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Vaginal and vulvar cancers are extremely rare. Together, they account for less then 5 percent of all female reproductive cancers. Vulvar cancer may be associated with human papillomavirus (HPV) infection, although half of all cases of vulvar cancer occur in women with no history of HPV infection.
Symptoms and Diagnosis
Symptoms of vaginal and vulvar cancer include a lump or mass, and pain or bleeding with intercourse. Vulvar cancer may also cause itching.
Occasionally, a physician will notice a lump or mass during a physical exam. Rarely, cancerous cells may be discovered as part of a routine PAP smear. If cancer is suspected, a biopsy is needed to confirm the diagnosis.
The treatment of vaginal and vulvar cancer depends on the size and location of the tumor, as well as the cell type. Vaginal and vulvar cancers include squamous cell carcinomas, adenocarcinomas, sarcomas, melanomas, small cell vaginal cancer and basal cell carcinoma.
The goal of treatment is to preserve as much normal tissue as possible while destroying cancerous cells. 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.
Surgery. Vulvar cancer is almost always treated with surgery. Surgery is almost never used for vaginal cancers.
Brachytherapy (internal radiation therapy). Brachytherapy places focused doses of radiation directly into the cancerous region. 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.
External radiation therapy. 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. External beam radiation is often used to treat vulvar and vaginal cancers.
Chemotherapy. Chemotherapy may be used in combination with radiation to treat vaginal and vulvar cancers.