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More than 71,000 women in the United States are diagnosed with a cancer affecting the reproductive organs each year, according to the National Cancer Institute. These cancers can include endometrial, ovarian and cervical among others. Some of these cancers are more difficult to detect and treat than others, but advances are being made to help if you are facing one of these diseases.
Baylor offers a comprehensive approach to diagnosing and treating women with gynecologic cancer. Physicians on the medical staff at Baylor work with other health care specialists to treat and heal the whole woman.
The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.
Precancerous conditions of the cervix are identified as cells that look abnormal, but are not cancerous at the present time. However, the appearance of these abnormal cells may be the first evidence of cancer that develops years later.
Precancerous changes of the cervix usually do not cause pain and, in general, do not cause any symptoms. They are detected with a pelvic exam or a Pap test.
Squamous intraepithelial lesions (SIL) is a term that refers to abnormal changes in the cells on the surface of the cervix:
Squamous. These cells are the flat cells found on the surface (of the cervix)
Intraepithelial. This means that the abnormal cells are present only in the surface layer of cells
Lesion. This refers to an area of abnormal tissue
According to the National Cancer Institute, changes in these cells can be divided into 2 categories:
Low-grade SIL. This refers to early changes in the size, shape, and number of cells that form the surface of the cervix. They may go away on their own, or, with time, may grow larger or become more abnormal, forming a high-grade lesion.These changes may also be called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1).
High-grade SIL. This means there are a large number of precancerous cells, and, like low-grade SIL, these changes involve only cells on the surface of the cervix. The cells often do not become cancerous for many months, perhaps years, but without treatment, they will become cancer.High-grade lesions may also be called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ.
If abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. Cervical cancer occurs most often in women younger than the age of 50. It is different from cancer that begins in other parts of the uterus and requires different treatment. Most cervical cancers are squamous cell carcinomas and adenocarcinomas.
The mortality rates for cervical cancer have declined sharply as Pap screenings have become more prevalent. According to the American Cancer Society about 12,340 cases of invasive cervical cancer will be diagnosed in the U.S. during 2013. Some researchers estimate that noninvasive cervical cancer (also referred to as carcinoma in situ) is nearly 4 times more common than invasive cervical cancer.
The following have been suggested as risk factors for cervical cancer:
Infection with the human papillomavirus (HPV). HPV is the cause of nearly all cervical cancers. Infection with HPV is most often the result of unprotected sex.
Not getting regular Pap tests. Cervical cancer is more common in women who don't have regular Pap tests. Pap tests help doctors find abnormal cells. These cells can then be removed, which usually prevents cervical cancer.
Infection with HIV or other conditions that weaken the immune system. HIV is the precursor to AIDS and can increase your risk of cervical cancer. Taking certain medications that suppress the immune system also increases the risk of cervical cancer.
Smoking. Women who smoke are nearly twice as likely as nonsmokers to have cervical cancer.
Diet. Women with diets low in fruits and vegetables and those who are overweight are at increased risk for cervical cancer.
Chlamydia infection. Some studies have seen a higher risk of cervical cancer in women whose blood test results show evidence of past or current chlamydia infection when compared with women who have normal test results. Chlamydia is spread by sexual contact.
Using birth control pills for a long time. Using birth control pills for 5 or more years may slightly increase the risk of cervical cancer, but the risk decreases when women stop using birth control pills.
Having many children. Studies suggest that giving birth to 3 or more children may slightly increase the risk of cervical cancer in women with HPV infections.
Having sexual intercourse before the age of 18
Having many sexual partners, and having partners who have had many partners themselves
First full-term pregnancy at a young age. Women who were younger than 17 years when they had their first full-term pregnancy are almost 2 times more likely to get cervical cancer later in life than women who waited until they were 25 years or older to get pregnant.
Poverty. Many low income women do not have access to adequate health care services, including Pap tests. So they are not screened or treated for cervical precancers.
Family history of cervical cancer. This cancer may run in some families. A woman's chance of developing it are 2 to 3 times higher if her mother or sister had cervical cancer than if no one in her family had it.
Diethylstilbestrol (DES). DES is a drug that was used to prevent miscarriage between 1940 and 1971. Women whose mothers took DES while pregnant with them develop this cancer more than would normally be expected. The risk seems to be highest in women whose mothers took the drug during their first 16 weeks of pregnancy. (The FDA stopped the use of DES during pregnancy in 1971.)
