Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Mayo Clinic in Minnesota has been recognized as the best Gynecology hospital in the nation for 2014-2015 by U.S. News & World Report.

Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia. The vulva is the area of skin that surrounds the urethra and vagina, including the clitoris and labia.

Vulvar cancer commonly forms as a lump or sore on the vulva that often causes itching. Though it can occur at any age, vulvar cancer is most commonly diagnosed in older women.

Vulvar cancer treatment usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. Sometimes vulvar cancer surgery requires removing the entire vulva. The earlier vulvar cancer is diagnosed, the less likely an extensive surgery is needed for treatment.

Source: http://www.mayoclinic.com

Signs and symptoms of vulvar cancer may include:

• Itching that doesn't go away
• Pain and tenderness
• Bleeding that isn't from menstruation
• Skin changes, such as color changes or thickening
• A lump, wart-like bumps or an open sore (ulcer)

When to see a doctor

Make an appointment with your primary care doctor or gynecologist if you experience any vulvar signs or symptoms that worry you, such as:

• Abnormal bleeding
• Burning
• Itching
• Pain

Source: http://www.mayoclinic.com

It's not clear what causes vulvar cancer. In general, doctors know that cancer begins when a cell develops mutations in its DNA. The mutations allow the cell to grow and divide rapidly. The cell and its offspring go on living when other normal cells would die. The accumulating cells form a tumor that may be cancerous, invading nearby tissue and spreading to other parts of the body.

Types of vulvar cancer

The type of cell in which vulvar cancer begins helps your doctor plan the most effective treatment plan. The most common types of vulvar cancer include:

• Vulvar squamous cell carcinoma. This cancer begins in the thin, flat cells that line the surface of the vulva. Most vulvar cancers are squamous cell carcinomas.
• Vulvar melanoma. This cancer begins in the pigment-producing cells found in the skin of the vulva.

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Diagnosing vulvar cancer

Tests and procedures used to diagnose vulvar cancer include:

• Examining your vulva. Your doctor will likely conduct a physical exam of your vulva to look for abnormalities.
• Using a special magnifying device to examine your vulva. During a colposcopy exam, your doctor uses a device that works like a magnifying glass to closely inspect your vulva for abnormal areas.
• Removing a sample of tissue for testing (biopsy). To determine whether an area of suspicious skin on your vulva is cancer, your doctor may recommend removing a sample of skin for testing. During a biopsy procedure, the area is numbed with a local anesthetic and a scalpel or other special cutting tool is used to remove all or part of the suspicious area. Depending on how much skin is removed, you may need stitches.

Determining the extent of the cancer

Once your diagnosis is confirmed, your doctor works to determine the size and extent (stage) of your cancer. Staging tests can include:

• Examination of your pelvic area for cancer spread. Your doctor may do a more thorough examination of your pelvis for signs that the cancer has spread.
• Imaging tests. Images of your chest or abdomen may show whether the cancer has spread to those areas. Imaging tests may include X-ray, computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).

Vulvar cancer stages

Your vulvar cancer is assigned a Roman numeral that denotes its stage. Stages of vulvar cancer include:

• Stage I describes a small tumor that is confined to the vulva or the area of skin between your vaginal opening and anus (perineum). This cancer hasn't spread to your lymph nodes or other areas of your body.
• Stage II tumors are those that have grown to include nearby structures, such as the lower portions of the urethra, vagina and anus.
• Stage III cancer has spread to lymph nodes.
• Stage IVA signifies a cancer that has spread more extensively to the lymph nodes, or that has spread to the upper portions of the urethra or vagina, or that has spread to the bladder, rectum or pelvic bone.
• Stage IVB is a cancer that has spread (metastasized) to distant parts of your body.

Source: http://www.mayoclinic.com

Reduce your risk of sexually transmitted diseases

To reduce your risk of vulvar cancer, reduce your risk of sexually transmitted infections such as HPV and HIV. To reduce your risk of these diseases:

• Limit your number of sexual partners. The more sexual partners you have, the greater your risk of exposure to HPV.
• Use a condom every time you have sex. A condom can protect you from HIV transmission. Condoms may reduce your risk of contracting HPV but can't fully protect against it.
• Consider the HPV vaccine. Girls and young women may want to consider getting the HPV vaccine to protect against the strains of the virus that are thought to cause the most cases of vulvar cancer.

Ask your doctor about pelvic exams

Ask your doctor how often you should undergo pelvic exams. These exams allow your doctor to visually examine your vulva and manually examine your internal reproductive organs to check for abnormalities. Talk to your doctor about your risk factors for vulvar cancer and other pelvic cancers in order to determine the most appropriate screening exam schedule for you.

Source: http://www.mayoclinic.com

Living with vulvar cancer can be challenging. Although there are no easy answers for coping with vulvar cancer, the following suggestions may help:

• Learn enough about vulvar cancer to feel comfortable making treatment decisions. Ask your doctor to explain the basics of your cancer, such as what types of cells are involved and what stage is your cancer. Also ask your doctor or nurse to recommend good sources of information. Learn enough about your cancer so that you feel comfortable asking questions and discussing your treatment options with your doctor.
• Talk to someone about your feelings. When you feel ready, consider talking to someone you trust about your hopes and fears as you face cancer treatment. This might be a friend, a family member, your doctor, a social worker, a spiritual adviser or a counselor.
• Connect with other cancer survivors. You may find it helpful to talk to other people with vulvar cancer. They can tell you how they've coped with problems similar to the ones you're facing. Ask your doctor about support groups in your area. Or contact support organizations, such as the American Cancer Society or the Women's Cancer Network. Online message boards, such as those offered by the American Cancer Society's Cancer Survivors Network, can also connect you to other women with vulvar cancer.
• Don't be afraid of intimacy. Your natural reaction to changes in your body may be to avoid intimacy. Although it may not be easy, discuss your feelings with your partner. You may also find it helpful to talk to a therapist, either on your own or together with your partner. Remember that you can express your sexuality in many ways. Touching, holding, hugging and caressing may become far more important to you and your partner.

Source: http://www.mayoclinic.com

Although the exact cause of vulvar cancer isn't known, certain factors appear to increase your risk of the disease, including:

• Increasing age. The risk of vulvar cancer increases with age, though it can occur at any age. The average age at diagnosis is 65.
• Being exposed to human papillomavirus (HPV). HPV is a sexually transmitted infection that increases the risk of several cancers, including vulvar cancer and cervical cancer. Many young, sexually active women are exposed to HPV, but for most the infection goes away on its own. For some, the infection causes cell changes and increases the risk of cancer in the future.
• Smoking. Smoking cigarettes increases the risk of vulvar cancer.
• Being infected with the human immunodeficiency virus (HIV). This sexually transmitted virus weakens the immune system, which may make you more susceptible to HPV infections, thereby increasing your risk of vulvar cancer.
• Having a history of precancerous conditions of the vulva. Vulvar intraepithelial neoplasia is a precancerous condition that increases the risk of vulvar cancer. Most women with vulvar intraepithelial neoplasia will never develop cancer, but a small number do go on to develop invasive vulvar cancer. For this reason, your doctor may recommend treatment to remove the area of abnormal cells and periodic follow-up checks.
• Having a skin condition involving the vulva. Lichen sclerosus, which causes the vulvar skin to become thin and itchy, increases the risk of vulvar cancer.

Source: http://www.mayoclinic.com