Vulvar Cancer

Vulvar cancer develops on the vulva, the external skin folds around the vagina, urethra, and clitoris, with squamous cell carcinoma constituting 95% of cases. There are two primary types: HPV-related (younger women, warty/basaloid subtypes) and non-HPV (older women, keratinising, linked to lichen sclerosus or dystrophy). Smoking, a weakened immune system, long-term inflammation of the vulva, and a history of cervical cancer are all things that can raise your risk.

Early signs of this disease can look like harmless problems, such as constant itching, burning, or pain; changes in skin colour (redder or whiter); lumps, blisters, ulcers, or growths that look like warts; and bleeding that isn't related to menstruation or bad discharge. As the condition worsens, it may lead to pelvic pain during urination or sexual intercourse, swollen lymph nodes, and swelling in the legs due to lymphatic spread. Biopsy, colposcopy, and imaging (CT/MRI/PET) are used to figure out the stage of the cancer using the FIGO/TNM systems. They look at the size and depth of the tumour (more than 1 mm of invasion raises the chance of spreading to lymph nodes), as well as whether it has spread to other parts of the body.

Surgery is the most important part of treatment. For early stages (IA), extensive local excision is done. For larger tumours, radical vulvectomy/lymphadenectomy is done. A sentinel node biopsy lowers the risk of complications. Radiation or chemoradiation (cisplatin) is useful for advanced or inoperable cases or positive nodes. Topical treatments are used to treat pre-cancers like VIN. Five-year survival is 90% for stage I but only 20–30% for distant spread. The HPV vaccine stops many cases. Regular self-exams and quick visits to the dermatologist can save lives.