Vulvar Cancer (Cancer of the Vulva)

The term vulva refers to all of the external genitalorgans (external genitalia) of women, which extends from the pubis to the anus: mons pubis, labia majora, labia minora, Bartholin’s glands, and clitoris. The vulva is involved in three main types of functions:
• urination (expulsion of urine)
• sex
• childbirth.

Vulvar cancer is a rare but serious malignant tumor that predominantly affects elderly women but sometimes young woman. This disease develops in the cells of the lining tissue of the vulva, rarely in the cells of the outermost layer of the female genitals. Treatment consists primarily of surgical removal of the vulva (vulvectomy). Chemotherapy does not work in almost all cases.

Vulvar cancer accounts for about 4-5% of women’s cancers; that is, about 1in every 25 female cancer cases is a malignant tumor of the vulva. The disease affectsmainly elderly women who are deficient in certain hormones, especially estrogen.

There are different types of vulvar cancers, classified depending on the origin where the primary tumor developed:
• Squamous cell carcinoma – this condition started in the epithelial cells, mainly the cells of the outermost layer of the epidermis or the posterior of the labia minora. This is the most common, accounting for about 90% of vulvar cancers.
• Basal cell carcinoma – this type of cancer started in the deepest layer of the epidermis:Bartholin’s glands or vulvar sweat glands.
• Adenocarcinoma – this form of malignant tumor develops in the glandular tissue of the vulva, and affects mostly the opening of the vagina.
• Melanoma – in this type of vulvar cancer, the tumor develops in the pigmented skin cells of the vulva, and affects mostly the clitoris or the labia minora.

The vulva can also be affected by a disease called Paget’s diseaseof the vulva (extramammary Paget’s disease), a very rare slow-growing malignancy that originates in the glandular cells of the vulva. It tends to manifest by red, pink or white scaly patches on the skin of the vulva. The patches are itchy and similar to the appearance of eczema. The disease affects mostly postmenopausal Caucasian women.

In addition, the vulva may also be affected by these non-cancerous conditions:

  • Vulvitis, inflammation of the vulva; it is often associated withinflammation of the vagina(vaginitis) when infectious.
    • Vulvovaginitis, benign inflammation of the external parts of the female genital organs (vulva) and vagina, which is manifested by itching, discharge, bad odor, and excessive vaginal secretion •Genital herpes , this is a sexually transmitted disease (STD) caused by Herpes Simplex Virus type 2 (HSV2 – although HSV1 can also cause it). Its symptoms ( blisters, ulcers, burning, itching ) are recurrent and painful and can seriously disrupt the sex life of patient.
    • Bartholinitis – this condition is characterized by an inflammation of one or both glands in the labia, known as the Bartholin’s glands. It often arises from a vaginitis.
    • Kraurosis vulvae , this is a skin disease, also known as lichen sclerosus, which usually affects skin of the vulva (although it may affect skin on any part of the body ) and occurs after menopause. This condition manifests by atrophy of the vulva and a narrowing of its opening, causing itching, burning and urinary pain.
    • Bowen’s disease, this condition is considered as a precancerous tumor. It can affect the skin and mucous membranes, especially the vulva, by causing painless lesions.

                                                        Vulvar Cancer Causes and Symptoms

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