What is Vulvar Cancer
Vulvar cancer is a cancer with a higher incidence in the female reproductive system after cervical cancer, endometrial cancer and ovarian cancer. Vulvar cancer is dominated by primary tumors, accounting for 3% to 5% of female genital tumors. Early detection and timely treatment can improve the cure rate. Vulvar cancer can occur in the vulvar skin, mucous membranes and their accessories, and the common pathological types are as follows. ① It is mainly primary squamous cell carcinoma, accounting for about 95% of vulvar cancer. The average age of onset is 50 to 60 years old, and it may occur before the age of 40. ②Vulvar malignant melanoma, ranking second in vulvar cancer, comes from malignant transformation of vulvar melanoma. In 10% of patients, the lesions did not contain melanocytes and were nonpigmented vulvar malignant melanomas. ③ Basal cell carcinoma is a very rare vulvar cancer, accounting for 2% to 3% of vulvar malignant tumors. Although its manifestations are similar to squamous cell carcinomas, the malignant transformation rate is low, the growth is slow, and the course of disease is long. Mainly, abdominal lymph node metastasis is rare. ④ Vulvar Bartholin adenocarcinoma, with a younger age of onset, with a median age of 45 to 55 years old, with a smooth mass, and a few may have secondary infection or ulcers. ⑤ Vulvar Bartholin cystoid adenocarcinoma, tumor growth is slow, about 10% of patients have groin metastasis. ⑥Paget’s disease of the vulva is a slowly developing vulvar cancer, more common in elderly women, mainly manifested as vulvar ulcers and nodules.
The main pathogenic factors of vulvar cancer
The etiology of vulvar cancer is not completely clear, but most scholars believe that it may be related to human papillomavirus infection, vulvar dystrophy, lymphogranuloma, and syphilis.
1. Vulvar infection. Such as sexually transmitted diseases, viruses, bacteria, trichomoniasis, fungi, etc., and vulvitis caused by menstruation.
2. Long-term chronic stimulation. Such as bad hygiene habits, improper washing, long-term accumulation of vulva dirt, tight underwear, sweat stains, urine, feces and diabetes mellitus irritation.
3. Allergic vulvitis. Allergic dermatitis mainly caused by detergents, cosmetics, condoms and utensils.
4. Foreign body in the vagina. Long-term placement of pessary and foreign body residual vaginal infection, stimulation of the vulva, long-term swelling and pain.
5. Certain diseases. Such as obesity, hypertension, systemic lupus erythematosus, papular psoriasis and diabetes, etc., often associated with vulvar cancer.
6. Cancer of other organs. Such as breast cancer, endometrial cancer, vaginal cancer, etc., prone to vulvar cancer.
7. Chronic inflammation of the vulva. Such as chronic dermatitis of the vulva, chronic ulcer, genital itching, traumatic hematoma, unexplained vulvar swelling and pain and other long-term stimulation.
8. STDs. Vulvar leukoplakia, syphilis, festering venereal disease, prone to vulvar cancer.
Main symptoms of vulvar cancer
1. Vitiligo. In the early stage, there may be skin color changes in the vulva, or there may be tiny, smooth white spots or stripes that merge into thick and shiny milky white spots, which are rough to the touch.
2. Nodules. In the vulva, such as the labia majora, labia minora, vaginal vestibule or clitoris, there can be felt bean-sized nodules or papillary lumps that gradually increase.
3. Ulcers. The vulva may appear incurable depressed hard-bottomed ulcers and infections, accompanied by occasional mild pain, and sometimes a small amount of secretions or bleeding can be seen.
4. Itching. After excluding female genital pruritus caused by candida infection, pubic lice, scabies, vaginal trichomoniasis, etc., if the vulvar itching persists for a long time and the cause cannot be found, and it is intractable, it should be considered as female vulvar cancer.
Vulvar Cancer Treatment
Common treatments for vulvar cancer include surgery, radiation therapy, chemotherapy, and biological immunotherapy. Surgery is the first choice for vulvar cancer, which rarely invades deep tissues. Therefore, even if the tumor is large, curative or palliative surgical resection can be performed. Conventional operations for vulvar cancer include radical vulvar excision and bilateral inguinal lymph node dissection; for Bartholin adenocarcinoma, part of the vagina and levator ani muscle can be removed according to the situation.
In recent years, with the improvement of radiotherapy technology and the reduction of side effects, many patients with vulvar cancer choose radiotherapy, especially those patients with contraindications to surgery or those who are not suitable for surgery in the advanced stage. Biological immunotherapy can improve the functional state of the body, prevent metastasis and recurrence, improve the curative effect, reduce the toxic and side effects, and is conducive to the early recovery of surgical injury. For advanced patients who are not suitable for surgery, radiotherapy and chemotherapy, biological immunotherapy can be used as the main treatment method.
Early prevention of vulvar cancer is critical
1. Maintain a good mental state, be positive and optimistic, and relieve stress in time. Chinese medicine believes that stress can lead to mental tension, causing qi stagnation and blood stasis, poisonous fire invagination, decreased immune function, etc., and it is easy to cause vulvar cancer.
2. Life must be regular, go to bed early and get up early, and combine work and rest. Avoid staying up late, playing mahjong, and staying up late at night, and you should ensure adequate sleep, otherwise it will aggravate the acidification of your body, and you will be prone to cancer.
3. To strengthen physical exercise, sunbathe and sweat more, the acidic substances in the body can be excreted with sweat to enhance the body’s resistance.
4. To develop good eating habits, quit smoking and drinking, eat light, balanced nutrition, do not eat hot, cold, expired, spoiled, contaminated, spicy and irritating food, to prevent disease from entering the mouth. Eat more high-protein, blood-qi, anti-cancer, alkaline foods to improve disease resistance.
5. Usually keep the skin of the vulva clean and dry, and wash the vulva with warm water every day. Avoid using strong local irritants to wash the vulva. Change underwear frequently, bathe frequently, and pay attention to the cleanliness of both genitals during sex, especially to avoid infection of syphilis and AIDS.
6. To avoid the occurrence of gynecological inflammation, once there is vaginitis and vulvitis, it should be actively treated to avoid vaginal secretion stimulation, leading to malignant lesions.
7. When genital itching occurs, avoid long-term scratching, and do not scrub with irritating drugs or solutions to prevent aggravating skin infection.
8. Regular physical examination, focusing on examination, can also prevent vulvar cancer by inoculating human papilloma virus (HPV) vaccine.