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The vulva is the external part of the female genitals, including the clitoris, the vaginal lips, the opening to the vagina, and the surrounding skin and tissue. Most vulvar cancers are squamous cell carcinoma.
This type of cancer begins in squamous cells (thin, flat skin cells) and is usually found on the vaginal lips. A small number of vulvar cancers are adenocarcinomas (cancers that begin in cells that make mucus and other fluids). This type of cancer is usually found on the sides of the vaginal opening.
Vulvar cancer usually forms slowly over a number of years. Abnormal cells can grow on the surface of the vulvar skin for a long time. This condition is called vulvar intraepithelial neoplasia (VIN).
- Itching that doesn’t go away
- Pain and tenderness
- Bleeding that isn’t from menstruation
- Skin changes, such as color changes or thickening
- A lump, wart-like bumps or an open sore (ulcer)
SurgerySurgery used to treat vulvar cancer include:
- Removing the cancer and a margin of healthy tissue (excision).
- Removing a portion of the vulva (partial vulvectomy).
- Removing the entire vulva (radical vulvectomy).
- Extensive surgery for advanced cancer. If cancer has spread beyond the vulva and involves nearby organs, the doctor may recommend removing all of the vulva and the involved organs in a procedure called pelvic exenteration. The surgeon may remove the lower colon, rectum, bladder, cervix, uterus, vagina, ovaries and nearby lymph nodes depending where the cancer has spread.
Radiation therapyRadiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy for vulvar cancer is usually administered by a machine that moves around the body and directs radiation to precise points on the skin (external beam radiation). Radiation therapy is sometimes used to shrink large vulvar cancers in order to make it more likely that surgery will be successful. If cancer cells are discovered in the lymph nodes, the doctor may recommend radiation to the area around the lymph nodes to kill any cancer cells that might remain after surgery.
ChemotherapyFor women with advanced vulvar cancer that has spread to other areas of the body, chemotherapy may be an option. Sometimes chemotherapy is combined with radiation therapy to shrink large vulvar cancers in order to make it more likely that surgery will be successful.
Vaginal cancer is a rare cancer that occurs in the vagina, the muscular tube that connects the uterus to the outer genitals. It most commonly occurs in the cells that line the surface of the vagina, which is sometimes called the birth canal. While several types of cancer can spread to the vagina from other places in the body, cancer that begins in the vagina (primary vaginal cancer) is rare.
Vaginal cancer is divided into different types based on the type of cell where the cancer began.
- Vaginal squamous cell carcinoma, which begins in the thin, flat cells (squamous cells) that line the surface of the vagina, and is the most common type
- Vaginal adenocarcinoma, which begins in the glandular cells on the surface of the vagina
- Vaginal melanoma, which develops in the pigment-producing cells (melanocytes) of the vagina
- Vaginal sarcoma, which develops in the connective tissue cells or muscles cells in the walls of the vagina
- Unusual vaginal bleeding, for example, after intercourse or after menopause
- Watery vaginal discharge
- A lump or mass in your vagina
- Painful urination
- Frequent urination
- Pelvic pain
SurgeryTypes of surgery that may be used to treat vaginal cancer include:
- Removal of small tumors or lesions. Cancer limited to the surface of the vagina may be cut away, along with a small margin of surrounding healthy tissue to ensure that all of the cancer cells have been removed.
- Removal of the vagina (partial or full).
- Removal of the majority of the pelvic organs (pelvic exenteration). This extensive surgery may be an option if cancer has spread throughout the pelvic area or if vaginal cancer has recurred. During pelvic exenteration, the bladder, ovaries, uterus, vagina, rectum and the lower portion of the colon may be removed.
Radiation TherapyRadiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation can be delivered externally or internally (brachytherapy) or both.
ChemotherapyIf surgery and radiation does not control the cancer, chemotherapy may be offered. It is unclear whether chemotherapy is useful for treating vaginal cancer and generally isn’t used on its own to treat vaginal cancer. Chemotherapy may be used during radiation therapy to enhance the effectiveness of radiation.
Endometrial cancer is a type of cancer that begins in the uterus, the hollow, pear-shaped pelvic organ in women where fetal development occurs. Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.
- Vaginal bleeding after menopause
- Bleeding between periods
- An abnormal, watery or blood-tinged discharge from your vagina
- Pelvic pain
Ovarian cancer begins in the ovaries, the reproductive glands on each side of the uterus that produce eggs and hormones. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.
The ovaries are made of three main kinds of cells. Each can develop into a different type of tumor:
- Epithelial tumors, which begin in the thin layer of tissue that covers the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors.
- Stromal tumors, which begin in the ovarian tissue that contains hormone-producing cells. These tumors are usually diagnosed at an earlier stage than other ovarian tumors. About 7 percent of ovarian tumors are stromal.
- Germ cell tumors, which begin in the egg-producing cells. These rare ovarian cancers tend to occur in younger women.
- Abdominal bloating or swelling
- Quickly feeling full when eating
- Weight loss
- Discomfort in the pelvis area
- Changes in bowel habits, such as constipation
- A frequent need to urinate
SurgeryTreatment generally involves removing both ovaries, the fallopian tubes, the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue (omentum) where ovarian cancer often spreads. Less extensive surgery may be possible if the cancer was diagnosed at a very early stage. For women with stage I ovarian cancer, surgery may involve removing one ovary and its fallopian tube.
ChemotherapyAfter surgery, chemotherapy will likely be administered to kill any remaining cancer cells. Chemotherapy drugs can be injected into a vein or directly into the abdominal cavity or both. Chemotherapy may be used as the initial treatment in some women with advanced ovarian cancer.
Cervical cancer occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. The most common type of cervical cancer is squamous cell carcinoma which begins in squamous cells (thin, flat skin cells) on the wall of the cervix. However, some cervical cancers are adenocarcinomas (cancers that begin in cells that make mucus and other fluids). While most cervical cancers are squamous cell carcinomas, both types of cells may be involved in cervical cancer in some instances. Very rarely, cancer occurs in other cells of the cervix.
- Vaginal bleeding after intercourse, between periods or after menopause
- Watery, bloody vaginal discharge that may be heavy and have a foul odor
- Pelvic pain or pain during intercourse