The vulva refers to a woman’s external sex organs, including the mons pubis, labia and clitoris. Vulval cancer may develop in any of these areas, but most commonly will affect the labia. Cancer of the vulva typically presents in women after menopause, with approximately 280 women diagnosed annually. It may present as a lump or mass, or as an ulcer on the vulva. Risk factors for development of vulval cancer include vulvar intraepithelial neoplasia (pre-cancerous skin changes; VIN), HPV infection, untreated benign skin conditions such as lichen sclerosis and smoking.
To confirm the diagnosis, Dr Tang will perform vulvoscopy (colposcopy of the vulva) and a biopsy to send to the pathologist for histological examination.
Definitive treatment depends on the stage or extent of spread of the cancer to other parts of the body. A CT scan of the pelvis, abdomen and chest will be performed to work out the stage of the cancer.
Most patients will benefit from surgery, with the aim of removing all tissues with cancer together with a margin of health tissue. Dr Tang uses the “Sentinel node biopsy” technique to ascertain the disease status of the lymph nodes in the groin.
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