The external part of the female genitals is called “vulva“. The vulva consists of the following organs: Mons pubis, labia majora and minora, clitoris, urethal orifis and vestibular glands such as Bartholin and Skene
Vulvar cancer can be defined as the uncontrolled proliferation of cells in the remaining areas in the external part of the female genitals, called vulva. The vulvar cancer, which make itself apparent with various symptoms such as chronic pruritus, regional sensitivity, burning in the genital area and changes in skin, begins generally in labia majora or minora and can rarely occur in clitoris or Bartholin’s glands.
What Are The Causes of Vulvar Cancer?
As with many other types of gynecological cancer, the causes of vulvar cancer are not well known and it is considered a more accurate approach to mention the risk factors that trigger this cancer.
Risk factors that may cause vulvar cancer can be listed as follows:
- Human Papilloma Virus (HPV): HPV is a sexually transmitted virus with more than 100 types. While some types of HPV does not cause any symptom, its risky types such as HPV 16 and HPV 18 can lead to vulvar cancer.
- Age:The incidence of vulvar cancer, which affects approximately 20% of women at the age of 50 Age is generally considered as an important risk factor for vulvar cancer in women around the age of 70.
In addition to these two risk factors, it is accepted that smoking, HIV virus, skin problems called lichen sclerosus, chronic pruritus problems in the vulva and weaknesses in the immune system are also among the risk factors for vulvar cancer.
Symptoms of Vulvar Cancer
Symptoms of vulvar cancer may vary from person to person depending on the type of vulvar cancer. Some women have not any symptom for many years, while other women may have symptoms such as hemorrhage independent from menstrual cycle, vaginal discharge, itching, wart-like lesions on the vulva, thickening of the vulvar skin and forming nevus larger than 6 mm with changing shape and structure and unspecified borders.
Types of Vulvar Cancer
- Squamous Cell Carcinoma: This type of cancer, which includes keratinizing-type, basaloid and verrucous carcinoma, is the most common type of vulvar cancer It usually occurs with symptoms such as forming wart.
- Adenocarcinoma:A type of vulvar cancer that occurs in the glands. It is seen in about 8 of every 100 patients with vulvar cancer. It usually starts in Bartholin’s gland.
- Melanoma:A type of vulvar cancer responsible that starts in cells responsible for pigment production.
- Sarcoma:It begins in bone, muscle and connective tissue cells. The incidence is about 2% The difference from other types of vulvar cancer can occur in women of all ages.
Diagnosis and Treatment of Vulvar Cancer
For the diagnosis of vulvar cancer, patient history and her/his complaints are initially evaluated; a comprehensive gynecological examination including pelvic examination can be carried out. PAP Smear and HPV test can be applied in this process.
In cases of suspicion of cancer, biopsy is performed to determine whether cancer or precancerous formations develop. In addition, lesions, if any, are extensively evaluated with vulvar colposcopy, i.e. vulvoscopy,. When cancer is detected, imaging methods such as CT, MRI and PET scan are also used to understand how far it has spread to the body.
As a result of the findings, a special treatment is planned in accordance with the age, general health status and vulvar cancer stageof the patient. Radiotherapy, chemotherapy and vulvar cancer surgery can be applied to the person diagnosed with vulvar cancer.
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