VAGINA OR VULVA CANCER

General Information

DEFINITION--Uncontrolled growth of malignant cells in the vagina or on the vulva (vaginal lips).

BODY PARTS INVOLVED--Vagina; vulva.

SEX OR AGE MOST AFFECTED--Females of all ages, but the peak incidence is from ages 45 to 65. One type (rhabdomyosarcoma) occurs in children.

SIGNS & SYMPTOMS

• Itching; abnormal vaginal bleeding.
• Discomfort or bleeding with intercourse.
• Small or large, firm, ulcerated, painless lesion of the vulva. Cancers on the vulva have thick, raised edges and bleed easily.
• Uncomfortable urination, if cancer spreads to the bladder.
• Rectal bleeding, if it spreads to the rectum.

CAUSES

• Unknown, except for intrauterine exposure to DES (diethylstilbestrol, a drug prescribed [up to 1971] to control spotting or bleeding in pregnant women).
• A possible connection may be exposure to human papillomavirus (HPV), the cause of venereal warts.

RISK INCREASES WITH

• Family history of cancer of reproductive organs or other cancer.
• Smoking.
• Multiple sex partners.

HOW TO PREVENT

• No specific preventive measures. Have a yearly pelvic exam and Pap smear (See Glossary) to detect the disease during early stages when treatment is most effective.
• Become familiar with the appearance of your genitals. (Use a mirror and examine once a month.)

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests may be numerous, first to diagnose the cancer, and then to determine any spread to other body organs (staging). May include laboratory blood tests, Pap smear, chest x-ray, CT scan, mammogram, barium enema, cystoscopy, colposcopy with biopsy, sigmoidoscopy (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment (surgery, radiation, chemotherapy) depends partly on the location and extent of the disease and the age and physical condition of the patient.
• Surgery (usually) may include vulvectomy, vaginectomy, hysterectomy and lymph node removal. Laser vaporization is often used for treatment of some vulvar cancer.
• Radiation treatment (sometimes). External radiation shrinks the primary tumor. Internal radiation (implants) affects cancer that has spread to adjoining tissues.

POSSIBLE COMPLICATIONS--Fatal spread to other body parts. Common sites of spread are the lymph nodes in the groin, wall of the pelvis, bladder, rectum, bone, lungs or liver.

PROBABLE OUTCOME--This condition is currently considered incurable, but early detection and treatment offer a good chance for normal life expectancy. Symptoms can be relieved or controlled during treatment. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• The more you can learn about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Pain relievers as needed.
• Antibiotics, if urinary-tract infection results from use of a bladder catheter during radiation treatment.
• Stool softeners to prevent constipation.
• Anticancer drugs are usually not prescribed for this disease, with the exception of one type (sarcomas).

ACTIVITY--

• After surgery, resume your normal activities gradually, allowing 6 weeks for full recovery. Most patients can be fully active while receiving radiation therapy.
• Resume sexual relations when healing is complete in 8 to 10 weeks.

DIET--No special diet after treatment.

Call Your Doctor If

• You have symptoms of cancer of the vagina or vulva.
• The following occurs at the treatment site after surgery or radiation treatment: Signs of infection, such as increasing pain, fever and swelling. Excessive bleeding.