Vulvar cancer is a malignant tumor of the external part of female genital organs. This cancer is on the fourth place in gynecologic oncology after endometrial cancer.
Disease is mainly diagnosed in the elderly over 65 years old and is rarely met in women of reproductive age.
Risk factors of vulvar cancer are:
Tumor is often occurs as a consequence of precancerous conditions and vulvar illnesses including:
Clinical course of vulvar cancer may differ, but the most common signs are:
The next group of symptoms develops as a result of regional metastasis of vulvar cancer into neighboring anatomical structures:
Intoxication syndrome can be also observed. It is manifested by fever, weakness, quick fatigue.
Following vulvar cancer symptoms are detected during diagnostics:
Vulvar cancer is a generalized name for tumors of different localization that can occur in:
"Vulvar cancer" term is used in diagnostics because all the anatomical structures of the external reproductive organs are close to each other. Tumor may sprout into the neighboring tissues making it impossible to define its primary location.
Diagnosis is established after the cytological test of a smear from the reproductive organs. Also biopsy (tissue sample test) is done.
Visualization techniques are done to evaluate the level of pathological process prevalence. These help to determine tumor size and detect possible metastases:
German hospitals provide all high-tech diagnostic techniques for the vulvar cancer which allows doctor to obtain maximum information about the disease and chose the best treatment scheme possible.
Some women are ordered diagnostic laparoscopy if they have advanced stages of cancer. Video endoscopy equipment is introduced into the small pelvis cavity, and the image of the organs “from the inside” is viewed on the monitor. Laparoscopy is an invasive method of research, but at the same time it is one of the most accurate ways to determine the prevalence of vulvar cancer, to detect metastases and to plan the scope of a surgical operation.
Surgery is a key way to treat this type of cancer. Its scope is determined by the tumor location, its prevalence and size.
If a tumor is at the first stage, surgeon will perform one of the next operations:
Bilaterial lymphadenectomy is mandatory starting from the second stage of cancer. Also, radiation therapy is used postoperatively for the following indications:
Radiation therapy or chemotherapy is possible before the operation to improve tumor resection. Results of treatment are analyzed by a surgeon. Oncology surgeon decides on the possibility of the intervention.
Volume of operation can be significant at the third stage. Sometimes they remove a bladder, rectum fragment or other organs where a tumor has already affected. Doctors apply intraoperative intra-cavity gamma-therapy (irradiation) to improve treatment effectiveness.
Doctors are trying to minimize the amount of surgical treatment of stage 1 vulvar cancer, and even completely reject it in recent years. It is possible to perform laser ablation, photodynamic therapy, or combinationof those two instead of vulvectomy.
Such therapy is better tolerated by a patient, has low risk of complications and ensures quick recovery. Meanwhile, effect is the same as after the surgery.
Clinical trials are conductedto study some medicines that are planned to be included into the pharmacotherapy scheme of vulvar cancer treatment. These drugs allow increasing patients’ life expectancy.
Today, such target therapy medicines that are in clinical trials:
New approaches in the comprehensive treatment of the patients with locally advanced vulvar cancer are being developed. This involves simultaneous use of surgery, chemotherapy and radiation therapy.
General 5-year-survival of patients depending on the pathological process prevalence is:
Prognosis depends not only on the disease stage, but also on the primary location of a tumor. The most favorable prognosis is for those having vulvar cancer restricted by the small labia area. The worst prognosis is peculiar for those having clitoral cancer, because it quickly gives distant metastases in hematogenous (through the blood) way, bypassing the lymphatic system.
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