of vulvar cancer, but have been able to determine certain risk factors for this condition, including:

Risk factors

·         Age

Vulvar cancer can occur at any age, and 15% of women who develop it are under 40 years of age, but it is more common in women older than age 50.

·         Smoking

Each of these three is a risk factor in its own right, and even more so when combined. HIV may make a woman more vulnerable to HPV infections, and a woman has HPV and smokes may be at an increased risk of vulvar cancer. And HPV increases the risk of several types of cancer such as vulvar and cervical cancers.

·         Exposure to human papillomavirus (HPV)

·         HIV infection

·         A history of precancerous conditions

Of the vulva, cervix, vagina, or melanoma anywhere on the body.

·         Lichen sclerosus

A condition that affects the vulvar skin. Approximately 4% with this condition develop vulvar cancer.

·         Other

Starting sexual life early, multiple sexual partners, neglecting safe sex, failing to have regular gynecologic exams to check for precancerous conditions.

 

It is very important to identify the early symptoms of vulvar cancer so as to be able to let a doctor know about them, but it is even more important to get regular well-woman visits in order to screen for this condition and, if detected, treat it early when the outlook is more positive.

There is no single, specific test to screen for or diagnose vulvar cancer, but the following are commonly used:

·         Pelvic examination.

·         Biopsy.

·         Lymph node sampling.

·         X-ray.

·         Endoscopy.

·         Cystoscopy.

·         Proctoscopy.

·         Computed tomography scan.

·         Magnetic resonance imaging.

·         Positron emission tomography.

These tests help find tumors and set the stage of the cancer.

Vulvar cancer staging

Stage

Description

0

Very early cancer found only on the surface of the skin of the vulva where it started.

I

The tumor is smaller than 2cm and located in the vulva or the perineum (or both) and has not spread to lymph nodes or distant organs.

IA

The tumor is smaller than 2cm and has grown no deeper than 1mm into the underlying tissue.

IB

The tumor is larger than 2cm and/or has grown deeper than 1mm.

II

The tumor is larger than 2cm and has invaded the vulva or perineum to the anus or lower third of the vagina or urethra, but has not spread to lymph nodes or distant organs.

 

IIIA

Located in the vulva or perineum (or both) and may be invading the anus, lower vagina, or lower urethra. It has either spread to one regional lymph node covering a surface of 5mm or larger, or it has spread to 1-2 regional lymph nodes covering an area smaller than 5mm. It has not spread to distant organs.

 

IIIB

Located in the vulva or perineum (or both) and may be invading the anus, lower vagina, or lower urethra. It has either spread to 3 or more regional lymph nodes covering a surface smaller than 5mm, or it has spread to 2 or more regional lymph nodes covering an area of 5mm or larger. It has not spread to distant organs.

 

IIIC

Located in the vulva or perineum (or both) and may be invading the anus, lower vagina, or lower urethra. It has spread to regional lymph nodes and began to grow through the external covering of at least one lymph node. It has not spread to distant organs.

 

 

IVA

Located in the vulva or perineum (or both) and may be invading the anus, lower vagina, or lower urethra. It has spread to regional lymph nodes causing them to stick to the underlying tissue, or has caused open ulcers. It has not spread to distant organs; or, it has spread outside regional tissues to the bladder, rectum, pelvic bone, or superior part of the urethra. It may or may not have spread to regional lymph nodes.

IVB

It has spread to distant sites or lymph nodes.

 

The location and extent of the cancer also helps healthcare providers establish a survival prognosis, depending on whether the cancer is local, regional, or distant.

5-year survival rates

Local. Found in the vulva, has not spread to lymph nodes or regional tissues. Equivalent to stages I and II.

86%

Regional. Has spread to regional lymph nodes or tissues but not to distant sites. Equivalent to stages III and IVA.

54%

Distant. Has spread to distant sites and tissues. Equivalent to stage IVB.

16%

 

The treatment for vulvar cancer is based on the type and stage of the tumor. Alternatives include:

·         Surgery

-        Laser surgery. Burns pre-cancers off the skin with a focused light beam.

-        Excision. Removes the tumor and some of the normal tissue around it.

-        Partial vulvectomy. Removes part of the vulva and underlying tissue.

-        Radical vulvectomy. Removes the entire vulva, clitoris, and underlying tissue.

·         Radiation therapy.

·         Chemotherapy.

 

Related Read:

- Early symptoms of gynecologic cancers

- Early symptoms of ovarian cancer