Vulvar Cancer Treatment
At MD Anderson, a team of nationally known experts concentrates on giving you the most advanced treatments for vulvar cancer. Maintaining your quality of life is always a priority. For this reason, we focus on therapies that target cancer with the most advanced methods while minimizing side effects.
Our physicians are at the forefront of pioneering approaches, including sentinel node biopsy procedures. Research done here has helped the standard care for vulvar cancer evolve into surgery combined with other therapies, including chemotherapy and radiation. Radiation treatment is more precise with the use of advanced delivery techniques and the use of MRI guidance, which can minimize the impact on healthy tissue.
MD Anderson treats more women each year with this complex cancer than most oncologists in the nation. This gives us a level of experience and expertise that may lead to a higher chance of successful treatment in many cases.
And we are constantly researching newer, safer, more advanced vulvar cancer treatments. This translates to a number of clinical trials.
If you are diagnosed with vulvar cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:
- The type and stage of the cancer
- Your overall health
- Your age
- Your preferences
Your treatment for vulvar cancer at MD Anderson will be customized to your needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Surgery
Vulvar cancer treatment usually includes surgery. Like all surgeries, vulvar cancer surgery is most successful when done by a specialist with a great deal of experience in the procedure.
MD Anderson surgeons are among the most skilled and recognized in the world. They perform a large number of surgeries for vulvar cancer each year, using the least invasive and most advanced techniques.
The main types of surgery for vulvar cancer include the following:
Laser surgery:
Lasers may be used to treat precancerous changes. Abnormal cells are burned off with a laser beam. Lasers are not used for invasive vulvar cancer.
Wide local excision or simple vulvectomy:
These procedures may be used to treat precancerous lesions or small non-invasive cancer lesions.
Radical partial vulvectomy:
The purpose of this surgery is to remove any invasive cancer on the vulva.
Pelvic exenteration:
In this complex surgery, the vulva and lymph nodes in the pelvis are removed. Depending on how far the cancer has spread, the lower colon, rectum, bladder, uterus, cervix and/or vagina may be removed.
- If the bladder is removed, a piece of intestine may be used to make a new bladder. Then urine may be drained through a catheter (tube) into a urostomy, which is a small opening on the abdomen, or into a small plastic bag worn on the outside of the body.
- If the rectum and part of the colon are removed, you may have a colostomy, which is an opening on the abdomen that allows solid waste (stool) to pass into a small bag worn on the outside of the body. Sometimes the colon may be reconnected so that a colostomy is not needed.
Full inguinal lymph node dissection:
The surgeon removes all of the lymph nodes on one or both sides of the groin area. Lymphedema, which is caused by decreased fluid drainage, may be a side effect of this surgery.
Sentinel inguinal lymph node biopsy:
The surgeon only removes the first lymph nodes the cancer might have spread to on one or both sides in the groin area. Lymphedema may be a side effect of this surgery, but this technique may limit the severity of the condition.
Topical therapy
This type of treatment may be used in precancerous vulvar cell changes. Medicine is applied to the growth.
Chemotherapy
Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.
Learn more about chemotherapy.
Radiation
Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Learn more about radiation therapy.
Immune checkpoint inhibitors
Immune checkpoint inhibitors are a type of immunotherapy. They stop the immune system from turning off before cancer is completely eliminated. Patients may receive a single immunotherapy drug or multiple drugs in combination.
Learn more about immune checkpoint inhibitors.
Targeted therapy
Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer and the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.
Learn more about targeted therapy.
Our vulvar cancer clinical trials
Because of its status as one of the world¡¯s premier cancer centers, MD Anderson participates in clinical trials (research studies) of new therapies for vulvar cancer.
Learn more about clinical trials.
Learn more about vulvar cancer
8 viruses that cause cancer
Researchers know that several infections can lead to cancer. This includes infections caused by bacteria, fungi and viruses.
Studying infections and cancer helps researchers develop vaccines and other ways to reduce cancer risk, including early identification and treatment of viruses that cause cancer. We spoke with infectious disease specialist , to learn more.
What is a virus?
Viruses are very small organisms. They are made up of genes ¨C DNA or RNA ¨C surrounded by a protein coating. Viruses require the cells of living hosts, such as people, to survive.
How do viruses cause cancer?
Viruses have a complicated effect on cancer development. Experts don¡¯t fully understand all the ways some oncoviruses cause cancer. What we do know is that viruses hijack cells and insert their DNA or RNA into the host cell. This can cause the host cells to become cancerous.
There are several oncoviruses, or viruses that cause cancer.
Epstein-Barr virus (EBV)
Epstein-Barr virus is a herpes virus that¡¯s spread through saliva. EBV infection increases the risk of Burkitt lymphoma, some types of Hodgkin and non-Hodgkin lymphoma, and stomach cancer. There is currently no vaccine for Epstein-Barr virus.
Hepatitis B virus (HBV)
Hepatitis B virus is spread through infected blood, semen and other body fluids. is a leading cause of liver cancer. It is recommended that all infants be vaccinated against HBV at birth and complete the vaccination series within six to 18 months. Anyone who was not vaccinated at birth should get vaccinated. Talk to your doctor if you are not sure if you¡¯ve been vaccinated.
For some patients who are chronically infected with HBV, antiviral treatment against HBV decreases the risk of developing hepatocellular carcinoma, a type of liver cancer. Get screened for HBV, and if you have it, talk to your doctor about treatment recommendations.
