What is Vulvar Cancer?
Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia, known as the vulva. The vulva includes the inner and outer lips of the vagina (the labia minora and labia majora), the clitoris, and the opening to the vagina and its glands.
There are several types of vulvar cancer, each originating from different types of cells within the vulva. Here are the main types:
- Squamous Cell Carcinoma: This is the most common type of vulvar cancer, accounting for about 90% of cases. It starts in the thin, flat cells that line the surface of the vulva.
- Melanoma: This type of vulvar cancer develops from the pigment-producing cells known as melanocytes. Melanoma of the vulva is less common but can be more aggressive.
- Basal Cell Carcinoma: Another form of skin cancer, basal cell carcinoma, rarely occurs in the vulva. It tends to grow slowly and is less likely to spread compared to other types.
- Adenocarcinoma: This type arises from glandular cells in the vulva. There are subtypes of adenocarcinoma based on the specific gland from which the cancer originates, such as Bartholin gland adenocarcinoma.
- Verrucous Carcinoma: A rare type of squamous cell carcinoma that has a wart-like appearance. It grows slowly and is less likely to spread.
- Sarcoma: This type arises from the connective tissues, such as muscles, fat, or blood vessels, within the vulva. Sarcomas of the vulva are very rare.
Risk Factors
Several risk factors can increase the likelihood of developing vulvar cancer, including:
- Human Papillomavirus (HPV) Infection: HPV, particularly certain strains like HPV-16 and HPV-18, is a significant risk factor for vulvar cancer.
- Age: The risk of vulvar cancer increases with age. It is more commonly diagnosed in women over 50.
- History of Cervical or Vaginal Cancer: Women who have had cervical or vaginal cancer are at higher risk of developing vulvar cancer.
- Chronic Vulvar Conditions: Conditions such as lichen sclerosus and lichen planus can increase the risk of vulvar cancer.
- Smoking: Smoking is linked to an increased risk of vulvar cancer, especially in women with HPV infection.
- Immunosuppression: Women with weakened immune systems, such as those with HIV or those taking immunosuppressive drugs, have a higher risk.
- History of Precancerous Conditions: Vulvar intraepithelial neoplasia (VIN), a precancerous condition, can increase the risk of developing vulvar cancer.
- Sexual History: A higher number of sexual partners and early age at first sexual intercourse can increase the risk due to the higher likelihood of HPV infection.
- Genetic Factors: A family history of vulvar cancer or related cancers may increase risk.
- Exposure to Diethylstilbestrol (DES): Women whose mothers took DES during pregnancy to prevent miscarriage may have an increased risk of developing vulvar cancer.
It's important to note that having one or more of these risk factors does not mean that a person will develop vulvar cancer. By prioritizing regular check-ups and prompt medical attention, the GW Cancer Center Gynecological Oncology team can significantly improve the prognosis and survival of vulvar cancer.