What is vulval cancer?
Vulval cancer is a rare type of cancer that affects the external female genitalia, including the labia, clitoris, and perineum. This form of cancer accounts for around 5% of all gynaecological cancers and typically affects older women, though it can occur at any age. The most common type is squamous cell carcinoma, which accounts for approximately 90% of cases. This type of cancer usually develops slowly over several years and is often preceded by a pre-cancerous condition called vulval intraepithelial neoplasia (VIN). Early diagnosis is essential, as treatment is more effective in the early stages.
What are the symptoms of vulval cancer?
Symptoms of vulval cancer may vary, but some common signs to watch for include:
- Persistent itching, burning, pain or tenderness in the vulva
- Lumps, growths, or thickened skin on the vulva that do not go away
- Bleeding or discharge not related to the menstrual cycle
- Changes in skin colour on the vulva, such as redness or whitening
- Open sores or ulcers that do not heal
- Pain during urination or intercourse
If you notice any of these symptoms, it’s important to consult a medical professional as soon as possible. While these symptoms may be caused by non-cancerous conditions, they should still be evaluated to rule out vulval cancer or other underlying issues.
Risk factors for vulval cancer
Several factors may increase the risk of developing vulval cancer:
- Age: Vulval cancer is more common in women over the age of 65, though it can occur at any age.
- Human papillomavirus (HPV): Persistent infection with high-risk HPV strains is associated with an increased risk of vulval cancer.
- Lichen sclerosus: This chronic skin condition affects the vulva, causing itching and inflammation, and can increase the risk of cancer over time.
- Smoking: Smoking can weaken the immune system and make it harder for the body to fight HPV infections, which may lead to cancer.
- Weakened immune system: Individuals with a compromised immune system, such as those with HIV or those on long-term immunosuppressive medications, have a higher risk of vulval cancer.
- Previous gynaecological cancer or pre-cancerous conditions: A history of cervical or vaginal cancer or conditions like vulvar intraepithelial neoplasia (VIN) can raise the risk of vulval cancer.
Prevention and early detection
While it is not always possible to prevent vulval cancer, there are steps you can take to reduce your risk:
- HPV vaccination: The HPV vaccine is highly effective in preventing infection with the types of HPV most commonly associated with vulval cancer. It is recommended for girls and young women, ideally before they become sexually active.
- Regular check-ups: Attending regular gynaecological exams and cervical screenings. Cervical screening is primarily for cervical cancer, but regular gynaecological check-ups can help detect other abnormalities, including those related to vulval cancer.
- Quit smoking: Stopping smoking can significantly reduce your risk of developing vulval cancer, especially if you are infected with HPV.
Diagnosis of vulval cancer
- Physical examination: If you experience any of the symptoms associated with vulval cancer, your doctor will conduct a thorough examination, which may include a visual inspection of the vulva, a colposcopy (using a magnifying device to look closely at the vulva).
- Biopsy: If a suspicious area is found, a small sample of tissue will be taken for laboratory analysis to determine whether cancerous cells are present.
- Imaging tests: Tests such as ultrasound, MRI, CT scans, or other imaging techniques may be used to assess the extent of the cancer and whether it has spread to nearby lymph nodes or other organs.
Treatment options for vulval cancer
The treatment for vulval cancer depends on the type, size, and stage of the cancer, as well as the overall health of the patient. Common treatments include:
- Surgery: The most common treatment for vulval cancer is surgery to remove the cancerous tissue. This may involve a wide local excision, which involves removing the tumour along with a small margin of healthy tissue, or a more extensive procedure such as a vulvectomy, which involves the removal of part or all of the vulva.
- Lymph node removal: In cases where there is a risk that the cancer has spread, nearby lymph nodes may also be removed.
- Radiotherapy: This treatment uses high-energy X-rays to destroy cancer cells. It may be used before surgery to shrink the tumour or after surgery to kill any remaining cancer cells.
- Chemotherapy: Chemotherapy may be used in advanced cases of vulval cancer, particularly if the cancer has spread to other parts of the body.
Follow-up and recovery
After treatment, regular follow-up appointments are essential to monitor for any signs of recurrence. Recovery times will vary depending on the treatment received. Following surgery, it is important to care for the wound properly and avoid strenuous activities for the recommended period. Your doctor will provide guidance on post-treatment care and may suggest lifestyle changes to support your recovery.
Living with and beyond vulval cancer
A diagnosis of vulval cancer can be challenging, but there is support available.
- Psychological support: Counselling and support groups can provide emotional support and help you connect with others who are going through similar experiences.
- Rehabilitation services: These services can help with issues such as pain management, sexual health, and body image concerns following treatment.
Organisations like the The Eve Appeal and Macmillan provide resources and support networks to help patients and their families through diagnosis, treatment, and beyond.
While vulval cancer is rare, it’s important to recognise symptoms early and seek medical advice. By understanding risk factors and symptoms, and accessing prompt treatment, you can improve your chances of a positive outcome.
Why choose Birmingham Gynaecology Clinic
At Birmingham Gynaecology Clinic, we specialise in expert care for women concerned about or diagnosed with vulval cancer. Our team provides comprehensive screening, diagnosis, and treatment services.
We are dedicated to offering compassionate, expert care for women undergoing vulval cancer treatment. If you have any questions about your treatment options or wish to discuss your care plan, please reach out to us today. Our team is here to support you every step of the way.