Guest Author - Dr. Denise Howard
Vulvar cancer comprises 5% of the cancers of the female genital tract. Although less common, this malignancy can still contribute to significant morbidity and mortality in women. The signs and symptoms can be non-specific, making an early diagnosis difficult in some cases. If caught early, this cancer can be treated easily with medical or surgical therapy.
The vulvar tissue is composed of many cell types and cancer can arise from any of these cells producing different types of malignancies in this organ site. The majority of the tissue arises from squamous cells and squamous cell carcinoma accounts for 90% of the malignancies of the vulva. Typically when the term vulvar cancer is used, it is referring to these squamous cell carcinomas.
Other cells of the vulvar include columnar cells, which is typically found in the glands of the genital tract, cells from the basement membrane of the skin, melanin producing cells (melanocytes) and cells that produce the tissue support structures. The common types of cancer from these cells include melanoma, sarcoma, basal cell carcinoma, adenocarcinoma and Bartholinís gland carcinoma. These types will not be discussed in this article.
There are two types of squamous cell malignancies in the vulvar area and they can be distinguished by the etiology. The keratinizing, differentiated or simplex type is typically found in older women and often occurs in the setting of chronic inflammation that occurs with conditions like vulvar dystrophies. The classic, warty or bowenoid type is associated with human papilloma virus (HPV) infection. It is found in younger women and is easily diagnosed in an earlier stage due to its appearance. HPV types 16, 18 and 33 are most often associated with this type of vulvar malignancy. One variant, called verrucous carcinoma, has a cauliflower appearance. It is slow growing and rarely metastasizes but causes local destruction of adjacent tissue.
Of course the issue with all cancer is its potential to spread, interfering with normal organ function. Vulvar cancer spreads by local extension to adjacent structures, distorting their appearance and interfering with their function. The cancer cells can also spread through the lymph system passing through the lymph nodes or via the blood stream.
Early diagnosis allows for treatment of the cancer before it has an opportunity to spread. Understanding the signs and symptoms are important in the identification of an early cancer. If you have unusual itching or a growth you should see your gynecologist as soon as possible to identify the cause and get early treatment.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!