Understanding Vulvar & Vaginal Cancers

What are vaginal and vulvar cancer?

Cancer is a disease in which certain cells in the body grow out of control. The vulva is the external part of the female genital organs including the labia majora and labia minora, the clitoris, and the vaginal opening, while the vagina is the organ that connects the uterus with the vulva. 

Vulvar cancer is a relatively rare form of cancer and often develops slowly over several years, sometimes starting as precancerous changes called vulvar intraepithelial neoplasia (VIN)

Vaginal cancer is another rare type of cancer that occurs in the tissues of the vagina. It primarily affects older women and can develop in different parts of the vaginal tissue.

What Are the Symptoms of Vaginal Cancer?

The symptoms of vaginal cancer can present themselves as genital bleeding outside the days of menstruation, genital bleeding in menopause, abnormal unexplained changes in the rhythm of bowel or bladder evacuation, and abdominal and/or pelvic pain and/or during sexual intercourse. 

What Are the Symptoms of Vulvar Cancer?

Vulvar cancer usually causes vulvar pain, itching/stinging, changes in the color of the skin of the vulva, or the appearance of wart-like lesions

How Are Vulvar and Vaginal Cancer Diagnosed?

There are no 100% effective methods of prevention or early diagnosis of vaginal and vulvar cancer. During your annual visit to the gynecologist, abnormalities may be observed during the physical examination that could alert the professional to investigate and reach a definitive diagnosis. If you are experiencing any unexplained symptoms, be sure to bring them to your physician’s attention.

It is important to remember that regular pap tests are not useful for the early detection of vaginal-vulvar cancer. Its function is to detect pre-malignant lesions of the uterine cervix or cervical cancer in its very early stages.

If your gynecologist detects any suspicious lesions or growths, they will carry out a physical examination, including a speculoscopy and, if they consider it necessary, they will also carry out a biopsy.

• Speculoscopy is the visualization of the vagina and the uterine cervix by placing a speculum.
• Vulvoscopy is a procedure that consists of visualizing the skin of the vulva magnified with a high-definition microscope. This technique is performed in the same consultation without causing discomfort or pain.
• Biopsy is performed in the same consultation with local anesthesia as a small tissue sample is taken to be analyzed closer by the pathology lab.

Computed Axial Tomography (CAT) Scans for Vaginal & Vulvar Cancer

CAT scans are routinely performed prior to any cancer treatment to determine the extent of the disease outside the affected organ: lymph nodes, abdominal organs, or the chest cavity. Usually performed with oral and intravenous contrast.

Magnetic resonance imaging (MRI) for Vaginal & Vulvar Cancer

MRI scans are a useful complementary diagnostic tool to determine the local extension and potential spread of the disease.

What Causes Vaginal and Vulvar Cancer?

While it is unclear what specifically causes Vaginal and Vulvar cancer, there have been studies which have found a statistical link between a number of risk factors.

HPV Infection is known to increase the risk of developing gynecological cancers in women

Smoking and Immunosuppressive conditions (Like HIV, or use of immunosuppressant medication) have also been linked to an increased cancer risk.

Having any of the aforementioned risk factors does not mean that a woman will definitively suffer from vaginal or vulvar cancer in the future, but rather that the risks are necessary to discuss with a gynecologist.

Surgical treatment of vaginal cancer

Surgical treatment is usually the first therapeutic step to treat vaginal and vulvar cancer, which may include any of the following procedures:

Partial vulvectomy

A partial vulvectomy consists of the surgical removal of the tumor and 1 cm of surrounding healthy tissue.

Radical vulvectomy

A radical vulvectomy is the removal of the entire vulva and is performed in cases of locally extended tumors.

Inguinal lymphadenectomy

Consists of the removal of all the nodes of the inguinal region.

Sentinel Node Detection Technique

Each of these treatments are paired with the Sentinel Node technique, this technique consists of injecting a marker (technetium ⁹⁹) in the region of the tumor that serves to identify the sentinel node in the inguinal region where the tumor would migrate, at the time of surgery. Said node (although there may be 2 or 3) is identified, extracted, and analyzed at the same time by specialized pathologists. If malignant cells are identified, removal of all inguinal nodes is performed.

After surgery, pathologists will carefully review the submitted material to obtain a final diagnosis and determine the true extent of the disease. Next, all the best postoperative therapeutic option is made taking into account a series of factors that include:

Gynecology Consultation

If you want to resolve some doubts related to vaginal cancer, you may be interested in a consultation with a specialist in Gynecology.

Click on the button to make an appointment.

The decision may be simply observation and follow-up, or may rarely include radiotherapy and/or chemotherapy on a case-by-case basis.

Doctor Lucas Minig
Biography and Training

Follow up:

The oncological follow-up period begins after the initial cancer treatment. Its main objective is to detect early a possible recurrence of the disease.

Beyond adopting the most effective follow-up standards, we also pay special attention and interest in maintaining and increasing the level of quality of life of our patients and achieving a rapid and effective re-insertion into daily life as before the diagnosis of their cancer.

Opinions patients with Cancer of the vagina and vulva

Doctor Lucas Minig Specialist in Cancer of the vagina and vulva in Valencia, Spain