There are two main sorts of vulvar cancers, with one being premenopausal and the other postmenopausal. In premenopausal women, smoking and HPV infection are the most common causes of vulvar cancers that cause vulvar intraepithelial neoplasia (VIN), which is a precancerous state of the skin. HPV can cause gynaecological and anal cancers. Women who are immunosuppressed may also end up with more vulvar cancers.
The latter tends to arise from chronic itching that goes along with lichenoid conditions such as lichen planus or lichen sclerosus, affecting many women. Lichen sclerosus can occur at any age, but is a lifelong condition. The chances of lichen sclerosus turning into vulvar cancer is about five per cent.
Signs and symptoms of vulvar squamous cell cancer
- Lump on the labia majora, labia minora, clitoris or perineum
- History of vulvar itching
- Lump may be raised or ulcerated
- Less commonly, groin lumps
Treatment of vulvar squamous cell cancer
Treatment typically involves surgery, with a radical vulvectomy (complete removal of the vulva) on the table, depending on the extent of the cancer. This is incredibly distressing, so the goal for surgeons is to retain as much tissue as possible.
Outcomes of vulvar squamous cell cancer
The overall outlook for women diagnosed with squamous cell vulvar cancer is very reasonable, with the five-year survival rate being about 70 per cent. Some cancers may recur, so monitoring is essential.