Vulvar Cancer Symptoms and Treatment

According to the data obtained in the light of scientific studies carried out today, cancer is one of the most important health problems in society. A significant proportion of cancer cases in humans originate from the female reproductive system. One of these cancer types, which is more likely to develop especially in the presence of various risk factors, is vulvar cancer.

What is Vulva Cancer?

Vulva; It is the area of ​​the female reproductive system that covers areas such as the inner and outer lips of the vagina, the clitoris, vestibulum and the skin tissue covering these tissues, which are located in the outer appearance of the body. Again, the Bartholin gland and sebaceous glands located in the vaginal opening and responsible for the production of secretions in the region are evaluated within the framework of the vulva. It is known as vulva cancer when the cells forming the tissues in this region multiply abnormally and uncontrollably for various reasons, resulting in tissue integrity being disrupted and tumor-like structures. The cancerization process of epithelial tissue takes place gradually, over a long period of time. In this sense, cells in a certain part of the epithelial tissue may acquire the character of abnormal division. Although it is not possible to talk about a fully developed cancer disease in the tissue at this stage; It can be said that a step towards cancerization has been taken. This condition is called vulvar intraepithelial neoplasia (VIN). In women, vulvar cancer is usually the result of a chronic process that occurs as a result of the development and progression of VIN.

What Causes Vulvar Cancer?

Since vulvar cancer basically develops through cancerous structures called VIN, it can lead to the development of VIN in the epithelial tissue. Predisposing factors are considered risk factors for vulvar cancer. In this respect, the risk of developing cancer in the vulvar tissues increases in the following cases:

• Advanced age: Especially in women aged 55 and over, a predisposition to cancer may occur due to postmenopausal regression and atrophy in the tissues of the vulva region.
• Smoking consumption: Due to the numerous carcinogenic substances in cigarettes, it significantly increases the risk of vulvar cancer.
• History of HPV infection or genital warts: Human papilloma virus (HPV), especially the cervical region (cervix) � It causes infectious disease and genital wart development in the vulva and surrounding tissues. HPV Types 11 and 16; Along with cervical cancer, it greatly increases the risk of developing vulvar cancer.
• Lichen planus: The risk of developing vulvar cancer increases in the presence of lichen planus, which is a special health problem of this region, which is characterized by symptoms such as dryness and thickening of the skin in the vulva region. .
• HIV/AIDS infection: Cancer development is facilitated in cases such as HIV infection, which results in the suppression of the body's immune system. There are different types of cancers that can develop. In this condition, different risk factors should be considered for special types of cancer such as malignant melanoma.

  What are the Symptoms of Vulvar Cancer?

  The clinical picture of vulvar cancer in patients is correct with the stage and severity of the disease. proportionally monitored. In this regard, patients may not have any clinical symptoms in the early stages of the disease. However, as the disease progresses, the development of visible tumor structures in the region may be observed and various clinical manifestations may occur. In this regard, the following symptoms may occur in the course of vulvar cancer:

  • Itching in the vulva area
  • Discoloration or thickening of the vulvar skin
  • Burning sensation or pain when urinating
  • Vulvar pain or tenderness
  • Vulva swelling, vulvar sebaceous gland or wart-like structures
  • Abnormal vaginal bleeding
  • Vulvar sores that may appear on the skin or vaginal mucosa
  In addition, with the development of vulvar cancer, tumoral structures may develop horizontally along the vulva towards the skin or other tissues. Again, the tumor may spread to deeper tissues, or it may reach the lymph system and spread to the deeper lymph nodes through the lymphatic vessels. Since vulvar cancer usually primarily involves the superficial lymph nodes in the groin area, it can cause swelling and pain in this area. In more advanced stages, it targets the lymph nodes of deeper tissues. In this sense, a woman like a vagina It can spread to regions located in the inner parts of the reproductive system, as well as to other tissues such as lung and bone through blood and lymph circulation. For this reason, it is very important to recognize the disease in the early stages and to apply the appropriate treatment method without wasting time.

  How to Treat Vulvar Cancer?

  In order to treat vulvar cancer correctly and effectively, it is very important to apply the correct treatment method in the early period. diagnosis and staging. With an evaluation by a specialist physician, the patient's clinical symptoms and findings are determined as a result of a detailed disease history and detailed physical examination. The physician makes use of additional imaging and laboratory tests when he deems it necessary. The extent of cancer can be detected by computed tomography or magnetic resonance (MR) imaging. If necessary, special imaging methods such as cystoscopy can be used. The definitive diagnosis of vulvar cancer is made after histopathological examination of the biopsy sample taken from the tumor site. The staging of the disease is performed together with the diagnosis and imaging methods. Staging is very important in terms of determining the severity of the disease and the treatment method to be applied.
  Accordingly, the disease is staged as follows according to the anatomical region where the tumor tissue is located, the lymphatic system and the spread to distant organs:

  • Stage 0: There is an obvious tumor in the vulva region. It is the absence of a cancer phenomenon, but the development of signs of cancerization within the epithelial tissue such as VIN.
  • Stage 1: Cancer is limited only to the vulva and perineum regions. The perineum is the name given to the area between the vagina and anus openings. Again at this stage, the cancer has not spread to the lymph nodes.
  • Stage 2: Cancer has spread to regions outside the vulva (inner vagina, urethra or anus).
  • Stage 3: Cancer has spread to lymph nodes .
  • Stage 4: It is the state of cancer spreading to deeper tissues (such as deep parts of the vagina, bladder, rectum), deeper lymph nodes or distant organs.
  The vulvar cancer in the patient depends on the stage of the disease. different treatment, such as surgical approaches, radiotherapy or chemotherapy methods are used. Surgical approaches may include various techniques such as laser applications or open surgery. Small-sized tumor structures detected at an early stage with laser therapy can be removed from the body with high-temperature laser beams, and the patient can be discharged from the hospital in a short time with less scarring and side effects such as bleeding.
  Open surgery in more common and larger tumors. approaches can be used. Different levels of vulvectomy operations are performed according to the stage of the patient. In advanced stage cancers, radiotherapy and chemotherapy can be applied after surgery to increase the efficacy of treatment. Depending on the extent of the cancer, the removal of certain parts of the affected lymph nodes or organs may be included in the vulvectomy procedure. Again, in advanced stage cancers, in cases where the patient is not suitable for surgery, radiotherapy or chemotherapy can be applied alone or in combination. Therefore, the treatment of vulvar cancers is generally good and satisfactory. One of the factors affecting this is that the vulva consists of tissues that can be easily observed and become cancerous in a long time.

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