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Vulval cancer

Vulval Cancer diagram of the body

Facts and figures about vulval cancer

Vulval Cancer is the 20th most common female cancer in the UK, accounting for 0.7% of all new female cancer cases.

Age related, approximately 73% diagnosed are in those aged 60+ years and an average of 46% arise in those aged over 75 years. 85% are squamous cell carcinomas and 10% are malignant melanomas.

Risk factors include smoking, HPV exposure/infection (the younger patients tend to be HPV positive), genital warts, previous cervical cancer or having a first degree relative that has been diagnosed with cervical cancer, possibly HIV infection.

Vulval cancer symptoms

  • Persistent irritation, burning sensation or soreness of the vulva.
  • Lump, swelling, wart-like growth or ulcer on the vulva.
  • Thickened, raised red, white or dark patches of skin.
  • Post- menopausal bleeding or blood stained discharge.
  • Irregular bleeding or blood stained discharge in pre-menopausal women.
  • Tenderness or pain in the area.
  • Burning sensation when passing urine.
  • Lump in the groin.
  • Changes in a mole on the vulva.

Some of these conditions can be caused by other conditions such as infection.

Diagnosis of vulval cancer

Investigations may include:

  • Physical examination.
  • Biopsy: tissue samples will be taken for analysis.
  • Chest X-ray.
  • Cytoscopy: examination of the inside of the bladder.
  • Proctoscopy: examination of the rectum.
  • CT scan.
  • MRI scan.

Vulval cancer treatment

Depends on several factors:

  • The type and size of the tumour.
  • The stage of the cancer.
  • Age and general health.

Surgery

Surgery is usually the first treatment for vulval cancer, in precancerous vulval intraepithelial neoplasia (VIN) laser surgery or a combination of laser and regular surgery is an effective treatment.

In early stage disease, surgery will usually involve removing the affected tissue with some of the surrounding healthy skin. It is likely that some of the groin lymph nodes will be removed during surgery for analysis.

In advanced cases, part or all of the vulva may need to be removed (vulvectomy), reconstruction is sometimes possible. More advanced cases may require more extensive surgery.

Radiotherapy

Radiotherapy may be the main treatment if surgery is not possible. Also, it may be advised post-operatively if the lymph nodes are found to contain malignant cells or if the cancer was found to be deeper than 5cms or not adequately cleared at surgery to reduce the risk of recurrence.

Occasionally it is used to reduce the tumour prior to surgery. In advanced disease it may be used to relieve symptoms.

Chemotherapy

Chemotherapy may be advised if the disease has spread to other parts of the body, cisplatin is the most frequently used drug.

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