Vulvar Cancer

Services: Cancer

Vulvar Cancer

Most women with vulvar intraepithelial neoplasia (VIN) have no symptoms. When a woman with VIN does have a symptom, it is most often itching that does not go away or get better. An area of VIN may look different from normal vulvar skin.

Signs and symptoms may include itching, burning, inflammation, or pain. Other cancer symptoms include a lump or sore on the vulva, changes in skin color, or a bump in the groin.

Having pelvic exams and knowing any signs and symptoms of vulvar cancer significantly improve the chances of early detection and successful treatment.

Paula Ardila, MPAS, PA-C

Vulvar intraepithelial neoplasia:

Most women with vulvar intraepithelial neoplasia (VIN) have no symptoms. When a woman with VIN does have a symptom, it is most often itching that does not go away or get better. An area of VIN may look different from normal vulvar skin. It is often thicker and lighter than the normal skin around it. However, an area of VIN can also appear red, pink, or darker than the surrounding skin.

Because these changes are often caused by other conditions that are not pre-cancerous, some women don’t realize that they might have a severe condition. Some try to treat the problem themselves with over-the-counter remedies. Sometimes doctors might not even recognize the condition at first.

Invasive squamous cell cancer of the vulva:

Almost all women with invasive vulvar cancers will have symptoms. These can include:

  • An area on the vulva that looks different from usual could be lighter or darker than the normal skin around it or look red or pink.
  • A bump or lump, which could be red, pink, or white and could have a wart-like or raw surface or feel rough or thick
  • Thickening of the skin of the vulva
  • Itching
  • Pain or burning
  • Bleeding or discharge not related to the average menstrual period
  • An open sore (especially if it lasts for a month or more)

Verrucous carcinoma, a subtype of invasive squamous cell vulvar cancer, looks like cauliflower-like growths similar to genital warts.

Other non-cancerous conditions more often cause these symptoms. Still, if you have these symptoms, you should have them checked by a doctor or nurse.

Vulvar melanoma:

Patients with vulvar melanoma can have many of the same symptoms as other vulvar cancers, such as:

  • A lump
  • Itching
  • Pain
  • Bleeding or discharge

Most vulvar melanomas are black or dark brown, but they can be white, pink, red, or other colors. They can be found throughout the vulva, but most are in the area around the clitoris or on the labia majora or minora.

Vulvar melanomas can sometimes start in a mole, so a change in a mole that has been present for years can also indicate melanoma.

Bartholin gland cancer:

A distinct mass (lump) on either side of the opening to the vagina can be the sign of a Bartholin gland carcinoma. More often, however, a lump in this area is from a Bartholin gland cyst, which is much more common (and is not cancer).

What are the signs and symptoms of vulvar cancer?

Signs and symptoms may include itching, burning, inflammation, or pain. Other cancer symptoms include a lump or sore on the vulva, changes in skin color, or a bump in the groin.

Can Vulvar Cancer Be Found Early?

Having pelvic exams and knowing any signs and symptoms of vulvar cancer significantly improve the chances of early detection and successful treatment. If you have any of the problems discussed in Symptoms of Vulvar Cancers, you should see a doctor. If the doctor finds anything abnormal during a pelvic examination, you may need more tests to determine what is wrong. This may mean referral to a gynecologist (specialist in the female genital system).

Knowing what to look for can sometimes help with early detection, but it is even better not to wait until symptoms. Get regular well-women exams.

There is no standard screening for this disease.

Biopsy:

Certain signs and symptoms might strongly suggest vulvar cancer, but many can be caused by changes that aren’t cancer. The only way to be sure cancer is present is to do a biopsy. A small piece of tissue from the changing area is removed and examined under a microscope. A pathologist (a doctor specially trained to diagnose diseases with laboratory tests) will look at the tissue sample with a microscope to see if cancer or pre-cancer cells are present and, if so, what type it is.

How is vulvar cancer treated?

Treatment for vulvar cancer depends on its type and stage. Other factors can also help determine the best treatment plan, such as your age, general health, individual circumstances, and preferences.

Surgery often is needed to remove all cancerous tissue. Radiation therapy and chemotherapy also may be needed in addition to surgery.

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also essential to ask questions if there’s anything you’re not sure about.

It is often a good idea to seek a second opinion if time permits. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

What are BRCA1 and BRCA2 Genes?

BRCA1 and BRCA2 are tumor suppressor genes, which means that they keep cells from growing too rapidly. Everyone has these genes. Changes or mutations in these genes mean they do not work properly and cells can grow out of control, which can lead to cancer.

How much do BRCA mutations increase the risk of cancer?

The risk of breast cancer for the average American woman is about 12% in her lifetime. Having a BRCA mutation greatly increases the risk. The estimated risk of breast cancer in women with a BRCA mutation is 45–85% by age 70 years.

The risk of ovarian cancer for the average American woman is about 2% in her lifetime. The estimated risk of ovarian cancer in women with a BRCA1 mutation is 39–46% by age 70 years. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 years is 10–27%.

Women who have a BRCA mutation also have an increased risk of cancer of the fallopian tube, peritoneum, pancreas, and skin (melanoma). Men who have a BRCA mutation have an increased risk of cancer of the breast, prostate, and pancreas.

Why don’t doctors test everyone for BRCA mutations?

BRCA testing is only recommended for people with a high risk of having BRCA mutations. It is important to remember that most cases of breast and ovarian cancer are not caused by gene mutations. If there is a low chance of finding a BRCA mutation, your ob-gyn or other health care professional may not recommend genetic testing.

What is multigene panel testing?

Multigene panel testing is a type of genetic testing that looks for mutations in several genes at once. This is different from single-gene testing, which looks for a mutation in a specific gene. Single-gene testing is often used when a known gene mutation is already in a family. You may consider genetic testing if your personal or family history shows an increased cancer risk.

How can I prevent cancer if I test positive for a gene mutation?

If you test positive for a gene mutation, you can discuss cancer screening and prevention options with your ob-gyn, genetic counselor, or other healthcare professionals. It may be helpful to have earlier or more frequent cancer screening tests to find cancer at an early and more curable stage. Risk reduction steps like medication, surgery, and lifestyle changes also may be recommended.

If I have a gene mutation, should I tell my family?

Having a gene mutation means you can pass the mutation to your children. Your siblings also may have the gene mutation. Although you do not have to tell your family members, sharing the information could be life-saving. With this information, your family members can decide whether to be tested and get cancer screenings early.

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