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The first symptom of this neoplasm, i.e. itching, is neglected by women. Meanwhile, starting treatment too late drastically increases the risk of death.
Itching appears first. It sometimes lasts even several years. Women are treated by dermatologists, gynecologists, they take ointments without suspecting that a tumor is developing. After a while they will get used to the condition and consider it normal that sometimes there is a morning. Suddenly the morning grows bigger, it hurts and it doesn’t heal.
Beware of infections
The disease is primarily caused by infections, including the human papillomavirus (HPV), as well as chronic bacterial infections. It is also believed that immunosuppression, i.e. a poorer immune response by the body, may be a factor. – Environmental and chemical factors also have an impact, but mainly it is infections – says prof. Mariusz Bidziński, Head of the Clinical Department of Gynecology at the Świętokrzyskie Cancer Center.
Prevention of this cancer is, first of all, the prevention of infections. – Here, vaccinations are important, e.g. against the HPV virus, which additionally increase the immune barrier of the organism. Even in women who have been diagnosed with certain infections, vaccines can be used prophylactically because they make women have a higher level of defense barrier – explains Prof. Bidziński. Self-control and visits to the gynecologist are also important. – But due to the fact that it is a niche neoplasm, even gynecologists are not careful enough in this regard and not all of them are able to assess the changes – the gynecologist points out. Therefore, self-control and telling the doctor about all ailments are all the more important.
A rare but dangerous cancer
In Poland, there are approximately 300 cases of vulvar cancer every year, so it belongs to the group of rare cancers. It is most common in women over 65, but sometimes it is also found in younger people. – I think that older women get sick because they no longer attach so much importance to their physicality or sexuality. They stop caring about their intimacy because they are no longer sexually active and do not have to be attractive to their partner. Then, even when something starts to happen, they don’t do anything about it for years – says prof. Bidziński.
The prognosis depends on the stage at which the cancer was diagnosed. In the early stage of advancement, the chances of five-year survival are 60-70%. The more advanced the cancer, the survival rates drop significantly. There are vulvar tumors that are very aggressive – vulvar melanomas. – Where there are mucous membranes, cancer develops extremely dynamically, and here the risk of treatment failure is very high, even if we detect the disease at an early stage. In general, most cases are squamous cell carcinomas and the effectiveness depends on how quickly the disease is defined – explains the gynecologist.
Treatment of cancer of the vulva
The method of treatment depends on the stage at which the cancer is detected. – Unfortunately, due to the fact that women report late, more than 50% of them already have a very advanced stage of cancer, which is suitable only for palliative treatment, i.e. to reduce pain or reduce the rate of disease development, but not cure – regrets prof. Bidziński. The earlier the cancer is diagnosed, the less complicated the treatment. The main method of treatment is radical surgery, i.e. removal of the vulva supplemented by radiation or chemotherapy. There are cases where it is not necessary to remove the vulva, and only the lump is excised. – 50% of patients can be treated radically, and 50% can only be treated palliatively – sums up the gynecologist. After radical vulvectomy, a woman can function normally, because apart from the anatomically changed vulva, the vagina or urethra remain unchanged. Moreover, if the intimate life is very important for a woman, the removed elements can be plasticized and supplemented, e.g. the labia are reconstructed from dermal and muscular flaps taken from the thigh or abdominal muscles.
Where to Treat Vulva Cancer?
Prof. Janusz Bidziński says that vulvar cancer is best treated in a large oncology center, e.g. in the Oncology Center in Warsaw, in the Świętokrzyskie Cancer Center in Kielce, in Bytom, where there is a Vulva Pathology Clinic. – It is important to go to a large center, because even if the treatment is not carried out there, they will surely guide them properly and the action will not be accidental. In the case of vulvar cancer, the idea is to go where they deal with such cases, and remember that there are not many of them. Then the team’s experience is greater, the histopathological diagnosis is better and the access to adjuvant treatment is better. If the patient goes to a hospital where doctors do not have experience in this type of cases, neither surgery nor adjuvant treatment may not bring the effect that we assumed and would be expected – he adds. It is also worth taking a look at the website www.jestemprzytobie.pl, run as part of the program implemented by Fundacja Różowa Konwalia im. prof. Jan Zieliński, the MSD Foundation for Women’s Health, the Polish Association of Oncological Nurses and the Polish Organization for Fighting Cervical Cancer, Flower of Femininity. It includes the necessary information on the prevention, diagnosis and treatment of cancers of the reproductive organs (cervical cancer, vulvar cancer, ovarian cancer, endometrial cancer), and advice on where to seek psychological support. Via www.jestemprzytobie.pl, you can ask questions to experts, read real women’s stories and exchange experiences with other readers in a similar situation.