Cancer of the vulva

The vulvar cancer occurs in the vulva, the outer area of ​​the female genitals, and can affect any part of this structure, including the lips, the mons (the skin and the tissue covering the pubic bone), the clitoris or the vagina or openings the urethra. In most cases, the cancer affects the inner edges of the labia majora and labia minora.
Most vulvar cancers are squamous-cell floor. This tumor cells pavement begins, the main type of skin cells and generally develops over many years. Before graduating, generally appear abnormal cells on the surface layer of the vulva (epithelium) to what is called vulvar intraepithelial neoplasia.
Another common form of cancer of the vulva is melanoma, which usually occurs in the labia minora or clitoris. Other less common forms of cancer of the vulva include adenocarcinoma of Bartholin's glands and non-mammary Paget's disease. A small number of vulvar cancers corresponds to sarcomas, which occur in the tissue located beneath the skin.
Cancer of the vulva is rare, accounting for a very small percentage of cancers in women. Most women who are diagnosed with cancer of the vulva is older than 50 years and two-thirds have more than 70 years.
It has been recently diagnosed with vulvar intraepithelial neoplasia in younger women. This early detection and treatment of precancerous disease can prevent the development of a real cancer of the vulva.
Risk factors for cancer of the vulva include:
• the presence of abnormal cells vulvar pre-cancerous
• infection with human papillomavirus (HPV)
• smoking
• have an illness related to a state of immunodeficiency (an organ transplant, for example)
• the presence of vulvar dystrophy, a disease in which the skin have an abnormal appearance and is covered by whitish lesions
• the presence of precancerous changes in the cervix or a history of cancer of the cervix
• be of Northern European descent.
Treatment
The vulval cancer treatment depends on type of cancer and its stage of their location. The patient's age, health status in general and the importance of maintaining sexual function also influence treatment options.
Surgery is the most common treatment for cancer of the vulva. The exact type of surgery to the patient will be subjected depends on the amount of tissue that needs to be removed:
• Laser surgery destroys the layer of abnormal cells. Physicians treat vulvar intraepithelial neoplasia with laser surgery, but not invasive cancer.
• Excision (sometimes called wide local excision) removes the cancer and some surrounding normal tissue.
• The vulvectomy removes part or all of the vulva and underlying tissue. A simple vulvectomy removes only the vulva, while a partial radical vulvectomy removes part of the vulva and underlying tissue. A complete vulvectomy removes the entire vulva and underlying tissue including the clitoris. The impact on sexual function depends on the amount of the vulva is removed.
• Pelvic exenteration is more extensive surgical intervention, which includes vulvectomy the pelvic lymph node excision and removal of one or more of the following structures: the vagina, the rectum, the lower portion of the colon, bladder, uterus and cervix.
The treatment by radiotherapy is usually initiated after surgery. However, if the cancer affects a large area, this can be used before surgery to reduce its size.
Chemotherapy, or administration of anticancer drugs to cancer of the vulva, is currently under study. Researchers are testing a new treatment for women with severe cases of vulval cancer that involves the administration of intravenous chemotherapy, concomitantly with radiotherapy before surgery.
The greatest challenge is to select a treatment that maximizes the chances of removing all of the cancer while preserving sexual function, often lost with an aggressive surgery.
Some rare forms of cancer of the vulva may be associated with cancer elsewhere in the body. In these cases it may be necessary to carry out more tests and treatments, as well as increased monitoring frequency.
Prevention
There are some behaviors that can reduce the risk of having a cancer of the vulva. Equally important are measures to identify and treat precancerous conditions before they become an invasive cancer.
HPV infection is present in up to half of vulvar cancers. Almost all HPV infections are transmitted during sexual contact, but the most common viruses causing cancer are HPV types 16, 18 and 33. To reduce the risk of infection by HPV is:
• use latex condoms (female condom protects a wider area of ​​the genital tract and vulva low compared to the male condom)
• limit the number of sexual partners
• avoid having sex with someone who has, or has had many partners.
The early detection and treatment of precancerous disease help prevent cancer of the vulva cell-invasive pavement. Precancerous diseases and cancer can be detected early to perform a gynecological exam annually and shall proceed to a careful examination of all rashes, signs and vulvar nodules.
The vulva is usually examined when performing a Pap smear and a pelvic exam. In general, doctors recommend that women begin to perform Pap smears annually when they become sexually active or when they reach 21 years of age. After three negative Pap smears with at least one year apart, the physician may spend performing these tests at intervals of two or three years. This will depend on your age and the risk of developing cancer of the cervix.
Removal of the signal aspect stranger located in the vulva can help prevent vulvar melanomas some. On the other hand, smoking cessation may reduce the risk of many cancers, including cancers of the vulva. All these measures can also help prevent precancerous changes in the vulva.