Not all cancer types get the same level of publicity. Vulvar cancer is virtually unknown amongst women who are much more aware of breast and cervical cancers. While vulvar area cancer is not widely diagnosed, every woman should learn more about this disease. This brief overview will introduce basic but very essential information about vulvar cancer and what menopausal women need to know.

Vulvar cancer rates
Vulvar cancer is rare compared to other cancers. This disease is diagnosed in approximately 2,400 women in the U.S. each year, and around 250 women in the United Kingdom. The news for Canadian women is alarming: roughly 220 women die each year in Canada due to vulvar cancer. In fact Canada has the distinction of having some of the highest reported cases of vulvar cancer in the world as reported in a report by The Society of Gynecologic Oncologists of Canada.

Note that vulvar cancer refers to cancer that specifically starts in the vulvar area. It does not include cancers that begin in other parts of the body and then subsequently metastasize (spread) to the vulvar region.

Risk factors for vulvar cancer:

*Women over 60 are at greater risk as 70% of cases are diagnosed in this age group
*VAIN - Vulvar intraepithelial neoplasia – is a condition describing abnormal and unusual changes to the cells in the vulvar or genital walls; these changes may put some women at risk for vulvar cancer
*Human papilloma virus (HPV) is often present in 8 out of 10 women diagnosed with vulvar cancer
*If your mother took the miscarriage prevention drug diethylstibestrol (DES) which was commonly prescribe in the US from the 1940s until banned in 1971.
*If you have had a previous case of gynecological cancer, especially cervical cancer.
*Smoking
*Multiple intercourse partners
*Staring intercourse activity at a very early age
*HIV infection

Symptoms of vulvar cancer
Yearly pelvic examinations and Pap smears are crucial in maintaining good health. See your doctor immediately if you notice any of the following symptoms:

*Unusual vulvar or genital area discharge that is watery and may have a very unpleasant odor
*Unusual bleeding in between menstrual periods, after intercourse, or after going through menopause
*Painful urination
*A lump or lesion inside the vulvar area or on the outside
*Pain in the pelvic region

Stages of vulvar cancer:
Stage 0: the cancer is located in the first layer of the vulvar wall and has not spread – if diagnosed at this stage the first-year survival rates are around 96%.

Stage 1: at this stage the cancer is still limited to the vulvar wall area

Stage 2: the cancer has started to spread to the tissues surrounding your vulvar region

Stage 3: the cancer has spread further into the pelvic region and/or the nearby lymph nodes

Stage 4a: by now the cancer has spread to the lymph nodes, and as far as the bladder, rectum or pelvis

Stage 4b: in this most advanced stage, the cancer has spread beyond the pelvic region and may have entered the lungs

Treatment options for vulvar cancer:

Your doctor may perform surgery by either removing the cancerous cells or a more serious procedure called a vaginectomy; a partial or full removal of the vulvar region. This procedure may also be accompanied by a hysterectomy to remove the uterus and/or ovaries.

In the most severe cases some patients need to have possible removal of one or more of the vulva, rectum, bladder, ovaries, uterus and lower portion of the colon. Urostomy and colostomy bags are needed to eliminate urine and feces. After surgery radiation therapy or chemotherapy treatments may be used to treat any remaining cancer cells.

Only recently has vulvar cancer been studied by health care professionals. Many women are not even aware that this cancer exists. But the dangers of vulvar cancer are very real and the sooner this condition is diagnosed, the better the chances for survival. Menopause is a good time to become more familiar with your body and be alert for any changes, normal and abnormal. Talk to your doctor to learn more about vulvar cancer and ways to keep yourself healthy for years to come.

www.bccancer.bc.ca
www.mayoclinic.com/health
www.cancerhelp.org.uk

Menopause, Your Doctor, and You