Early detection of cervical problems is the best way to prevent cervical cancer. Routine, annual pelvic exams and Pap tests can detect precancerous conditions that often can be treated before cancer develops. Invasive cancer that does occur would likely be found at an earlier stage. Pelvic exams and Pap tests are used to determine if there are cervical problems. Women who are age 21 or older should have regular checkups, including a pelvic exam and Pap test.
According to the National Institutes of Health:
A pelvic exam and Pap test allow the doctor to detect abnormal changes in the cervix. If an infection is present, it is treated and the Pap test is repeated at a later time. If the exam or Pap test suggests something other than an infection, a repeated Pap test and other tests are performed to determine the problem.
Women who have had a hysterectomy (surgery to remove the uterus, including the cervix) should ask their doctor's advice about having pelvic exams and Pap tests.
Because certain strains of HPV have been found to cause most cases of cervical cancer, research efforts have focused on developing a vaccine against HPV. Two HPV vaccines have been approved:
Gardasil protects against 4 types of the HPV virus — the 2 types of viruses that cause most cervical cancers, and the 2 that cause 90% of genital warts. It protects against other cancers caused by HPV, too, such as cancers and precancers of the vagina, vulva and anus.
Cervarix protects against the 2 types of the HPV virus that cause most cervical cancers. It protects against anal cancers, too.
These vaccines can only be used to prevent certain types of HPV infection before a person is infected. They cannot be used to treat an existing HPV infection.
Both vaccines are administered as a series of 3 injections over a 6-month period. To be most effective, one of the vaccines should be given before a person becomes sexually active.
Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue:
The most common symptom is abnormal bleeding, which may:
Start and stop between regular menstrual periods.
Occur after sexual intercourse, douching, or a pelvic exam.
Other symptoms may include:
Heavier menstrual bleeding, which may last longer than usual
Bleeding after menopause
Increased vaginal discharge
Pain during intercourse
The symptoms of cervical cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.
When cervical problems are found during a pelvic examination, or abnormal cells are found through a Pap test, a cervical biopsy may be performed.
There are several types of cervical biopsies that may be used to diagnose cervical cancer, and some of these procedures that can completely remove areas of abnormal tissue may also be used for treatment of precancerous lesions. Some biopsy procedures only require local anesthesia, while others require a general anesthesia. Several types of cervical biopsies include:
Loop electrosurgical excision procedure (LEEP). A procedure that uses an electric wire loop to obtain a piece of tissue so it can be examined under a microscope.
Colposcopy. A procedure that uses an instrument with magnifying lenses called a colposcope, to examine the cervix for abnormalities. If abnormal tissue is found, a biopsy is usually performed (colposcopic biopsy).
Endocervical curettage (ECC). A procedure that uses a narrow instrument called a curette to scrape the lining of the endocervical canal. This type of biopsy is usually completed along with the colposcopic biopsy.
Cone biopsy (also called conization). A biopsy in which a larger cone-shaped piece of tissue is removed from the cervix by using the loop electrosurgical excision procedure or the cold knife cone biopsy procedure. The cone biopsy procedure may be used as a treatment for precancerous lesions and early cancers.
HPV DNA test. A test that detects the presence of cervical HPV infection. The cells are collected as they are for a regular Pap test, but it is not a replacement for a Pap test. The HPV DNA test may be used as a screening test for women over 30 or for women with slightly abnormal Pap test results to determine if further testing or treatment is required.
Cold knife cone biopsy. A procedure in which a laser or a surgical scalpel is used to remove a piece of cervical tissue for further examination. This procedure requires the use of general anesthesia.
Specific treatment for cervical cancer will be determined by your doctor based on:
Your overall health and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Cryosurgery. Use of liquid nitrogen, or a probe that is very cold, to freeze and kill cancer cells.
Laser surgery. Use of a powerful beam of light, which can be directed to specific parts of the body without making a large incision, to destroy abnormal cells.
Hysterectomy. Surgery to remove the uterus, including the cervix. In some cases, a hysterectomy may be required, particularly if abnormal cells are found inside the opening of the cervix.
LEEP or conization may also be used to remove abnormal tissue.
Cervical cancer occurs in the cervix, which is in the lower part of the uterus. It is caused by several types of the human papillomavirus (HPV) that spreads through sexual contact.
