The cancer of the outer surface of female genitalia is known as vulvar cancer. Although it is common in all ages, this cancer is most commonly diagnosed by experts like Gynecologist in Islamabad in older individuals. Of all the cancers in women , vulvar cancer accounts for 0.6% of cases. Read on to know more about this type of cancer: 

What is Vulvar cancer?

Vulvar cancer occurs when the cancerous cells grow out of control in the outer portion of the women’s genitalia or the Vulva.

Vulva includes: the opening of the vagina, the clitoris, the labia minora and majora, the mons pubis and the perineum. Vulvar cancer can involve any of these sites. 

What are the symptoms of vulvar cancer?

The first sign of vulvar cancer is usually an ulceration with itching, irritation, bleeding or a painless lump. In the early days, it may go undiagnosed as women delay seeking help and the symptoms are mild. However, it is important to remember that early diagnosis improves the outlook for the patient. 

Typically, the symptoms include:

• bleeding
• Painful sexual intercourse
• Persistent itching
• Thickened skin
• Dark discolouration
• Painful urination
• Pain and burning
• Wart like growths
• Ulceration 
• Rawness and sensitivity

What are the types of vulvar cancer?

There are several types of vulvar cancer:

•Squamous cell carcinoma: this type of cancer affects the outer layers of the skin. Around 90% of all Vulvar cancers belong to the squamous cell subtype. For symptoms to become noticeable, it takes several years for this tumor to grow. 

•Adenocarcinoma: this type of cancer originates in the glandular tissue and in this case, the glands of the vulva. This type of cancer accounts for a small proportion.

•Vulva melanoma: a melanoma presents as a batch of discolouration or a mole. As with all types of melanomas, the risk of spread is high, known as metastasis. Younger women are mostly diagnosed with this subtype of vulvar cancer.

•Sarcoma: this vulvar cancer originates commonly in the connective tissue and is malignant, though rare.

Verrucous carcinoma: is a subtype of squamous cell carcinoma. Initially, it may appear as a slow-growing wart. 

How is vulvar cancer diagnosed?

Vulvar cancer is diagnosed by the following investigations:

• Complete physical and history: your healthcare provider will ask you questions regarding your health including habits and illnesses.

• Pelvic examination: your doctor will check the vulva for signs of cancer, skin discolouration, lumps and assess the uterus, vagina, ovaries, rectum and bladder.

• Colposcopy: a magnifying tool is used to look up closely for any signs of cancer in the vulva, vagina and cervix.

• Biopsy: confirmatory test includes biopsy of the tissue. 

What are the risk factors associated with vulvar cancer?

The rest factors of vulvar cancer include the following:

Age: with increase in age the risk of vulvar cancer increases, even though it may occur at any age. The mean age of diagnosis is around 65 years.

Weak immune system: in patients who have undergone cancer therapy, organ transplant, or any chronic condition in which the immune system is weakened, the risk of vulvar cancer rises. The risk also rises in people who take medication to suppress the immune system, such as steroids and immunosuppressants. 

Exposure to human papilloma virus (HPV): the sexually transmitted HPV increases the risk of several cancers including cervical and vulvar cancer. In women who are sexually active with multiple partners the risk of this cancer rises exponentially. Once it enters the body, it can cause cell changes and the risk of cancer in the long run. 

Smoking: smoking increases the risk of several types of cancer including vulvar cancer.

History of precancerous lesions: precancerous conditions such as vulvar intraepithelial neoplasia increase the risk of vulvar cancer several folds. For women who are diagnosed with this precancerous lesion, the healthcare providers like a gynecologist doctor in karachi recommend prompt treatment and periodic follow-up.