Vulvar Cancer

Treatment

Some of the treatment options for vulvar cancer are:

• Treatment for vulvar pre-cancer: Vulval intraepithelial neoplasia is a condition that has the potential to progress into vulvar cancer. The patients may be prescribed topical drugs to treat this condition, thereby reducing their risk of vulvar cancer. However, topical therapy is not effective in patients with invasive vulvar cancer. Further, topical therapy is less effective compared to laser therapy.
• Surgery: Several types of surgical interventions are available to manage vulvar cancer. These include:
  Local excision: During this process, the cancer lesions, along with the margin of the healthy tissues, are removed. The process is also known as wide local excision. If the amount of tissue removed is large, it is known as particle vulvectomy.
  Vulvectomy: During this procedure, a part of the complete vulva of the patient is removed. Skinning vulvectomy involves the removal of only the upper layer, while simple vulvectomy involves the removal of the vulva. If cancer advances to the clitoris, the vulva, and the clitoris are removed (total radical vulvectomy).
  Sentinel node biopsy: Sentinel nodes are the nodes that drain the area in which the cancer is present. Thus, these nodes are expected to have cancer first. The sentinel nodes of the patients are removed through surgery for further examination.
  Removal of lymph nodes: If the nearby lymph nodes have swelling, the oncosurgeons remove the lymph nodes to prevent the spread of cancer.
  Laser surgery: It may be used for destroying the abnormal cells present on the upper layer of the vulva. It is not used for treating invasive cancer.
  Pelvic exenteration: Pelvic exenteration is performed in case of advanced cancer. It involves the removal of the vulva and pelvic lymph nodes along with one or more of the organs among the bladder, rectum, lower colon, cervix, uterus, and vagina.
• Radiation therapy: Radiation therapy is used before or after the surgery. Radiation therapy before the surgery shrinks the tumor, which can then be easily removed through surgery. Further, radiotherapy after surgery kills the cells that are not removed through surgery. It may also be combined with chemotherapy to improve outcomes.
• Chemotherapy: Chemotherapy may be prescribed in patients with metastatic vulvar cancer. Chemotherapy and radiation therapy may be used in combination before surgery to reduce the size of the tumor. Chemoradiation may also be prescribed in patients with cancer spread to the lymph nodes.
• Targeted therapy: Targeted therapy is prescribed in patients with advanced vulvar cancer. Targeted therapy targets the gene, proteins, or enzymes essential for cancer cell survival.
• Immunotherapy: Immunotherapy may also be an option in patients with advanced vulvar cancer. Immunotherapy interferes with the process that helps the cancer cells to evade the attack of immune cells.