The ovaries are female reproductive organs located in the pelvis. There are 2 of them — 1 on each side of the uterus. The ovaries produce eggs and the female hormones estrogen and progesterone. Estrogen and progesterone control the development of female body characteristics (for example, breasts, body shape and body hair) and regulate the menstrual cycle and pregnancy.
Ovarian cancer is a disease in which cancer starts in the cells of the ovary. There are 3 types of ovarian tumors, named for the tissue in which they are found:
Epithelial cell. These are cells that cover the surface of the ovary. Most of these tumors are benign (noncancerous) and account for most cases of ovarian cancer.
Germ cell. These are cells that form the eggs in the ovary.
Stromal cell. These cells form the structural tissue of the ovary and produce female hormones.
EOPPC is a cancer closely related to epithelial ovarian cancer. Its microscopic features and national history of disease and prognosis are identical to epithelial ovarian cancer. It occurs outside the ovary in the peritoneum, which is the lining of the abdomen (belly). Because it occurs outside the ovary, women who have had their ovaries removed can still develop this type of cancer.
EOPPC can mimic ovarian cancer in terms of symptoms and can also cause an increase in the CA-125 tumor marker. Treatment is similar to that for ovarian cancer and includes surgery and chemotherapy.
The cause of ovarian cancer is not yet known because most cases are sporadic. An estimated 21,980 new cases of ovarian cancer are expected in the U.S. in 2014. Ovarian cancer is the ninth most common form of cancer among women.
The cause of ovarian cancer is unknown, but there are certain risk factors that indicate an increase in a woman's chance of developing ovarian cancer. The following have been suggested as risk factors for ovarian cancer:
Age (over the age of 55)
Hormone replacement therapy. Some studies have suggested that women who use hormone replacement therapy after menopause may have a slightly increased risk of ovarian cancer.
Infertility (inability to become pregnant)
Personal history of breast or colon cancer
Family history. First-degree relatives (such as mother, daughter, sister) of a woman who has had ovarian cancer are at risk for developing the disease. The risk increases if 2 or more first-degree relatives have had ovarian cancer. A family history of breast or colon cancer is also associated with an increased risk of developing ovarian cancer.
Certain fertility drugs
Suggested preventive measures include the following:
Healthy diet (high in fruits, vegetables, grains, and low in saturated fat)
Staying at a healthy weight throughout life
Birth control pills
Pregnancy and breastfeeding
Oophorectomy. Surgical removal of ovaries if you're at high risk for ovarian cancer.
Research studies have shown that certain genes are responsible for increasing the risk of ovarian and breast cancer. Genetic counseling can tell you whether you have 1 of these gene mutations. If your family history suggests that you may have 1 of these gene mutations, you might want to talk to your doctor about genetic testing.
The following are the most common symptoms of ovarian cancer. However, each individual may experience symptoms differently. Symptoms may include:
General discomfort in the lower abdomen, including any or all of the following:
Feeling swollen or bloated
A loss of appetite or a feeling of fullness — even after a light meal
Gas, indigestion, and nausea
Diarrhea or constipation, or frequent urination caused by the growing tumor, which may press on nearby organs, such as the bowel or bladder
Feeling very tired all the time
Bleeding from the vagina
Buildup of fluid around the lungs, which may cause shortness of breath
If any of these symptoms occur almost daily or last a few weeks and are new, they should be reported to the doctor. In many cases, symptoms do not occur until the ovarian cancer is in an advanced stage, meaning it has spread beyond the ovary in which it started. The symptoms of ovarian cancer may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Diagnosis includes a medical history and physical examination, including a pelvic examination to check the vagina, rectum, and lower abdomen for masses or growths. A Pap test may be done as part of the pelvic examination. The definitive diagnosis is made at the time of surgery. The doctor may also order other tests, such as:
Ultrasound. An imaging technique that uses sound waves to produce an image on a monitor of the abdominal organs, such as the uterus, liver, and kidneys.
Computed tomography (CT or CAT scan). A noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. The CT scan may indicate enlarged lymph nodes — a possible sign of a spreading cancer or infection.
Lower gastrointestinal (GI) series. X-rays of the colon and rectum using a contrast dye called barium.
Intravenous pyelogram (IVP). X-rays of the kidneys and ureters, taken after the injection of a dye.
