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The term vulva encompasses all of the external sex organs of the human female. It includes the clitoris, the openings of the urethra and vagina, and extends to the perineum. Cancer of the vulva can be located in any of these areas, as well as the skin around them. It is most common on the skin outside the opening of the vagina, or the labia. Vulva cancer is relatively rare, although doctors are seeing an increase in the number of cases of this type of cancer in women of childbearing age.
There are several types of vulva cancer. The four most common types of vulva cancer are vulvar intraepithelial neoplasia, or VIN, invasive squamous cell cancer, vulvar melanoma and Bartholin Gland cancer. There are other conditions that can mimic vulva cancer, and some types of vulva cancer don’t cause many symptoms. Any peculiar health conditions in this area of the body are worth a visit to the doctor. Many women, unfortunately, miss early warning symptoms, and try to treat their condition with over the counter creams.
Many women who develop vulvar intraepithelial cancer do not experience any symptoms in the early stages of the disease. Some women will notice changes to the skin in the area. The skin may become thicker, or develop a lighter color than the skin in the surrounding area. It may also become pink or red. Another symptom of VIN is itching that doesn’t go away.
In its early stages, invasive squamous cell cancer mimics VIN. Itching, thickening of the skin and a change in the color of the skin are all early signals that something is wrong. As this type of vulva cancer develops, the effected region will develop a recognizable tumor, or tumors. The area may also become raw or develop a wart-like appearance. As the cancer progresses, it may become painful to urinate, and the woman may experience unusual bleeding or other discharge.
Verrucous carcinoma is one type of invasive squamous cell cancer that is often misdiagnosed. The tumor grows in a cauliflower type shape. This growth, combined with the intense itching and painful urination, leads many doctors, and patients, to initially suspect genital warts.
Vulvar melanomas often occur at the site of an existing mole. Any mole that changes color or size should be examined by your physician, even one that is an area such as the vulva, which is not typically exposed to the effects of the sun. If it doesn’t develop from an existing mole, vulvar melanoma leads to the development of a darkly pigmented patch of skin in the affected area.
The Bartholin Gland is located on either side of the vagina. Cancer can develop in this gland, and is recognized by the development of a marble like lump in the area. More common, however, are Bartholin cysts, which develop in the same way, but are harmless.
Doctors diagnose vulva cancer in a multiple step process. They will take a complete medical history. This is important because many types of cancer have a genetic component. The medical history will also alert the doctor to any symptoms the patient is experiencing.
Following the medical history, the doctor will perform a complete physical examination, including a pelvic exam and Pap smear. If there are areas of the vulva that the doctor believes may be cancerous, a biopsy will be performed. If the area of affected skin is small, the doctor will remove it entirely, using local anesthesia and stitching the skin up when done. If the area is relatively large, the doctor will perform a punch biopsy, which removes a small area of the skin so that testing can be performed.