Vaginal and Vulvar Cancers

Vaginal and Vulvar Cancers

Vaginal and vulvar cancers are extremely rare. Together, they account for less then 5 percent of all female reproductive cancers.

What is vaginal and vulvar cancer?

Vaginal and vulvar cancer is abnormal tissues of the vagina and/or vulva.

What are the risk factors?

  • HPV infection
  • Chronic irritation
  • Immunosuppression
  • Cigarette or cigar smoking

What are the symptoms?

  • Lump or mass in the groin, labia or the vagina
  • Pelvic pain
  • Bleeding with intercourse
  • Vulvar or vaginal itching

How do you screen for abnormal cells?

Pap smear of vaginal walls

How is it diagnosed?

  • Biopsy of affected tissue
  • Imaging- typically CT scan (Computed Tomography scan) or MRI (magnetic resonance imaging)

How is it treated?

The treatment of vaginal and vulvar cancer depends on the size and location of the tumor, as well as the histology, or cell type, and stage of the cancer.
Histology (cell type) of vaginal and vulvar cancers may include:

  • squamous cell carcinomas
  • adenocarcinomas
  • sarcomas
  • melanomas
  • small cell vaginal cancers
  • basal cell carcinomas
  • other

The goal of treatment is to destroy the cancerous cells while preserving as much normal tissue as possible. Within the Gynecologic Cancer Program, Medical College of Wisconsin gynecologic oncologists work closely with radiation oncologists who specialize in the treatment of gynecologic cancers to spare as much of the vagina, bladder, urethra and anus as possible.
Treatment options include:

  • Surgery: The primary skin lesion and draining lymph nodes should be removed by surgery. Many times a sentinel lymph node procedure is done to identify the first draining lymph node and limit the number of lymph nodes removed which reduced morbidities such as lymphedema (chronic swelling in the legs).
  • External radiation therapy: External beam radiation is often used to treat vulvar and vaginal cancers. Radiation therapy targets the primary tumor and lymph nodes. For vulvar cancer, one goal is retaining as much of the patient’s tissue as possible. Instead of removing the clitoris, for example, the gynecologic oncologist may refer the patient to a radiation oncologist for definitive or preoperative treatment.
  • Brachytherapy (internal radiation therapy): Brachytherapy is radiation that is treated to a localized region, increasing the amount of radiation that attacks the disease and minimizing the amount of radiation to the surrounding tissue. Radiation oncologists at Froedtert & the Medical College often treat vaginal cancer with interstitial implantation, a procedure that uses tiny needles to implant radioactive sources directly into the tumor.
  • Chemotherapy: Often, a combination of intravenous chemotherapy and radiation is prescribed for vaginal and vulvar cancers, with the chemotherapy acting as a sensitizer, to increase how well the radiation works to attack the cancerous cells. Specially trained oncology nurses administer chemotherapy and work with patients to minimize and manage side effects.