Blood test. To measure a substance in the blood called CA-125 (a tumor marker that is often found to be elevated in the blood of women with ovarian cancer). This test is more often used to monitor the progress of treatment than as a screening test since noncancer problems can cause it to be elevated.
Biopsy. A procedure in which tissue samples are removed from the ovary for examination under a microscope. This is done to see if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.
Specific treatment for ovarian cancer will be determined by your doctor based on:
Your age, overall health, and medical history
It's very important that your particular findings be put into context by an expert. Gynecologic oncologists are subspecialists with advanced training in the diagnosis, treatment, and surveillance of female cancers including ovarian cancer.
Ovarian cancer may be treated with surgery, chemotherapy, radiation therapy, or a combination of treatments.
Surgery. Surgery for ovarian cancer may include:
Salpingo-oophorectomy. Surgery to remove the fallopian tubes and ovaries.
Hysterectomy. Surgical removal of the uterus.
Pelvic lymph node dissection. Removal of some lymph nodes from the pelvis.
Chemotherapy. This is the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Usually, chemotherapy is given intravenously. Another way to treat ovarian cancer is through intraperitoneal (IP) chemotherapy. This type of chemotherapy is given directly into the abdomen through a long, thin tube called a catheter. It is only used for women with ovarian cancer that has spread to the inside of the abdomen.
Radiation therapy. Radiation therapy is rarely used for ovarian cancer. Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. There are 2 ways to deliver radiation therapy:
External radiation (external beam therapy). A treatment that precisely sends high levels of radiation directly to the cancer cells. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
Internal radiation (brachytherapy, implant radiation). Radiation is given inside the body as close to the cancer as possible. In some cases, a treatment called intraperitoneal radiation therapy is used. A radioactive liquid is given through a catheter into the abdomen. (Internal radiation is very rarely used to treat ovarian cancer.)
Ovarian cancer occurs in the ovaries, the female reproductive organs that produce eggs. It usually occurs in women over 50, but can affect younger women as well.
The uterus, also called the womb, is a hollow, pear-shaped organ located in a woman's lower abdomen (belly), between the bladder and the rectum.
Cervix. This is the narrow, lower portion of the uterus.
Corpus. This is the broader, upper part of the uterus.
Serosa. This is the outer layer that covers the uterus.
Myometrium. This is the middle layer of the corpus, the thick muscle that expands during pregnancy to hold the growing fetus.
Endometrium. This is the inner lining of the uterus.
Cancers that occur in each part of the uterus have their own names, such as cervical cancer or endometrial cancer, but are sometimes broadly defined as uterine cancer because the structure is part of the uterus. Cancer of the uterus spreads through the bloodstream or lymphatic system. According to the American Cancer Society, nearly 50,000 cases of cancer of the uterine corpus (body of the uterus) are diagnosed in the U.S. each year.
Some conditions in the uterus, caused by abnormal, rapid, and uncontrolled division of cells, are not cancer. They are called benign conditions. Three of these benign conditions are:
Fibroid tumors. These are common benign tumors of the uterine muscle that do not develop into cancer. Fibroid tumors of the uterus are very often found in women in their forties. And, although single fibroid tumors do occur, multiple tumors are more common. Symptoms of fibroid tumors, which depend on size and location, include irregular bleeding, vaginal discharge, and frequent urination. For fibroids that press against nearby organs and cause pain, surgery may be necessary. Many times, however, fibroids do not cause symptoms and do not need to be treated. After menstrual periods cease, fibroid tumors may become smaller and may disappear altogether.
Endometriosis. This is is a benign condition of the uterus that is common among women in their thirties and forties, especially women who have never been pregnant. Tissue that looks and acts like endometrial tissue begins to grow in unusual places, such as on the surface of the ovaries, on the outside of the uterus, and in other tissues in the abdomen.
Hyperplasia. This is an increase in the number of normal cells lining the uterus. Although it is not cancer, it may develop into cancer in some women. The most common symptoms are heavy menstrual periods, bleeding between periods, and bleeding after menopause.
The following are risk factors for uterine cancer:
Age. The risk goes up as women get older.
History of endometrial hyperplasia
Estrogen therapy (ET)
Obesity is the leading risk factor for endometrial cancer
History of an inherited form of colon cancer (called hereditary nonpolyposis colon cancer or Lynch syndrome)
History of breast or ovarian cancer
History of taking tamoxifen for breast cancer treatment or prevention
Race. African-American women are affected with uterine sarcoma at a rate twice that of white or Asian women.
