What are the Types of Vulvar Cancer?

Vulvar cancer is a cancer that originates from the vulva. The most common type of vulvar cancer is squamous cell carcinoma, which arises in the squamous cells. These are thin, flat cells that line certain organs and surfaces of the body. 

Melanoma is the second most common type of vulvar cancer. As melanoma is a type of skin cancer, vulvar melanomas are often treated the same as regular skin cancer. When it develops in the vulva, it is usually found on the clitoris or the labia minora. Women with melanoma in other body parts may be at higher risk of developing vulvar melanomas. Other less common types of vulvar cancer include: 

• Adenocarcinoma: Adenocarcinoma begins in the vulvar sweat glands or Bartholin’s glands. These are usually found around the vaginal opening.
• Paget’s disease: A rare form of cancer that affects the outermost layer of skin on the vulva. This usually occurs in postmenopausal women and is most often diagnosed in women over the age of 60. 
• Sarcoma: Vulvar Sarcoma is cancer of the connective tissues beneath the skin of the vulva.
• Verrucous carcinoma: This is a slow-growing form of squamous cell carcinoma that has the appearance of a wart.
• Basal cell carcinoma (BCC): A slow-growing vulvar cancer that rarely spreads to other parts of the body. Vulvar BCCs are relatively uncommon, making up less than 1% of all BCCs.

What are the Vulvar Cancer Treatments in Singapore?

Once vulvar cancer has been diagnosed, treatment options will be discussed with the patient. Treatment depends on the types of vulvar cancer. The treatment for squamous cell carcinoma and adenocarcinoma differs from the treatment for melanoma, Paget’s disease and sarcomas of the vulva. Vulva melanoma, a type of skin cancer, is treated the same way as melanomas that occur in other parts of the body.

Treatment for squamous cell carcinoma, the most common type of vulvar cancer and adenocarcinoma of the vulva depends on the stage of the cancer. Treatment encompasses various modalities including surgery, radiation therapy and / or chemotherapy.

The specialists at OncoCare in Singapore may suggest one or a combination of the following:

Vulvar Cancer Treatment: Surgery

For most vulvar cancer treatments, surgery is the first step in the treatment plan. Removing the affected tissue surgically may be enough for some patients, but others might need more specialised vulvar cancer treatment, including radiation or chemotherapy. Types of surgery for vulvar cancer include:

• Surgical Excision: The surgeon removes the tumour and some healthy tissue around it to ensure that all of the cancerous cells have been removed. For larger tumours, surgery to remove part of the vulva or the entire vulva may be required.  
• Lymphadenectomy:  Vulvar cancer may spread to the nearby lymph nodes, and these lymph nodes may need to be removed to reduce the risk of cancer spreading to more distant areas of the body.

Vulvar Cancer Treatment: Radiation Therapy

Radiation can be used after surgery to kill any cancer cells that might have been left behind. Radiation therapy is sometimes combined with chemotherapy, which can make cancer cells more susceptible to the radiation.

General side effects of radiation might include but are not limited to fatigue, skin reactions, and may cause the vulvar area to become sensitive and sore

Vulvar Cancer Treatment: Chemotherapy

Chemotherapy is a drug treatment to kill cancer cells. A single or a combination of chemotherapy drugs might be given. The drugs used are similar to those used in the treatment of cervical cancer and may comprise of:

• Cisplatin
• Carboplatin
• 5-Fluorouracil
• Paclitaxel

Side effects include but are not limited to fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite and diarrhoea.

Vulvar Cancer Treatment: Immunotherapy

Immunotherapy uses your own immune system to fight cancer. Cancer cells can produce proteins that help them hide and prevent detection by the immune system cells. Immunotherapy works by interfering with that process. Immunotherapy is a promising treatment for women with advanced or metastatic vulvar cancer, and may be an option for treating certain types of vulvar cancer.