Gynaecological Cancers & Conditions
Vulval Pre-cancer/Cancer
Vulval cancer is a relatively rare condition, affecting 2 in 100,000 women in Australia. Vulval cancer usually affects post-menopausal women (women who have gone through the menopause) between the ages of 55 and 75. However, it can occur in younger or older women and is becoming more common in younger women due to HPV infection, which also causes cervical cancer.
Often, vulval cancer develops from vulval pre-cancer: VIN (Vulva Intra-Epithelial Neoplasia). VIN may have no symptoms but there is usually itching around the vulva, burning and raised patches of skin which are a different colour to unaffected areas.
VIN treated appropriately will prevent its progression to a cancer. This will usually involve surgical removal of affected tissue (excision). There is also new evidence to suggest that the use of creams formulated with agents to boost the immune system may be effective to reverse VIN or reduce its size, so that a smaller surgical excision is required. It's use however, will be limited to patients with lesions deemed low risk of progression to cancer.
The treatment of vulva cancer will involve a "radical/wide local excision" of the lesion on the vulva to make sure all of the affected tissue is removed.
Unless if the cancer is in its very earliest stages, it is adviseable to also remove the lymph nodes in the groin. This may be performed either as a full groin node dissection, or as a sentinel lymph node procedure. Dr Tan will discuss the pros and cons between the two different approaches which have their advantages and disadvantages.
Depending on whether an adequate clearance margin around the cancer is achievable around the cancer or whether the lymph nodes are positive for tumour, radiation treatment after the surgery may be required to achieve a cure or prevent recurrences.
After treatment for vulval cancer, Dr Tan will suggest a minimum follow-up of 5 yrs as recurrences are common, and another surgical excision may be necessary.
It was previously common to do vulval smears as follow-up but these have never been proven to be of benefit, and a more effective approach is perform a vulvoscopy (examining the vulva using a colposcope/microscope) at subsequent visits.
Cessation of smoking after treatment of vulval cancer will halve the risk of recurrence.
Often, vulval cancer develops from vulval pre-cancer: VIN (Vulva Intra-Epithelial Neoplasia). VIN may have no symptoms but there is usually itching around the vulva, burning and raised patches of skin which are a different colour to unaffected areas.
VIN treated appropriately will prevent its progression to a cancer. This will usually involve surgical removal of affected tissue (excision). There is also new evidence to suggest that the use of creams formulated with agents to boost the immune system may be effective to reverse VIN or reduce its size, so that a smaller surgical excision is required. It's use however, will be limited to patients with lesions deemed low risk of progression to cancer.
The treatment of vulva cancer will involve a "radical/wide local excision" of the lesion on the vulva to make sure all of the affected tissue is removed.
Unless if the cancer is in its very earliest stages, it is adviseable to also remove the lymph nodes in the groin. This may be performed either as a full groin node dissection, or as a sentinel lymph node procedure. Dr Tan will discuss the pros and cons between the two different approaches which have their advantages and disadvantages.
Depending on whether an adequate clearance margin around the cancer is achievable around the cancer or whether the lymph nodes are positive for tumour, radiation treatment after the surgery may be required to achieve a cure or prevent recurrences.
After treatment for vulval cancer, Dr Tan will suggest a minimum follow-up of 5 yrs as recurrences are common, and another surgical excision may be necessary.
It was previously common to do vulval smears as follow-up but these have never been proven to be of benefit, and a more effective approach is perform a vulvoscopy (examining the vulva using a colposcope/microscope) at subsequent visits.
Cessation of smoking after treatment of vulval cancer will halve the risk of recurrence.