Causative & risk factors
Like most cancers, the exact cause behind the onset of vulvar cancer is not yet known. Certain factors have been identified that increase the risk of developing vulvar cancer. These include age beyond 60 years, smoking, human papilloma virus infection or having pre-existing conditions like lichen sclerosus or vulvar intraepithelial neoplasia.
Clinical presentation
The patient complains of itching, pain, burning and bleeding in the vulvar area. She may experience pain during intercourse and burning pain while urinating. A lump, swelling or ulcer may be seen or felt in the vulva. There may be an abnormal discharge or bleeding from the vagina.
Investigations
A pelvic exam is carried out to visualize the vulva and a biopsy sample is taken.
If metastasis is suspected, other investigations such as cystoscopy, proctoscopy and CT or MRI scans of the pelvis are performed.
Treatment
Surgery is the main mode of treatment and involves radical vulvectomy. If the tumor is large (more than 2 cm) or has grown deeply into the skin, the lymph nodes in the groin area may also be removed.
Radiation, with or without chemotherapy is recommended in advance stages.
The outcome of cancer of vulva is determined by its size, type, whether the cancer has spread or not. The earlier the condition is diagnosed, better is the outcome.
