Guest Author - Dr. Denise Howard
The fourth most common cancer of the female genital tract can be beaten. Vulvar cancer typically presents with itching or an abnormal lesion. The tissues of the vulvar can be easily examined with the naked eye or even under magnification. A sample of the concerned area can be taken and this biopsy will confirm the diagnosis. Once the diagnosis is confirmed then treatment can be undertaken.
The vulva area consists of the labia majora, labia minora, clitoris, mons, introitius, vestibule, and urethra meatus. Its function is to direct the urine stream, protect the genital tract and it serves as a sensory organ for sexual arousal. A cancer in this area can directly affect all of these functions and spread to adjacent and distant structures.
Once a diagnosis of cancer is made the next step is to determine the extent of its spread. This process is called clinical staging and helps determine both the treatment options and the prognosis. This consists of a complete history and physical examination, including a pelvic examination, taking note of abnormal lesions and even enlarged lymph nodes. A more detailed evaluation of the genital tract may include a colposcopy and vulvoscopy to examine for spread or other foci of cancer in the cervix and rest of genital tract. A cystoscopy allows for detailed evaluation of the urethra and bladder while an anoscopy allows for visualization of the anus. Additional imaging maybe advised depending on the examination findings.
The final staging is confirmed by surgical evaluation. The biopsy can describe the depth of the lesion. Additional surgery that maybe both diagnostic and therapeutic, includes removal of the vulvar structures and a biopsy of the lymph nodes. The extent of removal of the vulvar structures and lymph node biopsy is determined by the location, size and evidence of spread. A stage IB cancer is greater than 2 cm in diameter. Stage II cancers have spread to the birth canal, urethra or anus. Stage II has spread regionally beyond these structures and Stage IV is distal spread outside of the pelvic region. Metastasis is found in approximately 5% of cases at initial diagnosis.
Surgical treatment is possible in those cases that are diagnosed early. Radiation and chemotherapy are additional treatments that maybe utilized if the cancer is of advanced stage. An early diagnosis allows for easier treatment and the likelihood of success is much higher. You should seek the consultation of a gynecologist if you have unusual genital symptoms or a lesion. In some cases it may require persistence on your part to find the answer but donít be afraid to be an advocate for your health.
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!