Vulvar Cancer

What is Vulva Cancer?

Vulvar cancer is a rare cancer that can occur at any age. Vulvar squamous cell carcinoma is the most common type. HPV infection increases the risk of Vulvar cancer.

Vulvar cancer is a rare type of cancer of the vulva in females. The vulva comprises of the skin surrounding the urethra and vagina, and includes the clitoris and labia. It can occur at any age but is more commonly diagnosed in older women. The patient often presents with an itchy lump or sore on the vulva. Treatment of Vulvar cancer predominantly involves surgery.

The commonest types of Vulvar cancer are vulvar squamous cell carcinoma and vulvar melanoma; Vulvar squamous cell carcinoma is more common than the latter and arises from the thin flat cells lining the Vulvar surface. Melanoma arises from pigment-producing cells.

Causes and Risk Factors

The exact cause for vulvar cancer is yet to be known. In general, genetic mutations that lead to permanent uncontrolled cell divisions cause cancers. The following factors are thought to increase the risk of acquiring Vulvar cancer:

• Increasing age raises the risk of Vulvar cancer.
• HPV (Human Papilloma Virus), a sexually transmitted viral infection, predisposes young sexually active women to Vulvar cancer and cancer of the cervix. It should be noted that not all women exposed to HPV develop Vulvar cancer.
• Smoking is a known risk factor of Vulvar cancer.
• Infection with Human Immunodeficiency Virus (HIV) compromises the immunity of persons making them susceptible to HPV infections, thereby increasing the risk of cancer.
• Having a particular condition (or a history of having it) called vulvar intraepithelial neoplasia may increase the risk of Vulvar cancer. Only a minority with this 'precancerous' condition will develop the cancer.
• Lichen sclerosus is a condition that makes the Vulvar skin thin and itchy. It increases the risk of acquiring Vulvar cancer.

References:

1. Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012
2. Surgery for cancer of the vulva (vulvectomy). American Cancer Society
3. Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008.

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