Vulvar cancer is a rare type of cancer that forms in the vulva, the external female genitalia. Recognizing unusual changes in this area and seeking prompt medical attention are important steps. Early detection can improve treatment outcomes for vulvar cancer.
First Steps in Diagnosis
The diagnostic process for vulvar cancer typically begins with a thorough medical consultation and physical examination. Your doctor will inquire about any symptoms you might be experiencing, such as itching, pain, unusual bleeding, or changes in skin appearance on the vulva. A detailed medical history helps identify potential risk factors.
Following the discussion, a physical examination of the vulva, vagina, and surrounding areas is performed. This visual inspection helps identify any suspicious growths, lesions, or changes in skin color or texture. The doctor may also feel for any lumps or swollen lymph nodes in the groin area.
A specialized magnifying instrument, called a colposcope, is often used to examine the vulva more closely. This tool allows for a magnified view of the skin, helping the healthcare provider identify subtle abnormalities. Sometimes, a special solution may be applied to highlight abnormal cells.
Confirming the Diagnosis
If suspicious areas are identified during the initial examination, a biopsy is performed to confirm a diagnosis of vulvar cancer. A biopsy involves removing a small tissue sample from the abnormal area for microscopic examination by a pathologist.
Several types of biopsies can be used for vulvar lesions. A punch biopsy is a common method where a small, cylindrical piece of tissue, typically 3 to 5 mm in diameter, is removed using a circular blade. This procedure is often performed under local anesthesia, which numbs the area, though a brief sting may be felt during the injection.
For smaller lesions where the entire suspicious area can be removed, an excisional biopsy may be performed. This involves surgically removing the whole lesion, and stitches may be needed to close the wound. An incisional biopsy, on the other hand, removes only a portion of a larger lesion when a complete removal is not feasible or necessary for diagnosis.
After the biopsy, the tissue sample is sent to a laboratory where a pathologist examines it under a microscope. This examination determines whether the cells are cancerous, precancerous, or benign.
Assessing Cancer Spread
Once vulvar cancer is diagnosed, further tests are typically conducted to determine if the cancer has spread beyond the initial site. This process, known as staging, helps guide treatment planning. Imaging tests are often employed to visualize internal organs and lymph nodes.
Magnetic Resonance Imaging (MRI) is frequently used to assess the extent of the primary tumor and its involvement with surrounding structures, such as the urethra, vagina, or anus. MRI can also help identify enlarged lymph nodes in the groin, which may indicate cancer spread. This imaging technique uses strong magnets and radio waves to create detailed cross-sectional pictures of the body.
Computed Tomography (CT) scans also provide detailed images of the body’s interior, helping to determine the size and shape of the tumor and whether it has spread to lymph nodes or distant organs like the lungs. A CT scan uses X-rays taken from multiple angles, which a computer then combines to form cross-sectional images. Positron Emission Tomography (PET) scans, often combined with CT scans (PET-CT), can detect malignant tumor cells by identifying areas of increased metabolic activity, as cancer cells use sugar at a higher rate than normal cells.
Evaluating the lymph nodes is a crucial part of assessing cancer spread. A sentinel lymph node biopsy is a procedure that identifies and removes the first lymph node(s) to which cancer cells are most likely to spread from the primary tumor. If these sentinel nodes are free of cancer, it suggests that the cancer has likely not spread further.