Hepatitis C virus (HCV)
Hepatitis C virus is spread through infected blood. is a leading cause of liver cancer, and it can cause non-Hodgkin lymphoma. There is no vaccine against HCV, but it is treatable.
Antiviral treatment can cure HCV and decrease your risk of developing hepatocellular carcinoma. Get screened for HCV, and if you have it, talk to your doctor about treatment recommendations.
Human immunodeficiency virus (HIV)
HIV is spread through infected semen, vaginal fluids, anal fluids, blood and breast milk. While it does not cause cancer directly, researchers believe it increases the risk of cancer by damaging the immune system, which reduces the body¡¯s defenses against other oncoviruses. It can enable other oncoviruses to cause cancer. HIV-associated cancers include:
- Kaposi sarcoma,
- non-Hodgkin and Hodgkin lymphoma,
- cervical cancer,
- anal cancer,
- liver cancer,
- oral cancer,
- throat cancer and
- lung cancer.
There is no vaccine against HIV, but there is effective antiretroviral therapy to treat HIV and to help lower your risk of HIV-associated cancers. ?
Kaposi sarcoma-associated herpesvirus (KSHV)
Kaposi sarcoma-associated herpesvirus is also known as human herpesvirus 8 (HHV-8). This virus can cause Kaposi sarcoma in people with a weakened immune system. That includes patients with HIV. HHV-8 can also cause some types of lymphoma.
Human papillomavirus (HPV)
HPV has at least 12 strains that can cause several types of cancer in men and women, including:
All people ages 9¨C26 should get the HPV vaccine. Unvaccinated men and women ages 27¨C45 should talk to their doctor to see if the vaccine may be beneficial for them.
Human T-cell leukemia virus type 1 (HTLV-1)
Human T-cell leukemia virus type 1, also known as human T-cell lymphotropic virus type 1, is linked to adult T-cell leukemia and lymphoma. It is spread through infected semen, vaginal fluids, blood and breast milk. The infection is rarely found in the United States. There is currently no vaccine for HTLV-1.
Merkel cell polyomavirus (MCV)
Merkel cell polyomavirus is a virus that can cause Merkel cell carcinoma, a rare and aggressive type of neuroendocrine tumor that forms in the skin. Experts are still learning about this virus, but it is believed to spread through direct contact with the skin. Currently, there is no vaccine for MCV. ??
What can people do to avoid getting these cancer-causing viruses?
Here are ways to reduce your risk of getting oncoviruses.
- Get vaccinated. The HPV vaccine can help prevent cervical cancer, anal cancer, vaginal cancer and vulvar cancer, and it can help lower your risk of getting HPV-related cancers of the throat and penis. The hepatitis B vaccine can help reduce your liver cancer risk.
- Get screened. Screening is available for some cancer-related viruses, like HPV, HIV and hepatitis B and C. If you¡¯re at risk, get screened. In addition, follow our cancer screening guidelines. Screening is one of the best ways to catch cancer early when it¡¯s easiest to treat. Talk to your doctor to learn if you need earlier or additional screening.
- Practice safe sex. HPV, HIV, HTLV-1, hepatitis B and hepatitis C can be sexually transmitted.
- Don¡¯t share needles or syringes. Don¡¯t share syringes, needles or other infected equipment or personal items that might have blood on them. This reduces your risk of developing blood-borne viruses, such as hepatitis B and C and HIV.
If you think you may have or be at risk for an oncovirus, talk to your doctor about how to lower your cancer risk.
or call 1-877-632-6789.
What is a vulvectomy? Purpose, procedure and recovery
The vulva is part of the female genitalia and sits at the opening of the vagina. Sometimes benign or cancerous growths can develop on the vulva. When that happens, a patient may need a vulvectomy to surgically remove those growths.
Here, I¡¯ll share common types of vulvectomies, when they¡¯re used for treatment and what you can expect during and after the procedure. ???
Reasons for a vulvectomy
Doctors may perform a vulvectomy to treat conditions such as:
- Vulvar intraepithelial neoplasia (VIN) or vulvar dysplasia, a precancerous condition where abnormal cells form on the skin of the vulva. VIN is not cancer, but sometimes it can turn into vulvar cancer.
- Vulvar cancer ?
Types of vulvectomies
The type of vulvectomy you get will depend on whether the lesion is cancerous, its size and its location.
Your doctor will talk to you about which surgery is right for you.
Simple vulvectomy
A simple vulvectomy is often referred to as a wide local excision. At MD Anderson, we use this procedure to treat precancerous lesions on the vulva. We may also do a simple vulvectomy if you¡¯ve been treated for vulvar cancer and develop a new lesion that we suspect may be cancerous.
During a simple vulvectomy, your doctor will remove the lesion and some of the tissue under the skin. Tumor margin is the healthy tissue bordering the tumor that¡¯s removed during surgery. For a simple vulvectomy, we want to get a tumor margin between 0.5 cm and 1 cm.
Radical partial vulvectomy
A radical partial vulvectomy is used to treat vulvar cancer. During the procedure, the doctor removes the lesion and deeper layers of tissue under the skin. The tumor margin for a radical partial vulvectomy is 2 cm. This margin may be limited due to neighboring structures.
At the time of a vulvectomy, your doctor may also recommend a lymphadenectomy or sentinel lymph node biopsy to remove some of your lymph nodes, depending on where the lesion is and how deep it goes into the vulva.??