Vulvar Cancer Treatments

The vast majority of cancers of the vulva are a form of skin cancer called squamous cell carcinoma. Melanoma is another type of skin cancer that occurs less frequently as vulvar cancer. Adenocarcinomas, including Paget's disease, are a type of cancer that begins in glandular cells of the vulva within its tissues instead of on its surface as skin cancers do. Sarcomas can occur at any age and develop in your connective tissue under the skin.

The best treatment of vulvar cancer requires a multidisciplinary team approach. Aurora cancer patients benefit from multidisciplinary case reviews, which can include specialists from various disciplines.

  • Cancer Nurse Navigator: a registered nurse with special training who can help answer questions and provide information on resources and support services.
  • Gynecologic oncologist: an obstetrician/gynecologist with additional fellowship training in the study and treatment of cancers of the reproductive system.
  • Pathologist: a physician who examines tissues and cells under a microscope to determine if they are normal or abnormal.
  • Radiation oncologist: a physician specializing in treating cancer with radiation therapy.
  • Radiologist: a physician who uses X-rays and other imaging tests to diagnose disease.

Treatment plans are customized for each patient by our team of experts and may include cancer surgery, radiation therapyand/or chemotherapy.

Your diagnosis, cancer staging, general health and child-bearing preferences may play a role in deciding the appropriate treatments.

Surgery

Laser surgery

A focused beam of energy destroys the layer of skin containing precancerous cells (vulvar intraepithelial neoplasia).

Traditional surgery

Surgery is a common treatment for cancerous neoplasia and invasive cancers. The type and extent of surgery depends on the type and stage of your cancer. For more advanced or invasive cancers, reproductive organs or lymph nodes may be removed. In the most extensive cases, skin grafts or reconstructive surgery may be performed after cancer surgery is completed.

  • Excision: wide local excision uses a scalpel to remove the cancer and a "margin" of healthy tissue around it.
  • Vulvectomy: part or all of the vulva is surgically removed. A skinning vulvectomy removes the complete top layer of skin. A simple vulvectomy removes the entire vulva. A partial vulvectomy removes part of the vulva and some deep tissue. A complete or radical vulvectomy removes the entire vulva, clitoris and deep tissues.
  • Lymph node dissection: lymph nodes, which are part of the immune system, may be removed from the groin on one or both sides of the vulva if they contain cancer.
  • Pelvic exenteration: very rarely, more extensive surgery may be necessary. This may include removing the vulva and lymph nodes plus the bladder, rectum, part of the colon, uterus, vagina and/or cervix. Additional surgery may be performed to provide substitutes for some organs that are removed.

Surgery may be followed by chemotherapy and/or radiation therapy to kill additional cancer cells. In some cases, chemotherapy or radiation is used to shrink the tumor before surgery.

Chemotherapy

Systemic anti-cancer drugs can be given by mouth or injected through a vein. They affect the whole body to help control the cancer's spreading to other organs. Side effects may include loss of appetite, nausea, vomiting, hair loss, fatigue, mouth sores and vaginal sores. Systemic chemotherapy is typically given regularly for a few weeks and may be repeated after a rest period.

Topical chemotherapy is a cream or ointment, such as fluorouracil (5-FU), containing anti-cancer drugs that is spread on your skin surface. Side effects may include irritation and peeling where it is applied.

Radiation

External beam radiation uses a special machine outside the body to send beams of high-energy X-rays through the skin to target and kill cancer cells. Sometimes it is combined with low-dose chemotherapy. A course of external beam radiation treatment may be done five days per week for several weeks. Side effects may include nausea, diarrhea, cramping, loss of appetite, skin irritation and fatigue.

Clinical Trials

Clinical trials offer additional treatment options for some patients. Some promising new treatments may only be available in a research setting. Aurora offers access to these clinical trials of therapies that might not be widely available elsewhere.

Supportive Care

Aurora offers other treatments and palliative care to maintain quality of life during and after cervical cancer treatments. Reducing disease symptoms, managing treatment side effects, maximizing comfort and taking advantage of complementary therapies are part of the mission of the Cancer Counseling Center.