History of radiation therapy to the pelvic area
History of polycystic ovary syndrome (PCOS)
Reproductive and menstrual history. An increased risk is linked to never having children, having your first menstrual period before age 12, and/or going through menopause after age 55.
The following are the most common symptoms of uterine cancer. However, each individual may experience symptoms differently. Symptoms may include:
Unusual vaginal bleeding, spotting, or discharge
Vaginal bleeding after menopause
Frequent, difficult, or painful urination
Pain during sexual intercourse
Pain in the pelvic area
Cancer of the uterus usually does not occur before menopause. It usually occurs around the time menopause begins. The occasional reappearance of bleeding should not be considered simply part of menopause. It should always be checked by a doctor.
The symptoms of uterine cancer may look a lot like other conditions or medical problems. Consult a doctor for diagnosis.
When symptoms suggest uterine cancer, the following may be used to make a positive diagnosis:
A detailed medical history--family and personal
A thorough physical exam
Pelvic examination of the uterus, vagina, ovaries, bladder, and rectum (may include a Pap test)
Ultrasound to look at the uterus and nearby tissue and check for tumors
Biopsy. Removal of a sample of tissue to see if the tissue contains cancer cells.
Dilation and curettage (D & C). A minor operation in which the cervix is dilated (expanded) so that the cervical canal and uterine lining can be scraped with a curette (spoon-shaped instrument). The removed tissue is checked to see if it contains cancer cells.
When cancer cells are found, other tests are used to see if the disease has spread from the uterus to other parts of the body. These procedures may include:
Computed tomography (CT or CAT) scans of various sections of the abdomen (belly)
An ultrasound to view organs inside the body
Special exams of the bladder, colon, and rectum
Specific treatment for uterine cancer will be determined by your doctor based on:
Methods of treatment may include:
Hysterectomy. Surgery to remove the uterus. Sometimes this is done with salpingo-oophorectomy, which is a surgery to remove the fallopian tubes and ovaries. Nearby lymph nodes and part of the vagina may also be removed.
Uterine (Endometrial) cancer is a cancer that occurs in the uterus, an important female reproductive organ.
The vagina is the passageway through which fluid passes out of the body during menstrual periods. It is also called the birth canal. The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia).
Cancer of the vagina, a rare kind of cancer in women, is a disease in which malignant (cancer) cells are found in the tissues of the vagina. According to the American Cancer Society, about 2,890 cases of vaginal cancer will be diagnosed in the U.S. in 2013.
There are several types of cancer of the vagina. The 2 most common are:
Squamous cell cancer (squamous carcinoma):
Squamous carcinoma is most often found in women older than age 60, and accounts for about 70% of all vaginal cancers.
Adenocarcinoma is more often found in women older than 50 and accounts for about 15% of all vaginal cancers.
A rare form of cancer called clear cell adenocarcinoma results from the use of the drug DES (diethylstilbestrol) given to pregnant women between 1940 and 1971 to keep them from miscarrying. It occurs most often in the daughters of the women who took DES.
Other, less common types of cancer that can be found in the vagina include:
Cancers that begin in other organs (such as the cervix and rectum) and spread to the vagina
The following have been suggested as risk factors for vaginal cancer:
Age. Almost half of cases are in women age 70 or older.
Exposure to diethylstilbestrol (DES) as a fetus (mother took DES during pregnancy)
History of cervical cancer
History of cervical precancerous conditions
Human papillomavirus (HPV) infection
The following are the most common symptoms of vaginal cancer. However, each individual may experience symptoms differently. Symptoms may include:
Bleeding or discharge not related to menstrual periods
Difficult or painful urination
A mass that can be felt
Even if a woman has had a hysterectomy, she still has a chance of developing vaginal cancer. The symptoms of vaginal cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.
There are several tests used to diagnose vaginal cancer, including:
Pelvic examination of the vagina, and other organs in the pelvis. This is done to check for tumors, lumps, or masses.
Colposcopy. A procedure that uses an instrument with magnifying lenses, called a colposcope, to examine the cervix and vagina for abnormalities. If abnormal tissue is found, a biopsy is usually performed (this is called a colposcopic biopsy).
Pap test (also called Pap smear). A test that involves microscopic examination of cells collected from the cervix, used to detect changes that may be cancer or may lead to cancer, and to diagnose noncancerous conditions, such as infection or inflammation.
Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Positron emission tomography (PET) scan. Radioactive-tagged glucose (sugar) is injected into the bloodstream. Tissues that use the glucose more than most normal tissues (such as tumors) can be detected by a scanning machine. PET scans can be used to find small tumors or to check if treatment for a known tumor is working.
Biopsy. A procedure in which tissue samples are removed from the vagina for examination under a microscope; to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.
Specific treatment for vaginal cancer will be determined by your doctor based on:
Generally, there are 3 kinds of treatment available for patients with cancerous or precancerous conditions of the vagina:
Laser surgery to remove the cancer, including LEEP (loop electroexcision procedure)
Local excision to remove the cancer
Vaginectomy to remove all or part of the vagina
Cancer of the vagina is rare and usually occurs in women over 60. An infection of the human papillomavirus (HPV) may also increase your chances of developing vaginal cancer.
The vulva is the external portion of the female genital organs. It includes:
Labia majora. Two large, fleshy lips, or folds of skin.
Labia minora. Small lips just inside the labia majora and surround the openings to the urethra and vagina.
Vestibule. Space where the vagina opens.
Prepuce. A fold of skin formed by the labia minora that covers the clitoris.
Clitoris. A small protrusion of nerve tissue sensitive to stimulation.
Fourchette. Area beneath the vaginal opening where the labia minora meet.
Perineum. Area between the vagina and the anus.
Anus. Opening at the end of the anal canal.
Urethra. Connecting tube to the bladder.
Vulvar cancer can occur on any part of the external organs, but most often affects the labia majora or labia minora. According to the American Cancer Society, about 4,850 cases of cancer of the vulva will be diagnosed in the U.S. in 2014. Cancer of the vulva is a rare disease, which accounts for 0.6% of all cancers in women, and may form slowly over many years. Most vulvar cancers are squamous cell carcinomas. Melanoma is another common type of vulvar cancer, usually found in the labia minora or clitoris. Other types of vulvar cancer include:
Basal cell carcinoma
The following have been suggested as risk factors for vulvar cancer:
Age. Of the women who develop vulvar cancer, over 80% are over age 50, and half are over age 70.
Infection with certain types of human papillomavirus (HPV)
Lichen sclerosus. This can cause the vulvar skin to become very itchy and may slightly increase the possibility of vulvar cancer.
Melanoma or atypical moles on nonvulvar skin. A family history of melanoma and dysplastic nevi anywhere on the body may increase the risk of vulvar cancer.
Vulvar intraepithelial neoplasia (VIN). There is an increased risk for vulvar cancer in women with VIN, although most cases do not progress to cancer.
Other genital cancers
While each woman may experience symptoms differently, the most common symptoms are:
Changes in the color and the way the vulva looks
Bleeding or discharge not related to menstruation
Severe burning, itching, or pain
An open sore that lasts for more than a month
Skin of the vulva looks white and feels rough
The symptoms of vulvar cancer may look like other conditions or medical problems. Consult a doctor for diagnosis.
The cause of vulvar cancer is not known at this time, however, certain risk factors are thought to contribute to development of the disease. Suggestions for prevention include:
Avoid known risk factors when possible
Delay onset of sexual activity
Do not smoke
Have regular physical checkups
Get vaccinated against HPV
Have routine Pap tests and pelvic exams
Routinely check entire body for irregular growth of moles and check your vulva regularly for any signs of vulvar cancer
Vulvar cancer is diagnosed by biopsy, removing a small piece of tissue for exam in a lab by a pathologist.
Specific treatment for vulvar cancer will be determined by your doctor(s) based on:
Treatment for cancer of the vulva may include:
Laser surgery. Use of a powerful beam of light to destroy abnormal cells. The beam can be directed to specific parts of the body without making a large incision (cut). This type of therapy is only used for premalignant (noninvasive) disease of the vulva.
Excision. The cancer cells and a margin of normal tissue around the cancer is removed.
Vulvectomy. Surgical removal of part of all of the tissues of the vulvar. The extent of the tissue removed is based on the size and location of the lesion.
It's very important that your particular findings be put into context by an expert. Gynecologic oncologists are subspecialists with advanced training in the diagnosis, treatment, and surveillance of female cancers including vulvar cancer.
Vulvar cancer is cancer of the vulva, a woman's external genitals. This is a very rare form of cancer.
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