Vulvar and Vaginal Cancer

VULVAR AND VAGINAL CANCERS

Vulvar cancer is cancer of the skin around the vagina, outside the vagina. This includes skin around the opening of the vagina, labia, between the vagina and anus, and other areas nearby. The two most common types of vulvar cancer are squamous cell carcinoma and melanoma.

Vagina cancer is cancer of the lining inside the vagina, and is usually squamous cell carcinoma, like vulvar cancer, but rarely can be melanoma also.

Squamous cell cancers of the vulva and vagina, like cervical cancer, are also usually caused by HPV infection with high risk strains of HPV.

Unlikely cervical cancer, there are no routine pap testing to screen asymptomatic women with normal pelvic exam findings for precanerous lesions of the vulva or vagina.

The first opportunity to prevent most vulvar and vagina cancers is to receive HPV vaccination, if eligible. The next opportunity for prevention of some vulvar and vaginal cancer occurs by having regular/annual pelvic exams with a provider (usually at a gynecology office) who has the knowledge and experience to recognize tissues with subtle abnormal apperances, biopsy those subtle abnormalities, leading to diagnosis of precancerous (dysplasia) lesions of the vulva and vagina. Dysplasia lesions that are high grade and precancerous are then removed to prevent the development of invasive cancers.

Many vulvar and vagina cancers do not cause symptoms until the dysplasia has progressed to invasive cancer. Therefore, reguar pelvic exams are an opportunity to identify and treat dysplasia before the onset of symptoms. Nonetheless, precancerous lesions can be difficult to identify and women may not be diagnosed with a vuvlar or vaginal problem until the development of invasive vulvar or vaginal cancer.

Treatment

Treatment of vulvar and vaginal cancers depends on how early the cancer is diagnosed. Early and smaller cancers can often be removed surgically, with a good chance of cure. If the cancer is large, surgical removal may not be feasible. Some patients need evaluation of the lymph nodes to check if cancer has spread to regional lymph nodes such as the inguinal lymph nodes. Imaging is routinely performed when these cancers are diagnosed to look for any evidence of metastatic disease, usually with PET/CT imaging. If the cancer has already metastasized to other adjacent organs (bladder, rectum), nearby lymph nodes, or further in the body such as distant metastatic lesions, then surgery is usually not able to cure the disease and patients need radiotherapy and/or systemic therapy such as chemotherapy. Immunotherapy is another example of systemic therapy. In short, treatment is individualized based on the presentation of disease for each woman diagnosed with a vulvar or vaginal cancer.

Specialized Care

At Southland Uro+Gynecology, LLC, Dr. Seagle routinely evaluates and manages women with abnormal findings involving the vulva or vaginal epithelium. Most women have dysplasia that is precancerous and able to be treated prior to the development of cancer. Among women who are found to have an invasive vulvar or vaginal cancer, care is individualized based on the needs of each woman and, when needed, care is coordinated with each woman's local or preferred cancer center specialists, such as Medical Oncology and/or Radiation Oncology. When rarely needed or in the best interest of the patient, patients are referred to academic centers for Gynecologic Oncology (Medical College of Georiga or Emory) depending on their clinical trial eligibility and/or unusual circumstances. Most women with gynecologic cancer can receive outstanding care for their cancer at home or closer to home in South Georgia, including access to individualized use of newer treatments.

LEARN more about vulvar cancer

Vulvar cancer

LEARN more about vaginal cancer

Vaginal cancer