Vulvar cancer is a less common type of cancer that develops in the vulva, which encompasses the external female genitalia. This area includes the labia (inner and outer lips), clitoris, and the skin surrounding the urethra and vagina. Cancer often begins on the surface of the skin, typically forming as a lump or sore that might cause itching. Awareness of the vulva’s normal appearance and any changes is important for early detection.
Understanding Curability
Vulvar cancer is often curable, particularly when identified and treated early. In oncology, “curable” means there is no longer evidence of disease after treatment, or achieving a long-term remission where the cancer does not return. Early detection significantly improves the likelihood of a positive outcome. The goal of treatment is to eliminate cancer cells from the body, and success depends on the disease’s characteristics and the individual’s response to therapy.
Factors Affecting Curability
The curability of vulvar cancer is influenced by several factors, with the stage at diagnosis being a primary consideration. Early-stage cancers, confined to the vulva, have a more favorable outlook. As cancer progresses, its size and depth of invasion into surrounding tissues become significant.
The specific type of vulvar cancer also plays a role in prognosis. Squamous cell carcinoma is the most common form. Less common types, such as melanoma of the vulva, have a less favorable prognosis compared to squamous cell carcinoma. Sarcomas and adenocarcinomas are even rarer types.
Spread to nearby lymph nodes is another important prognostic factor. Cancer cells can travel through the lymphatic system, and lymph node involvement indicates a higher risk of wider spread. The number of affected lymph nodes also impacts the prognosis. An individual’s overall health and age can influence treatment tolerance and long-term outcome.
Treatment Options
Treatment for vulvar cancer often involves a combination of approaches, tailored to the cancer’s characteristics and the individual’s health. Surgery is the most common initial treatment. Procedures range from a wide local excision, which removes the cancer and a margin of healthy tissue, to a partial or radical vulvectomy, involving removal of part or all of the vulva. Lymph node dissection, including sentinel lymph node biopsy, may be performed to check for spread.
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It can be used after surgery to eliminate any remaining cancer cells, or before surgery to shrink larger tumors, potentially allowing for less extensive surgical removal. Radiation therapy is often combined with chemotherapy in a process called chemoradiation, which can enhance the effectiveness of radiation.
Chemotherapy employs anti-cancer drugs, typically given intravenously, to target and kill cancer cells throughout the body. It is often used with radiation therapy or for more advanced or recurrent cases.
Newer treatment modalities include targeted therapy and immunotherapy. Targeted therapy uses drugs that focus on specific molecules within cancer cells to inhibit their growth. Immunotherapy works by boosting the body’s own immune system to fight cancer cells. These newer options are considered for advanced or recurrent disease.
Life After Treatment
After completing treatment for vulvar cancer, ongoing follow-up care is important for monitoring and detecting any signs of recurrence. Regular appointments allow healthcare providers to assess recovery and address any long-term effects. The outlook after treatment varies widely depending on the initial stage of the cancer and how it responded to therapy.
General survival rates provide a statistical overview, though individual outcomes can differ significantly. For localized vulvar cancer, meaning it has not spread beyond the vulva, the five-year relative survival rate is approximately 86%. If the cancer has spread to nearby lymph nodes or tissues, the five-year relative survival rate is around 53%. For cases where the cancer has spread to distant parts of the body, the five-year relative survival rate is about 19%.
Survivors may experience various long-term side effects from treatment, such as lymphedema, which is chronic swelling that can result from lymph node removal. Treatment can also impact body image, sexual function, and bladder or rectal function. Support and management strategies are available to help address these physical changes and any emotional or psychological aspects of survivorship.