Medicines for Vulval cancer

What it is

Vulval cancer is a rare type of cancer that affects the vulva — the external female genitals, including the lips (labia) around the vaginal opening. It is uncommon and mainly affects older women, particularly after the menopause, though it can occur in younger women. Risk factors include infection with the human papillomavirus (HPV) in some cases, certain long-standing skin conditions of the vulva (such as lichen sclerosus), older age, and smoking. The symptoms of vulval cancer can include: a persistent itch in the vulva; pain, soreness, or tenderness; a lump, swelling, or wart-like growth; a raised, thickened, red, white, or dark patch of skin; an open sore or ulcer that does not heal; and, sometimes, bleeding, an unusual discharge, or pain when passing urine. Because these symptoms — particularly itching and soreness — are much more commonly caused by other, benign conditions (such as thrush or skin conditions), they usually do not mean cancer; but symptoms that persist, do not improve with treatment, or are unusual should be checked. Unfortunately, embarrassment about the area involved can lead some women to delay seeking help, which can allow the cancer to progress — so it is important to know that these symptoms are worth getting checked, and that doctors and nurses are used to assessing such problems. Vulval cancer is diagnosed and treated by specialist gynaecology and oncology teams, and treatment depends on the stage and usually involves surgery, sometimes with radiotherapy and/or chemotherapy; it is often treatable, particularly when found early. Being aware of the symptoms and not letting embarrassment cause delay are the key messages, and treating pre-cancerous vulval skin changes can reduce the risk.

How it is treated

Vulval cancer is diagnosed and treated by specialist gynaecology and oncology teams, and because it is often very treatable when found early, prompt assessment of persistent vulval symptoms is important. Assessment involves an examination and, if an abnormal area is found, a biopsy (taking a sample), along with scans if needed to determine the stage. Treatment depends on the size, position, and stage of the cancer, and usually involves surgery to remove the cancer (which ranges from removing the affected area to more extensive surgery, sometimes with assessment or removal of nearby lymph nodes), and may also include radiotherapy and/or chemotherapy in certain situations. The specific approach is planned by the specialist team, aiming to treat the cancer effectively while preserving function and appearance as much as possible, and support is provided through and after treatment. Pre-cancerous changes of the vulval skin (sometimes called VIN) may be identified and treated to reduce the risk of cancer developing, and long-standing vulval skin conditions (such as lichen sclerosus) are monitored and managed. Because early diagnosis greatly improves outcomes, and because embarrassment can cause harmful delay, the key messages are to be aware of the symptoms and to get persistent vulval symptoms — such as a persistent itch, soreness, a lump, an unusual patch of skin, or a sore that does not heal — checked, without letting embarrassment cause delay; doctors and nurses are experienced in assessing these problems. It is worth keeping perspective, as these symptoms are far more often due to common, benign conditions than to cancer — but persistent or unusual symptoms should not be ignored. Reducing risk is also possible: HPV vaccination protects against relevant HPV types, not smoking reduces risk, and treating and monitoring vulval skin conditions helps. The reassuring messages are that vulval cancer is rare and often very treatable, particularly when found early, that the symptoms are usually due to benign causes, and that getting persistent symptoms checked — without embarrassment — is the most important step.